Parents and caregivers play an important role in providing a sense of comfort to their children while they are staying in the hospital. Below are some effective tips drawn from evidence-based strategies to strengthen parent-child relationships and improve challenging behaviors while your family is staying in the hospital.

Tip #1: Praise your child. Hospital stays can be stressful for your child and for your family. It is important to focus on pointing out your child’s strengths during these difficult times.

Asking children to take medicine, having their blood drawn, or getting their port dressing changed can be difficult and scary for children. When dealing with your child’s challenging behavior, it’s easy to feel overwhelmed and frustrated.

For instance, if your child can remain calm during a nurse’s visit instead of hiding under the covers, it’s important to recognize and reinforce this positive behavior. Try offering words of encouragement or praise. You might say, “Thanks for sitting still! I like that you’re getting your body ready for your dressing change!” This will make your child feel better and help to maintain a supportive environment during your hospital stay.

When giving praise to children, it’s best to be as specific as possible. Instead of saying, “Great job,” try saying, “Great job taking a deep breath for your doctor.” Other examples of specific praises include, “Thank you for taking your medicine,” and “I like when you use your words to tell me when you need to use the bathroom.” When we praise our child for specific behaviors that we like, our child will do these behaviors more often.

In addition to praise, reward your child when they display good behavior. This is different from bribing your child which is given to stop bad behavior and is not recommended for long-term use.

Rewards can be small gifts or activities that are planned ahead of time and earned for good behavior. Example rewards are giving your child a sticker, having a dance party, doing a craft together, or building with playdough.

Be sure to give your child consistent rewards for good behavior.

Tip #2: Talk about emotions. When children do not feel well, they may be more irritable or upset than usual. It’s normal for children to experience many big emotions while they are in the hospital. Having nurses and doctors come in and out of their hospital rooms at all hours of the day can feel particularly upsetting and unsettling.

Children learn about their emotions from those around them. Children often feel relieved to have open discussions about what is happening and how they are feeling. By addressing these emotions head-on, children gain a better understanding of their own feelings, which will help them to feel a sense of calmness while in the hospital.

Show them how to manage their emotions by modeling your own emotion regulation. If you’re feeling upset, say it out loud for your child to hear.

For example, you might say, “I’m feeling sad today.” Then, explain to your child how you plan to help yourself to feel better. Show them a coping strategy like deep breathing by saying, “I am going to take three big breaths to help calm my body.” Then take three slow, deep breaths, and encourage your child to join in with you. This way, you’re not only teaching them valuable coping skills but also providing them with real-life examples of how to manage their emotions as well.

Label your child’s emotions. As parents, we want our children to feel good. When they’re upset, our instinct might be to tell children to calm down or stop worrying. However, telling a child to stop feeling an emotion can actually make your child feel worse in the moment.

Instead, when children are upset or scared, it’s best to validate their emotions by talking about them directly and labeling the emotion they are feeling.

If your child is feeling upset or scared, you might say, “You’re sad we can’t go home yet” or “You’re feeling mad you can’t eat until after your procedure.” Labeling helps your child verbalize their emotions which will strengthen their ability to communicate with you.

By providing them with the vocabulary to express their emotions, you empower them to manage their feelings more effectively.

Tip #3: Give your child specific instructions. When giving your child instructions, it’s important to set your child up for success. Here are a few things to keep in mind that will make it more likely for your child to follow your directions.

Be specific. Tell your child exactly what you’d like them to do. Instead of using broad terms like “behave” or “stay calm,” offer precise instructions like, “Please come sit next to mommy,” or “Keep your hands by your side.”

Use positively stated instructions. Focus on what you want your child to do rather than what you want them to avoid.

For example, if your child is throwing their toys around the room, redirect them by saying, “Please keep your toys on the bed” instead of saying, “Stop throwing.” This approach not only clarifies expectations but also provides clear information on how they should be behaving at that time.

Children may feel unsure of what to do without your instruction.

Give your child instructions one at a time. Many children find it difficult to understand and follow more than one instruction at a time.

To help them understand and follow through, break down the steps into simple parts. For example, instead of saying, “Clean up all of the toys,” tell them to “Pick up the blocks.” Then wait for them to finish cleaning up the blocks.

Once they’ve finished, offer specific praise for their accomplishment (“Thank you for cleaning up the blocks”) before moving on to the next instruction, such as, “Please throw your wrapper from lunch in the trash.”

Model manners. We all want our children to be polite and respectful. When telling children what to do, try to use polite language to set a positive example for them.

Beginning your instruction with “please” demonstrates politeness while maintaining firmness.

For example, “Please wash your hands” is direct and clear, while still modeling politeness to your child.

Say instructions in a neutral tone of voice. It’s common for parents and caregivers to yell or say directions in a harsh tone when they want their child to listen.

However, using a loud or angry tone while telling your child to do something can increase their stress and frustration. Instead, deliver instructions in a normal, neutral tone of voice just as you would in any other conversation.

Be consistent and predictable. If you set a consequence for certain behaviors, such as losing screen time for not cooperating during a dressing change, it’s important to follow through.

When children can predict their parents’ response, they learn how to respond appropriately.

Additionally, consistently praising children for good behavior reinforces positive actions and encourages continued cooperation.

Tip #4: Spend quality time with your child. You spend all day in the hospital room with your child, but they may still crave more of your attention.

Set aside five minutes each day for dedicated time to play with your child. During this time, turn off the TV, tablets, and phone.

Follow your child’s lead by offering a choice as to which toys they can use to play. Show them you’re paying attention by mirroring their actions, repeating the words they say, and describing their behaviors out loud.

For example, if your child is using a green crayon to color a tree, say, “You’re drawing a green tree.” This helps children know you’re paying attention and approve of their choices.

These brief moments of focused interaction will be cherished by your child, so be sure to shower them with praise during this time to boost their spirits.

Additional Resources

• Health Care Toolbox: https://www.healthcaretoolbox.org/behavior-change
• The Cooperation Chart: https://www.thecooperationchart.com/

References

• The Gottman Institute. An Introduction to Emotion Coaching. https://www.gottman.com/blog/an-introduction-to-emotion-coaching/
• McNeil, C. B., & Hembree-Kigin, T. L. (2010). Parent-Child Interaction Therapy. Springer. https://doi.org/10.1007/978-0-387-88639-8_1