Preparation can be effective in reducing distress in children undergoing medical tests and can minimize the amount of crying and resistance to the procedure. Research finds that lowering anxiety can actually decrease the sensation of pain felt by people during uncomfortable procedures.

Before the test, know that your child probably will cry and that preparation may not change the fact that your child will feel some discomfort or pain. You can try demonstrating what will happen during the test in advance to learn about your child's particular fears and concerns. Using a doll or other object to "act out" some of the procedure may help reveal worries that the child may not be willing to discuss directly.

This can help reduce your child's anxiety, because most people are more frightened of the unknown than they are when they know exactly what to expect. If a child's fears are unrealistic, you can explain what will actually happen; if he or she is worried about something that is an unavoidable part of the test, do not minimize his or her concerns but reassure the child that you will be there to help as much as you can.

Make sure your child understands that the procedure is not a punishment.

The most important way you can help your child is through this kind of preparation and by providing support around the time of the procedure.

PRE-PROCEDURE PREPARATION:

Limit your explanations about the procedure to 10 or 15 minutes, because preschoolers have a limited attention span. Preparation should take place directly before the test or procedure so that the child doesn't worry about it for days or weeks in advance.

Here are some general guidelines for preparing your child for a test or procedure:

• Explain the procedure in language your child understands and use concrete terms, avoiding abstract terminology.
• Make sure your child understands the exact body part to be involved and that the procedure will be limited to that area.
• If the procedure affects part of the body that serves a noticeable function (such as speech, hearing, or urination), explain how the procedure will affect or not affect the function.
• While talking about the procedure with your child, avoid words that have more than one meaning.
• Give your child permission to yell, cry, or otherwise express any pain verbally.
• If you think your child has not understood something you are explaining, ask if he or she understands, and be certain that you define all new terms in simple language.
• To the best of your ability, describe how the test will feel.
• Allow your child to practice different positions or movements that will be required for the particular test or procedure, such as the fetal position for a lumbar puncture.
• Be honest with your child about discomfort that may be felt
• Stress the benefits of the procedure and anything that the child may find pleasurable afterwards, such as feeling better, or going home. You may want to take your child for ice cream or some other treat afterwards, but do not make this conditional on "being good" for the test.
• Practice deep breathing and other comforting activities. If possible, have your child hold your hand and tell him or her to squeeze it when he or she feels pain.

DURING THE PROCEDURE:

Your presence, if possible, can help your child during the procedure, especially if the procedure allows you to maintain physical contact. If the procedure is performed at the hospital or your health care provider's office, you may be given the opportunity to be present. If you are not asked to be by your child's side and would like to be, ask your health care provider if this is possible. If you think you may become ill or anxious, consider keeping your distance but remaining in your child's line of vision. If you are not able to be present, leaving a familiar object with your child may be comforting.

Other considerations:

• Ask your health care provider to limit the number of strangers entering and leaving the room during the procedure, since this can raise anxiety.
• Ask that the care provider who has spent the most time with your child be present during the procedure.
• Ask that anesthetics be used where appropriate to reduce the level of discomfort your child will feel.
• Ask that painful procedures not be performed in the hospital bed, so that the child does not associate pain with the hospital room.
• If you are in your child's line of sight, imitate the behavior the the child needs to do, such as opening the mouth.