Tips for Helping Children Cope With Scanxiety
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Children and teens may need imaging scans at a hospital or clinic for many reasons, including broken bones, headaches, trouble breathing, or abdominal pain. Children with cancer, however, will need scans much more frequently — to monitor their response to cancer treatment or to check for recurrence in the years following.
These different scenarios all have a common denominator: Having a scan and waiting for the results can cause a lot of distress, a nagging state of mind known as “scanxiety.”
Symptoms of scanxiety may include headache, stomachache, chest pain, increased heart rate, and sweaty palms, says Karen Moody, MD, a professor in the department of pediatrics patient care at The University of Texas MD Anderson Cancer Center in Houston. These symptoms “can be disruptive to activities of daily living by interrupting sleep, focus, and mood,” she says.
Scanxiety can make it more difficult for scans to be performed, whether it’s computerized tomography (CT), magnetic resonance imaging (MRI), or another type of scan. Here are some tips to help your child cope with scanxiety and get through their next scan successfully.
Control Your Own Anxiety
Many children get very nervous and have significant anxiety before coming to a radiology suite, says Thierry Huisman, MD, PhD, radiologist-in-chief and chair of the department of radiology at Texas Children’s Hospital in Houston. “Though often,” he notes, “the parents and caregivers are also nervous and anxious, and that can also carry over to the children.”
Melissa Acquazzino, MD, a pediatric hematologist-oncologist at Children’s Nebraska and the University of Nebraska Medical Center in Omaha, adds, “It is common and normal to feel anxious that the scan or imaging results may be bad, and often the worry does not go away until results are available. Some patients and their parents worry for many days prior to their scheduled scans.”
As a parent, you can help your child feel less anxious by adjusting your own temperament and approach to this situation, says Siobhan Cannon, a certified child life specialist at Rush University System for Health in Chicago. Children tend to feed off of a parent’s energy or response, so keep in mind that “a calm parent may equal a calm child,” she says.
Familiarize Your Child With the Scan
“Scanxiety is often associated with lack of understanding and familiarity, which is why preparation plays a key role in reducing anxiety,” says Cannon.
“Preparation for scans includes explaining to children what will happen during the test, including all senses — what they will see, feel, hear, taste, or smell,” adds Amanda Hennessy, a certified child life specialist in pediatric outpatient oncology at Johns Hopkins Children’s Center in Baltimore.
When talking with your child about the upcoming scan, Cannon advises being simple, honest, and specific. “Use real medical words,” she says, “then explain what they mean in child-friendly language.”
If you’re having trouble simplifying complex terms, most hospitals have child life services available as a resource for pediatric patients and their families. “Reach out to a child life specialist beforehand to assist in preparation and finding the right language to use based on age,” says Cannon.
Know What to Do the Day of the Scan
Consider Bringing Comfort Items
Parents can speak with the hospital or clinic in advance to learn what your child is permitted to do before, during, or after a scan to lessen anxiety. For example, Cannon recommends asking staff if it’s an option for your child to bring a favorite comfort item from home.
Grace Laird, a mother of three daughters in Cypress, Texas, says her eldest, 8-year-old Paige, found comfort in bringing Coco, a stuffed puppy, into the MRI at Texas Children’s Hospital. Paige was diagnosed with a benign brain tumor at age 3, which her neurosurgeon removed in December 2021, two months before her seventh birthday.
“Coco has gone to every MRI with Paige, since she started doing MRIs,” Laird says. “She gets to keep it snuggled up close for each scan.”
A stuffed animal or blanket without metal or batteries is typically approved in imaging departments, says Cannon. “Children are often able to utilize their comfort items, fidgets, or other types of distractions throughout a scan,” she says. “Depending on the type of scan and resources available at the institution, some children can watch movies, listen to music, or interact with parents as well.”
Find Out About Food Restrictions
Some scans require refraining from food or drink after midnight in preparation for anesthesia, so Cannon recommends seeking clarification on what is allowed before the scan.
Review Your Schedule
Not knowing the sequence of the events for the day often contributes to scanxiety. Try setting expectations for the rest of the day to assist your child in completing the scan, Cannon suggests. For instance, telling your child, “First, we will go to the hospital to take your pictures; then we will go home and have a snack,” provides a clear start and finish to the day.
It’s also useful to inquire about the estimated length of time a scan will take. “We help kids understand that time by saying things like ‘one episode in a show’ or half of a movie,’” says Jill Freeland, a child life specialist at the University of Iowa Stead Family Children’s Hospital in Iowa City.
Practice at Home With Pretend Scans
You can tell your child that the CT or MRI scanner operates like a camera, and that “nothing will hurt them or touch them,” says Freeland. “Their only job is to hold still, just like when someone takes a picture of them on a phone or camera. They wouldn’t want you to move or wiggle around [because] it would make the picture blurry.”
