Why One Voice Matters: Supporting Children Through Healthcare Experiences

Imagine you are in the hospital about to have a painful medical procedure. There are doctors, nurses, other medical staff in the room all wearing scrubs, masks and holding unfamiliar medical equipment. The lights are bright and everyone is talking; trying to reassure you, telling you to, 'be brave’, ‘hold still’ and ‘it’ll be over soon’. The environment in which we expect children to ’comply’ with our medical interventions is often overwhelming and scary. 

While every comment is usually made with the best intentions, what many adults don't realise is that multiple voices speaking at once can actually increase a child's distress.

This is where the One Voice principle can make a powerful difference.

What is One Voice?

Developed by Debbie Wagers, MHA, CCLS, a Certified Child Life Specialist (CCLS), the ONE VOICE approach identified multiple common practices that cause children anxiety and replaced them with ways the stressors could be minimised by healthcare professionals and parents

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The One Voice approach is a child-centred communication strategy used in many children's hospitals around the world. During a medical procedure or potentially stressful healthcare experience, one designated person becomes the child's primary coach and communicator. Everyone else in the room minimises conversation directed at the child and focuses on their own role.

One voice should be heard during procedure

Need parental involvement

Educate the patient before the procedure 

Validate child with your words

Offer comfort position and pain management

Individualize your game plan

Choose appropriate distraction to be used

Eliminate unnecessary people not actively involved

That one voice may be a parent, Child Life Therapist, nurse, doctor or another trusted support person. Their role is to guide, prepare, coach and support the child before and throughout the experience.

While it sounds simple, the impact can be profound.

Why Multiple Voices Can Be Overwhelming

Imagine trying to concentrate on a difficult task while several people talk to you at once, each giving different instructions. Now imagine you are a child who is already feeling scared, uncertain or uncomfortable.

Children experiencing stress are often working incredibly hard to regulate their emotions, understand what is happening and use coping strategies. When multiple adults are talking at the same time, it can increase sensory overload, create confusion and make it harder for children to focus on the coping plan that has been established.

I often see this happen during blood tests, cannulations, injections and other procedures. A parent may be trying to comfort their child, a nurse may be giving instructions, another staff member may be talking about equipment, and everyone is trying to help. Yet from the child's perspective, the room can quickly become overwhelming. One calm, consistent voice provides something different. It provides an anchor.

Creating Safety Through Connection

At its heart, One Voice is not simply about reducing noise. It is about creating connection. Children cope best when they know who is supporting them, what to expect and where to focus their attention. A designated support person can help the child use their coping strategies, engage in distraction, practice breathing techniques or simply stay connected through a familiar and reassuring presence.

Rather than competing for the child's attention, the healthcare team works together to support the child through one trusted communicator. This allows the child to focus on coping rather than trying to process multiple sources of information.

One Voice and Trauma-Informed Care

For children who have experienced medical trauma, One Voice can be particularly valuable. Many children who have undergone repeated procedures, lengthy hospital admissions or intensive medical treatment can become highly alert to healthcare environments. Their nervous system may already be working hard to determine whether a situation feels safe.

When the environment becomes busy, noisy or unpredictable, their stress response can increase. A calm, predictable and coordinated approach helps communicate safety. The child knows who to listen to. They know who is supporting them. They know what to expect. These small moments of predictability can make a significant difference to how a child experiences healthcare.

The Role of Parents

One of the most important aspects of One Voice is recognising the valuable role parents play. Parents know their child best. They understand what comforts them, what worries them and how they communicate when they are distressed. In some situations, a parent may be the ideal coaching voice. In others, a parent may prefer to focus on providing physical comfort while a Child Life Therapist or healthcare professional guides the child through the procedure. There is no one-size-fits-all approach.

The most important thing is that everyone works together with a shared plan that places the child's needs at the centre. This reflects the principles of child and family-centred care, where families are recognised as essential partners in supporting children's wellbeing and healthcare experiences.

How Families Can Advocate for One Voice

If your child is having a medical procedure, you can ask the healthcare team whether a One Voice approach can be used.

Simple questions might include:

• Who will be my child's support person during the procedure?

• Can we identify one person to coach my child throughout?

• What coping strategies can we use?

• How can I best support my child during the procedure?

Many healthcare professionals are already familiar with One Voice principles, and most are very receptive to creating a calmer and more supportive experience for children.

Small Change, Big Impact

One Voice is a simple concept, but it reminds us of something important. Children do not just experience medical procedures physically. They experience them emotionally, cognitively and relationally as well.

When we reduce unnecessary stimulation, communicate clearly and work together as a team, we create space for children to use their coping skills, feel supported and build confidence in their ability to manage challenging healthcare experiences. Sometimes the most powerful support we can offer is not saying more. It is making sure the right voice is heard.

For more information about the One Voice strategy, visit ONE VOICE 4 Kids – Creating a less threatening environment for pediatric patients undergoing medical procedures

Kate Strickland is a community-based Child Life Therapist with a background in Occupational Therapy, Education and Integrative Somatic Trauma Therapy. She works with infants, children, and young people along with their families in managing the stresses associated with health care encounters, procedures, hospitalisation and medical trauma. Visit healingheartsbeyond.com.au for more information.