Pediatrician Gripe: Keeping Mum With Kids About Their Diagnosis

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The Offending Statement

"Please don't discuss my child's diagnosis in front of her."

It's natural for parents to want to protect their children, and a doctor's office can be a pretty frightening place. Your impulse may be to shield your child from scary medical lingo and talk of illness and disease. After all, impressionable and sensitive toddlers can pick up on anxiety and listen in on serious discussions, so shouldn't this conversation be for adults only?

Actually, no. You may be doing more harm than good by excluding your child from her healthcare.

Why We Don't Want to Hear It

Children should be involved in caring for their bodies as early as possible. Toddlers who haven't been exposed to medical discussions during their visits to the pediatrician become older children who are uniformed and uninvolved in their own health. Infants are helpless, and depend entirely on their parents to control all treatment from wellness information to consent, but as children grow they are expected to take on more responsibility.

So, how do we help our kids make this transition? Easy: In steps. These steps begin with a toddler high-fiving her doctor and answering a few simple questions. This toddler will grow into a preschooler who can name her medications and allergies, and eventually develop into an adolescent who can articulately describe her health issues, understand the benefits of her medicines, and call in for prescription refills. This way, parents go from controller to consultant in a gradual, seamless fashion, and children don't feel unprepared when their time comes to take on the load. (Check out this age-by-age guide to kids' relationships with their doctors.)

What You Should Say

You're finally ready to bite the bullet and give some responsibility to your child, but how do you go about it? Talk to your doctor before your appointment. Try asking, "What do you think is reasonable to discuss in front of my child?" or "How do I explain this to my child in a developmentally appropriate way?"

There is always at least some element of the diagnosis your child should be aware of. For example, a toddler with thyroid disease may not know the ins and outs of thyroid hormone binding globulin, but she surely knows that she takes a pill on a daily basis. She might even know that she is different, in this respect, because her sibling doesn't take such a pill, so she should know at least where this thyroid gland is; a young child will learn to proudly point to her neck and take charge of this issue. This is step one, and it should happen as early as developmentally appropriate. Fight your instinct to jump in to ask and answer questions for her at her next doctor's visit. This natural parental reflex can interfere with the overall process of bonding with her doctor and taking charge of her own care.

Helping Parents Deal

The instinct to protect our kids is not unlike that of a lioness guarding her little cub. The knowledge that our child has a chronic disease or illness is something we might be tempted to withhold from our vulnerable cub, because this lends a false sense that we are protecting her from the burden of knowledge—and in a strange and irrational way, from the disease itself.

Additionally, in some cultures, parents withhold information as an avoidance method because a sense of embarrassment exists about the child's condition. A child with a "defect"—one who has a medical illness or disability—may be a source of shame in some families. In these cases, hiding the issue is tempting (but futile).

Taking the tack of withholding information has many pitfalls. We often underestimate our children. As we know, a nine-month-old understands much more than she can verbally express, and older children are typically farther ahead of the learning curve than we give them credit for. How many times has your child surprised you by reaching a developmental milestone that you didn't think she was ready to attain for a long while? For example, the infant who rolls for the first time ... off of the changing table!

The lesson here? Start to give your kids developmentally appropriate involvement in and control over their healthcare as early as possible. Understand that control and knowledge are power for a child—even a small child—so bite your tongue. You and your pediatrician will be very glad you did.