Helping Your 2- to 5-Year-Old Cope During a Medical Crisis



A medical crisis can be a frightening experience for both you and your child who has PH. During an emergency, being able to communicate with your child about symptoms and help them stay calm are especially important. Handling an emergency begins long before the emergency happens: advance preparation can make all the difference. Read on for advice on communicating about symptoms and helping your child — and their siblings — cope during and after a crisis.

Communicating About Symptoms

Happy Face, Sad Face. Smiley face pictures can be a great way for kids to indicate how they are feeling: a smiling face means they feel well, a face with a flat mouth means not great, and a frowning face means they are in pain.

Families might prefer to use different symbols that their child associates with being happy or sad — for instance, foods your child likes and dislikes.

Stand-In. When your child is under stress, it can be more difficult for them to tell you what’s wrong. Using their doll or action figure as a stand-in for them to point out “where it hurts” can be a great technique — and the toy may be comforting to your child in the midst of a crisis, so it’s great to bring it out anyway.

Be Consistent. Each family has its own words for symptoms, treatments and medical equipment. When the Emergency Medical Technicians arrive, let them know what names you and your child use when talking about these things. It will facilitate their communication with your child, and the familiar names will be less frustrating, and more reassuring, for your child.

Helping Your Child Keep Calm During a Medical Crisis

Breathe In, Breath Out. Focusing on a breathing exercise helps children in two ways: it distracts them from the crisis, and deep breathing helps the body de-stress. Practice breathing exercises regularly so that your child is comfortable using them, and then guide them through the exercises during a crisis.

Use Imagination. Children have wonderful imaginations, which can be great for practicing guided imagery relaxation exercises. Take some time each week to practice imagining yourselves somewhere calming, like the beach. Ask your child questions to help them focus on what they are imagining — “What are you wearing? Who else is at the beach?” Then during a crisis, help your child go to their “happy place.”

Comfort Objects. Most children have a comfort object — a blanket, toy or doll — they want with them during unsettling moments. Make sure you bring along your child’s comfort object during a crisis.

If You’re Not There. If your child is on medication, you’ve probably trained your childcare providers in administering the treatment and being on the lookout for any side effects. Similarly, you want any adult caring for your child to know how to help your child stay calm if a crisis occurs. Along with your other instructions, show them any breathing exercises, relaxation techniques or coping tools you practice
with your child.

Don’t Lie. You want to build your child’s feeling of safety and trust in you and their medical professionals. Don’t make promises, and don’t tell your child, “It won’t hurt.” Broken promises will be more damaging in the long run.

Stay by Their Side — and Let Them Know It. An unplanned visit to the hospital can be frightening, and your child will take reassurance from your presence. Make sure they know that you’re aware of how they are feeling and that you’re going to stay by their side. For instance, you might say, “I know you’re having a hard time breathing right now. The doctor is going to help, and I’m going to stay with you.” If you’re required to leave the room for a procedure, explain to your child where you’re going, why, and when you’ll be back.

Helping Your Child — and Their Siblings — Cope

It’s No One’s Fault. Children, particularly around ages 3 and 4, often believe that their thoughts, feelings and actions significantly impact the reality around them. This means that they may blame themselves for events in their lives. Young children could easily believe that their medical crisis is their fault, and you may need to reassure them. Let them know that the crisis is NOT their fault. This is an additional reason to stay by your child’s side in the ambulance and hospital: it will reassure your child that you don’t blame them for what’s happening and that you love your child just as much as you did before the crisis occurred.

Brothers and Sisters. In the midst of a crisis, your focus is understandably on your child who has PH. Remember to take some time after things settle down to talk to your other children about how they felt during the crisis. Let them know you’re proud of them for being brave and thank them for any help they gave you — whether it was by staying in their beds, helping pack for the hospital or comforting their sibling.

Additional Resources

Books You and Your Child Can Read About Visiting the Hospital:

  • Franklin Goes to the Hospital (2000) by Paulette Bourgeois and Brenda Clark
  • Going to the Hospital (2009) by Anne Civardi
  • Clifford Visits the Hospital (2000) by Norman Bridwell

For additional book suggestions, visit the Boston Children’s Hospital website

Resources for Parents:

Sample Guided Imagery Relaxation Scripts:

This article originally appeared in the Spring 2013 issue of Pathlight. PHA is grateful to Patricia Dwyer, MSW, LCSW, of the Lucile Packard Children’s Center at Stanford Hospital and Clinics for her contributions and review.