How a child perceives and understands illness depends greatly on their developmental age. Kids change remarkably through ages and stages, and it is extremely helpful for parents to recognize and understand the differences. I hope that by breaking down the stages below, I provide a little bit of insight to parents as to what children are actually capable of doing and understanding at these points of development. Hopefully parents can use this information as a guideline to structure age-appropriate conversations and efforts when dealing with their sick children.

• Infants and Toddlers:  At this stage, children have little to no understanding of their illness.  They sense that they don’t feel well, but they cannot effectively express themselves without being irritable or crying. There is limited if any verbal communication, so trying to explain to a child that they will feel better soon and that this illness is only temporary provides no relief. Similarly children cannot explain to parents exactly what they are feeling and what specifically is bothering them. This can be extremely frustrating for both parents and children. Children are entirely reliant on their parents to provide them with a sense of security and comfort. This typically involves a lot of patience, holding, cuddling, and a kind voice to soothe the child during this difficult time.

• Preschool Children: At this stage, children begin to understand a little bit more about their illness. They can more readily identify their symptoms, and to some extent express their feelings and concerns about being sick. They are beginning to develop a sense of independence and tend to rebel when they sense their freedom is being taken away. This is especially true when they are not feeling well and are being forced to go to the doctor, stay home, rest, and take medicine. This can be extremely challenging for both parents and children. This is when it becomes extremely important for parents to be kind, yet firm, and explain to the child in simple terms what is going on and what needs to happen. Allowing children to exert some independence, like offering them choices when possible, is helpful at this stage of the game.

• Elementary School Children: This is the stage when children become more independent thinkers and try to understand or explain reasons for why things are happening. Why are they feeling sick? How did they get sick? When will they feel better? They tend to be curious and ask a lot of questions. Children also try to come up with their own answers to describe reasons for illness, although these reasons may not be completely logical. Parents are encouraged to offer honest explanations that can put a child’s mind at ease and diminish the stress associated with the unknown. This is a great time for parents to help kids learn how to deal with stress and illness, as this will only help them as they get older and experience more stress and more illness down the road.

• Middle School Children: This is a difficult stage overall, since kids are growing up, going through puberty, and becoming increasingly self-aware. They are more capable of understanding their illness, yet they are more inclined to be angry or frustrated as it interferes with their normal routine. It’s really a catch 22 because kids are likely thrilled at the idea of missing school, but then again feel left out when they miss sports or activities with their peers. Not to mention feelings of being overwhelmed when they have to make up missed work or feel behind the rest of the class once they return to school. It is best for parents not to “baby” kids at this age and speak to them as directly and honestly as possible.This will encourage them to look at the situation more logically and accept the situation for what it is. Kids want to feel independent, but they still want to know you are there. Staying calm, being supportive, and keeping the child focused on what needs to be done to get better and back on track is the key.

No matter your child’s age, understanding where they are developmentally helps to foster acceptance and understanding of a child’s behavior as well as medicine adherence and compliance. Feeling sick at all ages is never an easy or pleasant experience, however avoiding the stress of conflict that might arise when parents and children do not speak the same language can be helpful. Take the time to understand the best way to communicate with your child when they are sick to help speed and smooth the road to recovery.