Interacting with the Child

When a child chooses to disclose an experience of abuse to you, your immediate reaction is key to the child’s well-being and recovery. These are a few simple steps that help you establish a trusting relationship with the child with his/her best interest in mind.

Create a safe environment. Make sure the environment is private, quiet, and familiar to the child. Talk to the child and let him/her know that you are concerned and that you will do all that you can to keep them safe

Pay attention to what is and is not being said. How does the child respond when you are doing an examination? Does he/she flinch? Does he/her cower? How does he/she look at the parent or the trusted adult? Is there a sense that the child feels safe and comfortable with the parent or the trusted adult?

Be mindful of your tone and facial expression. Is your tone inviting, safe-sounding, slow-paced, gentle? Or is it clipped, as though you are rushing to get to the next patient? Also, remember to use kind eyes.

Ask simple questions about physical signs such as, “That looks painful. Do you want to tell me how you got it?” or “Do you want to talk about that bruise you have?” Don’t ask leading questions such as “Did you get that bruise when someone hit you?” Also, avoid “why” questions, which can add to the child’s confusion and will not offer helpful information.

Consider the child’s age. For young children, use simple terms and phrase your questions accordingly. For teens, consider asking the parent or trusted adult to leave the room and then use age-appropriate terms and ask about age-appropriate issues. Are they smoking, using drugs or alcohol? Are they being bullied or experiencing violence? Is someone touching them in ways that make them uncomfortable?

Refrain from correcting the child. If you do not understand a term a child uses to describe a body part, ask the child to explain further or point to the body part. Let them use their own words. And let the child know when you understand them.

Let the child know that it is O.K. to feel hurt, angry, confused, or scared.

If the child indicates that he or she has experienced sexual abuse, let him know that you believe him, as it is quite rare for a child to lie about such abuse. Then tell the child you will be contacting the people who will be able to help. Protecting the child is your primary responsibility. You can discuss your concerns and your duty to report child abuse with the parent or guardian after interviewing the child. In addition, you might provide a referral for the child to a specialist or counselor.

Remember to respect the child’s privacy. Refrain from asking too many details, as they will need to share their story later on.

Keep your emotions in check so that you don’t inadvertently convey disapproval of the child, the parents, or the situation. Do not express judgment or blame the child or the parents.

Let the child know they did the right thing by letting you know about the abuse. And let them know they are not to blame. They may feel guilt or fear punishment for disclosing this information. From Tips for Physicians on To Interact with the Child by Minnesota Medicine: Click here