Enhancing child and infant medical experiences with positive leading
As I've begun to immerse myself into the content for my Marte Meo training groups, I've realised just how much better we could be doing as medical and health professionals, when it comes to infants and young children who attend our practices.
My two girls come into contact with many different professionals each week outside of school and family.?These range from swim instructors to gymnastics teachers,?GPs, ENTs, nurses, hearing assessors, pharmacists and more. Some of these professionals are wonderful at creating a pleasant experience while for others there a lot of missed opportunities.
If any of you have had to take a baby or young child for a COVID swab over the last few years, you'll know just how true this can be. It can be distressing for both parent and child!
I feel incredibly frustrated when I do my part in preparing my children for medical procedures but?the medical professionals don't?do their part. And I'm not talking about the?procedural?skills here, I mean the social-emotional skills that help contain a young child in an unfamiliar setting. We can do a lot better at making these a more positive (or at least, less distressing!) experience.
This is the subject of my latest blog post (see below), as I draw on positive leading skills from the Marte Meo method and how it can help health and medical professionals to enhance their clinical practice with infants and young children.
Have you booked your spot at my online introductory?Marte Meo workshop next month? It's on Thursday June 22nd and will be recorded if you can't make it live.
Limited spots still remain for the next intake of?Marte Meo Practitioner Level?(6 days) training. This is the last training group I will run this year- so don't miss out!
This week:
Enhancing child and infant medical experiences with positive leading
It takes a particular set of skills to guide someone through a task or a procedure, and this is especially so, if the patient is an infant or young child.
Why?
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Because it is the child’s parent that consents to medical procedures, not the child. They don’t have a say in whether it happens or not and so we can make the process more comfortable for young children (and their parents!) through interactions that activate the relationship between the medical practitioner and the child.?
We do this through connection and positive leading.?
Whether it is a blood test, teeth clean, or checking their tonsils… all of these procedures can be uncomfortable, and if not handled well, can be distressing for a child. Indeed, it’s a fact of life, that we will continue medical and health professional encounters throughout our lives, so those early encounters are really important and may very well set up all future medical experiences.
If anyone had young children during the first two years of COVID, you’ll know just how true this is. Getting a COVID swab was a distressing experience for both parent and child (and likely the medical professionals, too.)?
The child’s experience of getting a COVID swab is very much dependent on the skills of the medical professional. Now, I'm not talking about the “medical procedural”skills here, though they are equally important. No, I’m talking about?social-emotional?skills and the ability to communicate and connect with a child throughout the process. To create a safe and secure space for both parent and child. Positive leading paves the way to safety and security for young children in situations where an adult is in charge.?
What is positive leading?
Positive leading is a basic communication element taught in the Marte Meo method. ‘Marte Meo’ means “on one’s own strengths” and is a strengths-based approach to supporting child-caregiver interactions and activating child development and resilience in everyday life. The method was founded by Maria Aarts fifty years ago and came out of her work with Autistic children in an institutional setting. These days it has widespread applications across various professional settings from child care centres to aged care facilities to medical settings.?
Positive leading is the process of?guiding?someone through a series of steps, or a task. Marte Meo breaks down HOW we do that in concrete ways. Positive leading is required in adult-led interactions such as medical procedures but is just as effective in getting children to brush their teeth, eat their dinner and put on their shoes for school. Marte Meo uses video learning sets to teach parents, educators and professionals step by step how to do this.?
Positive leading techniques help you remain in charge of a situation but also provide safety, security and connection for the child. These techniques can also be shared with parents who may have to administer treatments to their children at home.?
A positive leading example: What NOT to do?
Sticking with the COVID swab example, I can say that I would deliberately drive to a site that would have longer waiting times because I knew that they were better at administering the swabs than the medical professionals at several other sites I’d been to. And when COVID swab tests are required every time your little one has a runny nose, the experience of the procedure becomes a very big part of deciding where to go.?
First, let’s start with what NOT to do.?
What does a poor medical encounter look like?
A poor medical encounter for young children usually looks like the child being distressed from beginning to end with little comfort or support.?
In my experience, the medical professionals reached their hands through the car window, guided the child’s head back and did the swab. By this time the child is already screaming and at times I saw professionals hesitate before continuing (without providing any emotional or verbal comfort to the child) and this hesitation is not encouraging for the parent observers. At that moment, we don’t feel like the professional is in charge. And if we feel this way, then the child would feel this way, too.?
