The following is one in a series of essays written by Catherine McTamaney about how to be a Montessori parent.
The Essential Question: Your Toddler at the Pediatrician’s Office
What does my child need from this environment and how can I provide it?
In your child’s first two years of life, she may visit the pediatrician ten times or more. Preparing for these visits can help soothe the anxiety for your child (and you!) and make your time with your child’s primary doctor much more useful for you all. By preparing thoughtfully before well-child visits, the trips to your pediatrician when your child is not feeling so well are likely to go more smoothly, too.
As adults, we know what to expect at the doctor’s office. The sterile environment, the cold surfaces, the bright lights, the paper-topped tables… What makes these spaces appropriate for healthcare can make them alien and uncomfortable for young children, especially if those children are used to the quieter, more responsive climates of Montessori homes and classrooms. Put your own distractions away. Allow your child to take the time she needs to take in what’s different about these spaces, even if it’s a return visit. Move slowly as you walk to the sign-in desk. Notice what your child is noticing. Whenever possible, ask if the sign-in forms are available for you to complete at home before you arrive. When making your appointment, ask for a brief run-down of what tests or examinations are standard for your child’s age at that office and which nurse will be attending that day.
A child in a sensitive period to order may remember the differences in the office between visits, like a change in personnel or a toy that’s no longer available. A child in a sensitive period to movement may want to open and close all the cupboards in the examination room. A child in a sensitive period to small objects may be fascinated with the shiny tip of the pediatrician’s pens, poking out of her coat pocket. A child in a sensitive period to language may notice all the new sounds and unheard words in use. Your child may be in any or all of these sensitive periods simultaneously! Think about what you know of your pediatrician’s office to consider how to navigate the attractions and stressors that may be there.
While you’re in the waiting room, be attentive to your child’s affect. Remember: children’s anxiety doesn’t necessarily look anxious! Your child might be more reserved than usual or more rambunctious. If your child needs some time to warm up, choose a seat and let your child use you as a home base if she feels comfortable to explore the waiting room. If your child is moving actively around the room, look for a space on the floor where you might engage with her play. Avoid getting lost in the magazines and instead, be aware of your child’s comfort level, modeling a peaceful, quiet demeanor. Prepare your child for what is likely to come next: the nurse may ask to weigh and measure her. Let your child know, “When we go into the office, maybe you’ll stand on the scale to see how much you’ve grown!” Afterwards, you’re likely to be shown to an examination room. Even in shared practices, many pediatricians are assigned the same examination rooms… over time, you’ll be able to prepare your child by asking “Do you think we’ll be in the room with the giraffe wallpaper or the one with the monkeys?” Help your child to think ahead to what will happen next, while modeling your own ease with the process.
Once you’re in the examination room, notice aloud what is different about this space, even though it may be familiar to you. “The examination table has a paper sheet to keep it clean. Isn’t that clever!” “Look, the doctor has everything she needs right here on the countertop.” “The lights are bright in this room to make it easier to see you!” Your child may be asked to remove some or all of her clothing. Keep this time playful… smile and cuddle your child as she is comfortable to do so. Again, predict who she’ll see next and what is likely to happen. “Soon, the doctor will be here to see what a healthy child you are! She may tickle your stomach. She may look in your throat. She may touch your neck. There are so many places on your body!”
Your pediatrician is a partner resource in your parenting: she offers expertise in healthful practices and care for illness, to contribute to the decisions you make as your child’s most important caregiver. When you have questions about your child’s development, ask them confidently, remembering that your child will learn a great deal about her relationship with her doctor from watching your relationship with her doctor. You can check before your visit to see if your child is scheduled for any vaccinations. Although “getting a shot” can be a frightening experience, preparing your child beforehand soothes some of the stress. The language of “shots” can, by itself, be scary! “Today, the doctor is going to help make your body even stronger by giving you a vaccination.” Talk to your pediatrician’s office during earlier visits to see if there is a common protocol for how vaccinations are administered. Some pediatricians make the process very playful. Others try to get it over with as quickly as possible. Discuss your options for toddler vaccinations when your child is still an infant. The more prepared you are for how the vaccination will be administered, the more comfortably you can model the process for your child. Your child might sit on your lap during a vaccination or hold your hand. Be careful not to make the anticipation of a vaccination more stressful than the vaccination itself! While your child’s own discomfort may grow between visits as she remembers the pinch of earlier vaccinations, maintain your own composure. When the vaccination is over, remind your child that she is safe and that the vaccination helps her body to be strong and healthy. Model breathing deeply to catch one’s breath and help your child to regain composure by moving on to getting dressed and gathering your belongings.
Because toddlers are great listeners, be particularly attentive to the kinds of conversations you have in their earshot. If you have more involved questions that you want to discuss with your child’s pediatrician that might increase your child’s confusion or anxiety about visiting the pediatrician, ask if there is a time when you can have a telephone consultation later in the day. Arrange, whenever possible, to discuss predictable side-effects of medications, concerns you may have about your child’s development or other issues when your child is not listening. Although there will be an appropriate way to engage your child in knowing about her own body and its growth, you can support her by waiting until she’s not present to talk through all the implications of your healthcare choices. As your child grows, you’ll begin in integrate her into these conversations and, ultimately, you’ll want to prepare her to have them herself. But in infancy and toddlerhood, it’s more important to model comfort and ease in interacting in these curious environments. The most essential lesson for your child to learn in her visit to the pediatrician’s office is that doctor’s offices, even when they’re set up differently than our homes and classrooms, are still safe places where her needs are met. Maintaining your own focused composure is the first step in that lesson, whatever the nature of the visit.