A routine visit to a doctor or dentist raises anxieties in almost all children. While most take the necessary pokes and needle sticks in stride, or become upset only on occasion, a few toddlers and preschoolers are truly terrified. They burst into tears, squirm, fight, and do other things that, ironically, make their visits more uncomfortable and traumatic both for them and for their parents. Whether a child comes away from a doctor’s visit feeling masterful or like a failure depends, in part, on how the child handles his anxiety and how the parents and physician or dentist help.

The first thing to consider is the child’s stage of development. Toddlers are just beginning to pay attention to the integrity of their bodies. They may wonder what happens to their hair or nails when you cut them, and may even insist on keeping them in a box. Some become upset at the sign of a drop of blood from a scraped knee, and insist that even the slightest bump have a bandage put on it. Others are very concerned when they see their urine or feces flushed down the toilet.

That fascination with bodily integrity is one of the reasons why toddlers may suddenly seem more concerned if they have to see a doctor. Another reason is that emotions are as contagious as viruses within a family. Sometimes the emotional messages to children are obvious, as when a father cringes when describing getting an injection or having a tooth drilled. Often, however, it’s much subtler. A mother may emphasize to her child that the visit won’t be painful or frightening. The child, who realizes that he never receives such reassurances before visiting someone else, becomes anxious. After all, why would his mother bring up the topic unless he really should be scared!

An Unfamiliar Environment

Toddlers are often frightened of doctors’ examining rooms because they look so different from the rooms he’s familiar with at home. One way to cut down on that anxiety is, whenever possible, to have the physician conduct as much of the examination as possible with the child on the mother’s or father’s lap. Also, children this age look to their parents for clues to how they should respond and how fearful they should be. A toddler will find it comforting if the doctor first looks in his mother’s ears or listens to her heart before doing the same things to him.

The burgeoning verbal skills of preschoolers make them appear much more sophisticated than they were a few years earlier. Parents of three- and four-year-olds may try to reassure them about an upcoming doctor’s or dentist’s visit by talking in great detail about the examination. The child’s fundamental questions — Is the doctor a nice and trustworthy person? Will I be safe? Will it hurt? Will I get a dinosaur sticker or a new toothbrush as a present?—get lost in the flood of words. In fact, by overexplaining you can easily make a preschooler more anxious because he doesn’t understand what you’re talking about.

It’s also important to remember that young children don’t have the sense of perspective and life experiences that adults have. While a 35-year-old will view having her teeth cleaned or her blood pressure taken as trivial events, their strange sounds and sensations may frighten a five-year-old. In fact, a preschooler who’s told that the doctor will “take” his blood pressure may ask where the doctor will put it.