There was no acknowledgement of the discomfort, no connection (“Hello, my name is…”), no introduction and no guidance about what the child should expect of the procedure.
In this case, the procedure was done TO the child and the child felt unsafe, scared and confused. Not a good starting point for when the next COVID swab is due, right??
What does a positively-led medical encounter look like??
I opted for the walk-in-clinic for swabs wherever possible. This meant I could have my child on my lap, we could have a chat and prepare for what was to come. This, I believe, is the role of the parent.?
The role of the medical professional is to take charge, in a kind way. They say “hello” directly to the child (yes, the child is acknowledged as an actual human!), they ask the child’s name and make a connection by talking about the toy the child holds or the clothes they are wearing.?
This is the first element of positive leading.?Connection?before?action. Making a connection with the child?before?doing something to them. This ensures the child is with you and is engaged in the process.
Next the medical professional explained what they were going to do. They’d say “I have this swab here and I need to swipe it inside your nostrils 5 times and then I’ll do the other side, okay.”?
This is the second element, telling the child?what to expect.?This provides predictability and the child becomes familiar with the process of the swab test.?
They told the child (and parent) what they can do (not what they can’t do). Instead of saying, you can’t move around while I do this. They say, “You have to sit really still and hug your teddy tight and mum's going to hold your head back.”?
These clear, step-by-step instructions ensure the child and parent feel calm and safe.?
The professional administered the swab and they were confident in doing so. If the child cried, they acknowledged the discomfort (“Oh it feels a bit tickly”) but remained in charge and completed the task.
Acknowledging and validating the experience is important. Saying things like “It wasn't so bad was it?” is not helpful if the child is genuinely distressed.?
Then the professional marked the end of the procedure by saying something like, “there, it’s all done.”?This gives a signal to the child that the procedure is over. A clear beginning and ending helps children cope with tasks and prepares for the next time it happens.?
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Finally, a celebration. A sticker or lollipop is given to the child for being so brave. This is not essential of course, but it is a nice positive confirmation that they’ve managed to get through an unpleasant procedure.?
Why is positive leading so important when treating children?
Positive leading skills provide predictability, safety and security to infants and young children in unpleasant situations. It builds resilience.?
We want children to feel safe with medical and health professionals, not fearful. If children learn to distrust professionals then this can lead to adults who distrust professionals. And when GPs and other medical professionals are at the first point of call for a range of physical and mental health conditions- it is imperative that we make these services emotionally accessible.?
This is why early positive experiences are?so?important.?
Even as adults, it calms us when we are told what someone is going to do to us. When you have your eyes closed on a dentist’s chair and you’re feeling vulnerable, imagine if there was no talking and the dentist just poked and scraped at your teeth without giving you any clear instructions, “open your mouth wide.” It would be terrifying!?
It’s also incredibly frustrating, when as a parent, we set up and prepare a child for a situation as much as possible and the medical professionals do not do their part. Children will have encounters with medical and health professionals from birth across the lifespan. Imagine what it would be like to make these unpleasant situations just?unpleasant?and not?distressing. It will lead to resilience and not fear.
If children’s fear isn’t well managed, medical procedures can get harder and harder and the child may end up refusing altogether. This is not what we want!
Key takeaways:?
Want to learn more about positive leading and the Marte Meo method??
Join me in my upcoming two hour (online)?introductory workshop?to the Marte Meo method.?
Want a customised workshop with video demonstrations for your workplace? Want to upskill your staff who work with infants and young children???Get in touch.
Free Marte Meo video lesson
In this mini video lesson I introduce the concept of?following?using a video clip of a mother and 3.5 month old baby. The Marte Meo method is demonstrated by breaking down moment to moment interactions with a strengths-based lens. We will see a beautiful display of attentive waiting and how she follows her baby’s cues and interests.?
Click here?to access the FREE video.?
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Podcast features
I've had two podcast interviews go LIVE this month!
I chat with Dr Hayley Kelly about my work as a perinatal psychologist and a writer. Is it possible to do both? Yes, and I give you tips on how you can make an income from your passions.
I sit down with Vicki Mansfield of Emerging Minds to talk about all things genograms! I share ways we can deep dive into a family history and use genograms as a relational tool in assessment and formulation.
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That's it from me this month.?
Warm regards,?
Lauren
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