Communication
General Considerations:
- Communication requires considerable understanding of the language and cognitive skills of children at different ages. Children’s conceptualization of illness corresponds to their cognitive development and maturation.
- Listening is critical. The first step in good communication with children is understanding their point of view.
- The verbal development of children often does not enable a full description of their point of view. Tools other than words may be necessary to augment communication (play, art, music).
- Learning each child’s cultural, religious, intellectual, experience level, and personality type before giving difficult explanations is helpful.
- Evaluating a child’s current knowledge and understanding of her or his illness facilitates communication. Dorn (1984) recommends asking children to describe what they believe is making them sick and based on their responses, constructing an explanation that incorporates the child’s understanding in an honest and truthful way. Asking a child to draw pictures to represent the nature of his or her illness can help to know the child’s level of understanding(3).
- The vocabulary must be carefully chosen. It is important neither to underestimate nor overestimate a child’s ability to understand complex information and it is necessary to tailor vocabulary to the individual child’s level of understanding. “Being concrete” includes avoiding health care jargon, technical terms and euphemisms that have multiple meanings or can lead to ambiguity(3).
- It is sometimes useful to incorporate figurative language including the use of analogies, metaphors or similes when explaining an illness. These approaches can be successful in children who are at least 7 or 8 years old.
