With all this talk about vaccinations – sometimes we forget to think about how to prepare our children, especially those who are deathly afraid of the doctor, nurses and those scary needles! Often, parents tell me doctors’ appointments can be extremely stressful! Questions such as, what if I have to hold him down or what distraction strategies can I use so she won’t know it’s coming are very common. What if there was a better way to prepare?
In our program we have lots of children who struggle with really important life skills such as going to the doctor, dentist or hairdresser. Using applied behaviour analysis (ABA) we break down these needed skills into small attainable goals and systematically reinforce each small goal until the child is able to accomplish the whole task.
This month we had a client who turned 12 and was eligible for the Covid-19 vaccination. His parents took him for his first appointment and they struggled with him while the nurse tried to give him his needle, causing it to be an extremely negative experience for everyone. When the parent told me about this experience, I suggested we build what’s called an exposure hierarchy where we role play getting vaccinated and work on small steps to success. In this case, we wrote a list of all of the steps he would need to learn in order to successfully obtain his vaccine. These included: sitting in his chair calmly, greeting the “nurse” as she walked in, tolerating the “needle” on the table (we used a syringe for role play), tolerating the “nurse” rolling up his sleeve and wiping his arm with an alcohol pad, tolerating the “nurse” picking up the “needle” and saying “ok, here we go”, counting to 10 out loud while the “needle” touched his arm, and tolerating a band aid on his arm.
We started with the first step – “sitting in his chair calmly”. This was the only skill that was required of the child and when he demonstrated an ability to do so he was reinforced with time with a favourite activity as well as lots of social praise. Following mastery of this step the second step was introduced. Now the child was taught to sit in his chair calmly and to greet the “nurse” as she walked in. Demonstration of this chain of skill 1 and 2 lead to him obtaining reinforcement again. Over the course of 4 weeks, the child was able to build his way up through the steps in the hierarchy ultimately completing all steps successfully before accessing reinforcement.
When his second vaccine appointment was scheduled I received an email right away from the parent expressing how proud she was of her son, he was able to demonstrate all of the steps required and successfully obtained his second vaccine without any struggles. While his parents and the clinical team were exceptionally proud of him the best part was that he was proud of himself!
Sometimes all our children need is some preparation and understanding of what is coming. Breaking down the big daunting tasks into smaller steps and pairing each step with reinforcement can help a child to be successful. These techniques can be used to teach a variety of skills that are common fears for children such as, getting their teeth cleaned, getting a haircut or being around pets like dogs and cats.
For more information on this or to book a consultation, feel free to fill out the contact form on the website!