When you interact with the staff of the doctor or dentist office, let them know that you will be using some strategies to encourage your child’s cooperation and reduce the likelihood that your child will have behavior challenges. Office staff are usually more than happy to help make the visit go smoothly for the child.
Use “wait time.” A wait time of about 4 to 20 seconds is often all that is needed for a child to process and respond to a request. If your child hesitates, give him the wait time before you give another direction or demand that your child comply.
Provide transition warnings. Most young children need help transitioning from one activity to another, especially if they are engaged in an activity that is enjoyable. It’s difficult for a child to move from an activity he really enjoys to one that he is uncertain of or does not like. To help your child transition, you might:
• Give your child a verbal warning. If he is playing with a puzzle, say “Maleek, I see the nurse. She called your name. I’ll help you clean up. Let’s go see Dr. Fares.”
• Use a visual (picture) warning along with verbal directions. You might show a picture of the doctor/dentist or refer to your child’s personal picture book and say, “Cooper, it’s time to see Dr. Kind. Let’s clean up and go see him.”
• Use a countdown or count up strategy and say, “Lei, it’s time to see Dr. Ortez. Let’s count (pause). 1…2…3…4…5. Okay, let’s go see Dr. Ortez.”
Provide choices, whenever possible. Providing limited choices (two or three) for a child in a difficult situation can be a powerful strategy in preventing challenging behavior and redirecting a child to more acceptable behavior and cooperation. Choices help give children a sense of control over their surroundings and activities while still doing what needs to be done! Be sure that ALL the choices you offer are helping reach that goal! For example, if your child has to be examined or take medicine, you might say, “Charlie, let’s help Dr. Care. You can sit on the table or sit on my lap. Then he will look in your ears.”
Provide frequent and specific praise. Let your child know when he is being cooperative and helpful by praising him specifically for what he is doing. For example, you might say, “Danny, you played and waited so nicely in the Waiting Room. Let’s tell Daddy.” “You were so brave. Now the shot is all done.No more shots.”
Empathize with your child’s feelings. If your child cries, hits, bites, screams or runs out of the waiting room or examination room, provide a label for how he might be feeling and reassure him. Avoid punishment or threats (e.g., “If you don’t sit still, I am going to spank you.” and negative, and usually, untrue comments “Big boys don’t cry.” or “There is nothing to be afraid of.” Let your child cry and comfort him by hugging, patting or using a soothing touch.
Follow the appointment with an activity that your child likes (e.g., a visit to the library or local park). Make sure this is something you can both enjoy together.
Brag about your child’s behavior to a family member or a friend in front of your child.
Encourage your child to share his experience with another adult such as a parent, grandparent, or friend.
In closing, please remember that the team of professionals that support you and your child will have additional specific ideas about how to help your child. Don’t forget to ask them! Your child’s speech and language therapist, physical therapist, occupational therapist, teacher, or other professionals should be able to help you think about the best way to support your child in their daily routines and community activities. They are usually more than willing to help you make any needed specific supports (for example, a waiting bag, a personal picture story, etc.). If your child is having persistent challenging behavior, you should ask the professionals who work with you to help develop a behavior support plan that will provide more specific strategies to prevent challenging behavior and help your child develop new social and communication skills.