How to Support Your School-Aged Child During Illness

A new diagnosis or medical setting can be stressful. A serious illness disrupts many aspects of a child’s life including school, activities, and social relationships. But your child and family will adjust with time. Here are some ways to support your child’s emotional, behavioral, and social development.

Have a consistent routine

Set a consistent daily schedule so your child knows what to expect. This can help life feel more “normal” and less stressful.

• Have regular morning, mealtime, and nighttime routines when possible. Try to maintain these routines when your child is outpatient and inpatient.
• Work with your child’s medical team to have a regular appointment schedule when possible.
• Review the daily schedule with your child. It helps to know what to expect.
• Find small ways to stick to a routine such as snack time, watching a favorite show, a short walk after lunch, playing a game, or reading a book.

Promote healthy sleep

Sleep is important for physical and mental health. Create a healthy sleep environment, schedule, and routine. 

• Have your child go to bed around the same time each night and wake up at the same time each morning (even on weekends).
• Create a relaxing bedtime routine that is under 30 minutes, such as reading a story.
• Turn off screens at least 1 hour before bedtime. Bright light from devices can keep your child awake.
• Make sure the sleep environment is comfortable, quiet, and dark.
• Use the bed only for sleeping. Avoid activities such as video games, playing with toys, or screen time in bed.
• During the day, open the curtains or let your child spend time outside if able. Sunlight helps re-set the body to sleep better at night. 
• If your child needs a nap, make sure it is not too long or too late in the day.
• Avoid drinking beverages with caffeine such as soft drinks or energy drinks, especially in the afternoon. 

Follow instructions for medicines and other treatments

It can be hard to manage schedules, medicines, and other medical tasks. It’s also important to take medicines at the correct dose and at the proper time. Tools and strategies can help you keep up with your child’s medical care.

• Make sure you understand the medical team’s instructions. Feel free to ask questions and ask for information in writing if needed.
• Let your medical team know if you have problems following the medical plan. You can problem solve together.
• Use a pill box to help manage your child’s medicines.
• Use written or electronic calendars and reminders. You can set reminders in your phone or use an app. Examples of apps to manage medicines include MyMed Schedule, MyTherapy, MedCoach: Medication Tracker, mango CARE, Medisafe Medication Management, and Pill Reminder. 
• If your child doesn’t want to take medicine, use an “if-then” strategy. For example: If you take the medicine, then you can play with your tablet or toy.
• If your child can’t swallow pills, talk to the care team. There are ways to help your child learn to swallow pills.
• School-aged children understand the need for medicines and treatments to get well. They might ask questions about their medicines and treatments. Provide simple, honest answers to their questions. Ask your child’s medical team for advice if needed.

Manage pain and promote comfort

Simple strategies can often help your child manage pain, be less anxious, and be more comfortable during procedures. Talk with your child’s team about options for pain relief.

• Talk about your child’s pain without minimizing it. Be honest if a medical procedure might be painful. Don’t say that it won’t hurt if it likely will.
• It may help to use a numbing cream, a pain relief device (i.e., Buzzy^®), or other options before needle sticks. Talk with your child’s team about options for pain relief.
• If your child is in pain, use favorite activities to distract them such as watching a video, listening to music, or playing a game. 
• Help your child practice slow, deep breathing. 
  • Starfish breathing: Spread your fingers apart, and slowly trace each finger up as you inhale and down as you exhale. 
  • Pinwheel breathing: Use a pinwheel to show how big belly breaths make the pinwheel turn. 

Find healthy ways to manage your child’s emotions

Let your child know that it is okay to feel sad, scared, or angry. You can show this by sharing your feelings with your child. Talk with your child about how you help yourself to feel better.

• Encourage your child to talk about how they are feeling, but don’t force them.
• Create a “safe place” for them to share. Follow their lead with simple, honest answers to their questions. This helps to build trust.
• Help your child find a comforting object or activity that will help when they are afraid or upset (e.g., holding something that comforts them, holding your hand, playing a game, singing a song).
• Children often watch and learn from their parents. Stay calm and model the use of coping skills.
• Watch for changes in their emotions or thinking that lasts longer than a few days. Discuss this with your child’s medical team if needed.

Set consistent limits

Establish consistent rules for your child’s behavior. Keep the same rules and limits that you had before diagnosis. Use the same rules in your home or in housing and at the hospital.

• Give your child clear instructions. Tell them what to do, instead of what not to do.
• If there are options, offer choices to give your child a sense of control. If something must be done, then do not offer it as a choice.
• Praise your child for good behavior when it happens. Tell them why you are giving praise.

Encourage social engagement

Help your child stay connected to friends and be open to them making new friends during their treatment.

• Help your child plan visits with friends. There are many ways to communicate, and these may change during their treatment. Consider using gaming platforms, FaceTime, text messages, or phone calls.
• Ask your child what they want others to know about their illness and treatment. Help them plan for how they can share this information.
• If your child is interested, discuss how they can make new friends at the hospital.

Talk to your care team if you have questions about your child’s adjustment to illness or social, emotional, or behavioral health. A variety of care team members are available to support you, your child, and your family. Psychosocial services include psychologists, chaplains, child life specialists, music therapists, school teachers, and social workers.

Other resources