How to Use Reflective Functioning to Talk to Your Young Child

When your child is too young to tell you how they are feeling, it can be hard for you as a parent. If your baby or toddler has a serious illness, communication is especially tough.

What is reflective functioning?

Watching your child go through treatment for a serious illness can make you feel helpless. But there is a lot you can do. Through your words and actions, you can help your child make sense of their thoughts, feelings, and actions. You can make them feel safer, understood, and connected. This helps ensure that your child has healthy social and emotional development.

To practice your reflective skills:

1. Watch your child’s behavior.
2. Reflect on what you think it means.
3. Finally, voice your thoughts about it to your child.

The interaction with your child is the most important part. It does not matter if your thoughts are right. Respond based on your own ideas about how your child may be feeling or thinking. It may help to voice your ideas as a statement that wonders about what you think your child might feel or think. For example, you could state: “I wonder if you are tired.”

How parental reflective functioning and child communication works

Example 1: Dealing with a cranky child

Imagine you are getting ready to take your 2-year-old to the hospital. It is treatment day. You have a long drive to the hospital. Your child refuses to get into the car. You wonder if it could be because treatment days always make them cranky. Or it could be because they must stop playing with their favorite blocks for the car ride.

You say: “I wonder if you are cranky because it is treatment day.”

Your child seems to zone out, like they do not hear the statement. They continue building with blocks.

You say: “Or maybe it is hard to stop playing with your favorite blocks.”

Your child says, “Play. Blocks. Play!” and continues building with blocks.

You say: “It is hard to stop playing. I will set a timer for 2 minutes. Then we will put the blocks somewhere special until we get home."

Your child continues building until the timer dings. Then you say, “the timer dinged. Let’s put the blocks in their special spot.”

Your child slowly starts picking up the blocks. You tell your child what a good job they are doing, and you let them choose where to put the box of blocks. Then, as soon as your child is buckled in the car seat, you say, “I am so proud of you for getting in your car seat.” 

In this example, you connected your child’s actions to their thoughts and feelings in several ways:

If your child had not put up the blocks when the timer sounded, you could have calmly said: “You can choose where the blocks go, or I will put them on the table.”

If your child had begun to talk back, you could have calmly put the blocks on the table and said: “It is hard to do things we do not want to do, but it is time to leave. You can walk to the car, or I will carry you.”

In this example, you were aware of your own feelings (of frustration or even guilt that you need to go to another appointment), as well as of your child’s feelings. Using reflective skills means being aware not only of your child’s thoughts and feelings but also of your own.

Example 2: Avoidance

It’s the day of a doctor’s visit. You are picking up your child from preschool to go to the appointment. You go to the school office and ask if your child is ready. After being called, your child does not arrive in the office for 10 minutes. After reaching the car, your child sulks, saying, “I don’t want to leave!”

What do you do?

1. Notice the behavior: Your child has taken longer than usual to come to the office, is sulking, and is saying they don’t want to leave.
2. Reflect on the feelings or thoughts your child may be having: It could be anxiety about the doctor’s visit, sadness about leaving their friends at school, worry about getting poked at the doctor’s office, or something else you haven’t even thought of yet.
3. Connect with your child and respond to the behavior out loud, based on what you imagine are the reasons for the behavior.

Example response: “It is hard to leave friends. You get to see them again tomorrow. But I know it is still hard.” Or you could say, “I wonder if you feel scared about the doctor. Sometimes I worry when I see new doctors. But I will be with you the whole time.

Example 3: Acting out

Yesterday your child finished the first round of treatment. It made them feel nauseated. This morning, they vomited a few times. And this afternoon they started throwing some of their favorite toys. What do you do?

1. Notice the behavior: throwing toys.
2. Reflect on what feelings or thoughts your child may be having.
3. Respond to the behavior out loud, based on what you imagine are the reasons for the behavior. Set a firm limit for what behavior you will accept.

Example response: “I think you are upset that you feel sick today. It is OK to be upset. But toys are for playing. If you throw another toy, I will take it away. Maybe we could teach your bear how to take belly breaths together. Or, we could watch a movie.”

Through your words and actions, you can help your child make sense of their actions that result from what they are thinking and feeling.

Benefits of reflective functioning

Reflective skills help us communicate with others. It is natural to try to understand each other and to make sense of how we behave. If your child touches their mouth or bangs a spoon against their highchair, your first thought goes to what they want: food. So, you are already wired to search for the reasons behind behaviors.

Reflective skills foster relationships

Reflective skills help us in social relationships. The more we can understand thoughts and feelings, the more can have productive and lasting relationships. We can not only connect better with others but also feel like separate, independent people.

Using reflective functioning can help your child early in their childhood. Making these connections early helps your child develop socially and emotionally. Even a 3-month-old baby learns about thoughts and feelings by watching their caregivers.

Reflective skills help guide caregiver actions

Caregivers who practice reflective skills:

• Use their understanding of their child’s thoughts and feelings and resulting actions to guide their own actions
• Are aware of the main feelings they have as parents, such as guilt, anger, and joy
• Do not deny these feelings but accept them
• Understand that thoughts and feelings can change and be hard to understand

Reflective skills help children feel safe and confident

Everyone, from babies to adults, enjoys being understood. Recognizing your child’s thoughts, feelings, and actions helps them feel connected and heard. When they feel connected, they also feel safer and more confident.

This confidence allows them to develop in other areas. They are better able to learn, take healthy risks, and trust the world around them—including health care providers. Reflective functioning also strengthens the connection between you and your child.

You can use your reflective skills any time, from everyday interactions to outpatient clinic visits or inpatient hospital stays. These skills give you the power to help your child feel safe and connected during a time when so much is out of their control.