Educate or placate when young child is afraid of doctor's visits?
Educate or placate when young child is afraid of doctor's visits?
During the toddler and preschool years, it is common for children to have health care visits, for regular check-ups and preventive care services like vaccines, and to get care for illnesses or injuries. Young children can have a range of feelings about going to the doctor, including fear. The C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents about their children age 2-5 being afraid of going to the doctor.
About half of parents reported their child is afraid of going to the doctor, at some or most visits (26%) or once in a while (24%). Children’s fear of going to the doctor did not differ based on whether the child saw the same doctor at every visit or saw many different providers, and was not different for the oldest child in the family compared to younger siblings.
Among parents with a child afraid of doctor’s visits, fear of getting a shot (66%) and stranger anxiety (43%) were cited as the most common reasons children age 2-3 years were afraid. For children age 4-5, parents overwhelmingly said the most common reason was the child being scared of getting a shot (89%), followed by stranger anxiety (14%) and bad memories of being sick (13%).
Children’s fear of going to the doctor can affect their parents’ interactions with the health care provider: 22% of parents reported that it was hard to concentrate on what the doctor or nurse was saying, and 9% said they would sometimes not ask questions or bring up concerns, because their child was scared or upset during the visit. In a small proportion of families, children’s anxiety impacted the delivery of health care: 4% of parents reported they postponed getting a vaccine for their child, and 3% had canceled or delayed an appointment, because of their child’s fear of going to the doctor.
Parents used a variety of strategies to help their children age 2-5 get ready for a doctor’s visit. Many parents tried to educate their child about what would happen at the visit, by talking about it (61%), playing with a toy medical kit (26%), or reading a book or watching a show about going to the doctor (23%). Other parents tried to placate their young child, by promising to get a treat after the visit (31%) or telling the child there wouldn’t be any shots (21%). About 1 in 5 parents (22%) said they didn’t do anything special to prepare their child for health care visits.
Highlights
- Half of parents said their young child age 2-5 was afraid of going to the doctor.
- 1 in 5 parents said it was hard to concentrate on what the doctor or nurse was saying because their young child was scared or upset.
- 1 in 25 parents had postponed a vaccine for their young child due to fear of doctor visits.
- Parents prepared their young child for a doctor’s visit by educating (with books, shows, or explanations) or placating (promising a treat or no shots).
Implications
Children experience a range of emotions through their toddler and preschool years as they encounter different people and environments. Children’s demeanor can change from gregarious to shy, seemingly without cause; this can be particularly pronounced with people the child sees infrequently, which can include relatives, occasional sitters, or health care providers.
In this Mott Poll, half of parents report their child age 2-5 is afraid of going to the doctor. In normal circumstances, taking a young child to the doctor can be a hassle for parents, requiring arrangements to leave work, rushing to arrive on time, and perhaps waiting for the appointment to get started. When a child is upset or uncooperative due to fear, the situation can be frustrating for the child and parent.
The biggest culprit behind young children’s fear of doctor visits, according to parents, is that the child is scared of getting a shot. While “needle phobia” affects people of all ages, it can be especially tricky for younger children, when vaccinations are frequent. Children’s fear of shots can be exacerbated when they pick up on their parents’ anxiety; when both parents and toddler are feeling anxious, it can be difficult for both to calm down when it is time for vaccinations.
This Mott Poll identified two basic approaches that parents use to address young children’s fear of going to the doctor. The first approach is educating the child by reading books or watching a show about doctor visits, or by playing with a toy medical kit. The conversation between parent and child helps children develop a vocabulary around health care visits, learning terms such as doctor, nurse, waiting room, check-up, and shot. Learning these terms can help the child develop expectations about what happens at a doctor visit; once the child is at the visit, the actions and personnel seem familiar and non-threatening.
The second approach used by parents involves placating the child’s fears. With this approach, the parent might promise a treat, such as an ice cream cone or a trip to the park, if the young child can get through the appointment being cooperative or without crying. This strategy can help the child overcome his or her fear by looking forward on a positive activity.
One in five parents in this Mott Poll placated their young child by promising there wouldn’t be any shots at the doctor’s visit. However, this approach can backfire, because parents may not know in advance if the child is due for a vaccine. If the provider recommends that a vaccine be given, the child is likely to become upset over the broken promise and be uncooperative during the vaccination process—which in turn can exacerbate the child’s fear of going to the doctor. It can also cause a loss of the parent’s credibility in the child’s eyes.
Occasionally, parents placate their child by postponing a vaccination; this was reported by 4% of parents in this Mott Poll. Postponing a recommended vaccination leaves the child without full protection against vaccine-preventable disease. This aspect of placating a young child also is not helpful in helping the child overcome his or her anxiety about shots and places parents in a difficult situation.
Many child health providers help parents learn how to decrease children’s fear of shots. Having the child be held or hugged by the parent is calming for many children. Distracting the child with songs, a video, or even coughing briefly before the shot, has been shown to decrease anxiety. Numbing creams can both distract the child and decrease the pain of the vaccination. Parents of young children who are afraid of shots should ask their provider about these strategies.
Data Source & Methods
This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital. The survey was administered in April 2018 to a randomly selected, stratified group of parents age 18 and older (n=2,074). Adults were selected from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 61% among panel members contacted to participate. This report is based on responses from 726 parents who had at least one child 2-5 years. The margin of error is ±2 to 4 percentage points and higher among subgroups.
Findings from the C.S. Mott Children’s Hospital National Poll on Children’s Health do not represent the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.
Citation
Clark SJ, Schultz SL, Singer DS, Gebremariam A, Freed GL. Educate or placate when young child is afraid of doctor's visits? C.S. Mott Children's Hospital National Poll on Children's Health, University of Michigan. Vol 32, Issue 5, October 2018. Available at: https://mottpoll.org/reports/educate-or-placate-when-young-child-afraid-doctors-visits.
