Communicating with a child means addressing the child as well as the accompanying adult. The immediate task is to understand what the child has heard, explain what is about to happen and find a workable way for the child to express questions or concerns.
The American Academy of Pediatrics advises honest explanations suited to a child's age when preparing for an emergency visit. A nurse can apply that principle to an individual conversation without assuming that children of the same age understand or communicate in the same way.
Start with the child's understanding
Try an open invitation: “Tell me what you think is going to happen next.” Notice which words the child uses, then ask what needs explaining. Ask the caregiver about helpful communication methods, familiar routines and previous experiences, while continuing to speak directly to the child.
A child who does not answer a spoken question may need more time or another communication method. Do not turn silence into an assumption about understanding. A practical preparation note can record the method that worked: pictures, a demonstration, short spoken explanations or the child's own communication device.
Explain the next step accurately
Break the explanation into a short sequence: who will be present, what the child will see or hear, what the team needs the child to do and how questions can be raised. Obtain procedure-specific wording from the team responsible for the procedure.
Avoid promises such as “nothing will hurt” or “you can stop everything whenever you want” unless the responsible team can actually make and honor that commitment. If something is uncertain, say what is known and who will explain the rest.
For example, this fictional preparation statement leaves room for individual needs: “First, we will look at the equipment together. Then the person doing the test will explain the steps. Tell me which part you would like us to explain again.”
Offer real choices and specialist support
AAP's hospital guidance describes child life specialists as professionals trained in child development who help children understand and cope with hospitalization and procedures. It also recommends offering choices when available and providing privacy for older children and teenagers.
Ask whether a child life consultation is available when preparation needs exceed the team's usual approach. Agree on the explanation together so that different team members do not give conflicting accounts.
Offer only choices the care setting can support. Choosing which picture to discuss first is a practical preference; it does not replace the organization's consent or privacy procedures.
Carry useful information to the next team
A short handoff can identify what has already been explained, what the child wants to know and which communication supports should continue. Keep the child's words distinct from a caregiver's interpretation.
Review the explanation after a change in the plan. The purpose is a usable conversation with this child, not completion of a script.
For broader role information, see pediatric nursing. Related communication methods include augmentative communication and family-centered communication.
Sources
- 10 Things for Parents to Know Before Heading to the ER (accessed 2026-09-17) — American Academy of Pediatrics, updated January 15, 2026.
- What to Expect if Your Child Is Admitted to the Hospital (accessed 2026-09-17) — American Academy of Pediatrics, April 5, 2021.