Ever been driving and need to turn the radio off to make sure you don’t miss your turn? How about standing still with your eyes closed, do you feel yourself swaying around, feeling your body correct itself from the direction it is going to prevent falling?
These are just a few ideas of how our bodies process various sensory input. Everyone regulates sensory differently; in children, it is more difficult. As children grow, play is their greatest learning experience, teaching them where their body is in space and what their nervous system craves. Those with extreme difficulty have what is called Sensory Processing Disorder (SPD). SPD is a condition that involves difficulties in recognizing, regulating, and reacting to sensory input to the extent of affecting functional performance with all daily tasks.
So, what could be more fun than playing sports, jumping on trampolines, and swinging on monkey bars? How about an injury resulting in the need of casting?
Fracture care brings various sensations to the table. The initial injury brings pain and fear. The trip to the ER means the meeting of new people and unfamiliar seting. Patiently waiting for that appointment date and time to meet with the Orthopedic doctor or nurse practitioner can increase anxieties. The immobilization of the joints with a cast requires the body to re-adjust through proprioceptive and vestibular inputs to create a new way to successfully perform tasks. Finally, the day the cast comes off, there is excitement. Then the child sees the cast saw, thinks of the initial pain experienced, and gets positioned for its removal which is an overwhelming adrenaline rush. The entire process can be traumatizing for a child, sensory processing or not.
There are various things we can do as the healthcare providers and parents to assist in making this experience less frightening for the child. First, helping the child become accustomed to the surroundings, people, places, and things, allows him or her to feel more comfortable. This would include introduction of and simple explanation of what each supply is used for. With SPD, sometimes other aids are required to assist in decreasing sensory overload and increasing comfort. These include dimming the lights, weighted blankets, comfort toys like a stuffed animal, and/or noise reduction headphones.
On the day the cast comes off, the child is positioned in a manner that is most comfortable for them at the time while also allowing access for the medical assistant to maneuver with the cast saw. Next, a line is drawn onto the cast as a visual explanation to where the saw will be following. An explanation is then provided of what to expect with sound and sensation during the cast removal process. It is also encouraged before and during the removal process for the child to have “control” of the start and stop time, allowing breaks when needed.
Overall, though, having a strong connection built on trust between the child, parent, and healthcare provider will ultimately promote a more positive patient experience.
“Trust. It’s what friends do.” – Dory, Finding Nemo