To help prepare your child for lying still, Freeland recommends practicing at home — on the couch while watching a show or under a kitchen table or chair — and pretending it’s like being inside a scanner. “This can also help ease anxiety about being in a tight space,” she says, “if that is something the child is worried about.”
Looking up online videos of a similar scanner and listening to the sounds produced by an MRI may give your child an idea of what to expect during a scan, Freeland says.
“Sometimes it’s helpful to make a playful description and connection with the sounds, such as ‘Does it sound like construction site noises?’” adds Emily VanSwearingen, a child life specialist in the radiology department at Cincinnati Children’s Hospital. She suggests describing the MRI or CT camera as a spaceship or a big donut.
Prepare for an IV or Contrast Material
Many scans require an IV to be placed in the arm or hand to administer a contrast agent that highlights areas of the body being examined. Before some scans, the patient may have to drink large quantities of a liquid containing contrast material, which may have an unpleasant taste.
These additional steps to perform a scan may increase a young person’s anxiety, says Brianne Newman, a radiology certified child life specialist at Children’s Hospital Colorado in Aurora, Colorado.
Laird says Paige needs an IV to receive contrast during her MRIs. “That causes pain and anxiety as well for each scan,” she says. Paige, who has completed about 15 MRIs within the last five years, still gets them to check for a possible recurrent tumor. “Putting the IV in was the hard part for her overall — the needle stick,” she says.
If your child needs an IV, Newman says the staff may be able to demonstrate the procedure on a stuffed animal or doll. Then, while the IV is inserted, it may help to distract your child with a video game or a book. Encourage your child to sit on your lap, take deep breaths, or squeeze a stress ball.
Have Distractions Ready
For older children, writing down feelings or worries in a journal can be a welcome distraction from scanxiety. And getting good sleep is important, enabling children to feel their best and manage emotions, says Dr. Acquazzino.
Another approach to managing scanxiety is to request a visit with a therapy or facility medical dog — if the hospital has one available. Petting the animal may calm your child, says Newman, who sometimes brings along Galaxy, a 6-year-old male golden retriever, to meet with a patient and family before a scan.
You May Want to Stay With Your Child During the Scan, or Ask for Sedation
For some children, separation from caregivers during a scan is an issue. They may become tearful, cry, yell, or protest during the procedure, and they may be “reluctant to return due to previous negative experiences,” says VanSwearingen. As a parent or caretaker, you can ask to be present for as much of the procedure as possible if your child is not sedated or under anesthesia.
“An interdisciplinary team will work collaboratively with the caregiver to help determine your child’s ability to complete the scan with or without the use of medications or child life support specialists,” says Hennessy. “It is not uncommon for children to need both medication and psychosocial support to cope with a scan.”
In some cases, “sedation or anesthesia may be needed if a child has difficulty remaining still in the desired position for the duration of the scan,” says Susan Hiniker, MD, an associate professor of radiation oncology at Stanford Health Care in Palo Alto, California. “While it’s a simpler procedure if sedation is not required, at times it is necessary in order for a successful scan to be performed.”
Visit the Scanning Facility Ahead of Time, if Possible
“A variety of techniques are used to help children and teenagers tolerate scans more easily,” says Dr. Hiniker. “Decorated waiting rooms and scanners creating an immersive environment are becoming more widely used.”
You may want to visit the facility before making an appointment for a scan to see if the child-friendly decorations covering the scanners — such as a camping tent, jungle, or beach — look appealing. There also may be play areas that promote relaxation and comfort.
For some types of scans, virtual reality goggles can be worn to “provide an immersive and relaxing experience,” says Hiniker. “Through virtual reality goggles, children can see a variety of scenes. If used in preparation for a visit, the images might consist of what to expect in the scan environment. If used for relaxation during a scan, children may see calming and interesting scenes from various environments, including under sea images, outer space, and others.”
Cincinnati Children’s also provides “movie goggles,” and patients are told they function like their “own personal movie theater,” because they can’t see the camera or anything else around them, says VanSwearingen. Once a patient puts on the movie goggles, a screen inside plays a movie.
You can also ask if the facility has a mock scanner that your child can use for a test run. “The mock scanner has the same sounds, noises, light, and movements as the real one, so this acts as a practice, hopefully making the patient more at ease and comfortable before their imaging session,” says Caryn Karff, a certified technologist who is director of radiology clinical operations at Children’s Hospital of Philadelphia.
Thanks to a mock MRI, Laird says Paige “was able to experience what an MRI is like in a low-pressure way, where she had some control and could go at her own pace.” Her daughter could then do a real MRI that afternoon without sedation.
“It was a very big day for her, and we were so incredibly proud,” she says. Paige used the mock MRI one or two more times, but no longer needs it.
The entire team — from the nurse to the radiologist to the child life specialist — plays an important role in creating a calm environment for your child before a scan, says Dr. Huisman. During the imaging session, the technologist performing the scan can provide the reassurance and support your child needs at that time.
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