Talking to Pediatric Patients

A Pediatrician at UCLA Shares Tips for Getting Young Patients to Communicate

Diagnosing and treating patients requires an ongoing conversation. This can be challenging for pediatricians, whose patients are often too young or too shy to communicate how they feel. How do pediatricians get young patients to tell them where it hurts?

Jessica Lloyd, MD, a pediatric hospitalist at UCLA and assistant clinical professor at the David Geffen School of Medicine at UCLA, has picked up some tricks of the trade. Here, she shares tips for talking to your pediatric patients.

Communicate on Their Level

Pediatricians treat a wide range of patients, from newborns to young adults. Dr. Lloyd's approach to engaging patients depends on their age, maturity and developmental level.

"With little kids, you kind of try to be silly," she explains. "With school-age kids, you find some common ground, like talking about a Disney character or TV show. For teenagers or young adults, you talk to them with the same respect you would use when talking to a grown-up."

Determining the appropriate way to communicate with developmentally delayed patients often requires talking to the parents in advance. "A patient might be 15 years old but developmentally be more like a 6-year-old. In that case, it's really important to chat with the family and get a sense of where the child is at."

Engage the Parents

For shy or stoic children, pediatricians must rely on parents for both information and assistance.

Dr. Lloyd says toddlers, in particular, often hesitate to talk to doctors. So she steps back and has parents ask questions for her. "The family can tell you a lot, but it's important to hear symptoms in the child's words, too," she says. "Some patients might be too intimidated to talk to me, but if their parents repeat my questions, they'll usually answer."

She also relies on parents when communicating with children who don't want to admit how bad they feel. "We see this a lot with chronically ill kids," says Dr. Lloyd. "It's a defense mechanism. They know if they say something hurts, you might poke them again for blood or do more procedures on them. Parents will often say, 'He won't tell you when something is really hurting and his face won't change.' Knowing that is really helpful because you need to do more investigation and reassure the child that it's important to discuss his or her pain with us so you can help diagnose the issue and make it better."

Build Trust

Talking to your pediatric patients can be challenging if they find you intimidating. When children seem scared to open up, Dr. Lloyd recommends removing the white coat and literally taking a few steps back. She also talks to parents and nurses to learn about patients' hobbies and interests.

"For instance, a 3-year-old child was recently admitted to the hospital. She was pretty shy, but she loved Taylor Swift. On rounds, when my team played Taylor Swift and danced with her, then she would talk to us. Finding common ground and having fun with them makes you seem less intimidating — like someone they can open up to. Sometimes it takes time to build that sense of trust, but it's important not to stop trying."

(Related Article: Is Being a Pediatrician Hard?)