Using Drawing and Art to Communicate About Reflux
Adults often comment about how difficult it is for them to communicate their symptoms and concerns to the doctor. Imagine how intimidating it must be for a child. Children with Gastroesophageal Reflux Disease (GERD) often have a difficult time communicating with the adults in their lives about their reflux symptoms, even their parents.
It is likely that children will need to communicate primarily with their caretakers (parents, child care providers) and to a lesser degree the doctor and school nurse. Gastroesophageal Reflux Disease often causes daily or weekly symptoms with varying intensity and severity. It is very important for parents to know about symptoms so they can track symptoms and report trends and changes to the doctor.
Some children are very forthright and communicate their symptoms frequently to their caretakers. Other children (like my refluxers) give a non specific answer.
The conversation may go like this:
Parent : How are you feeling today?
Child: ”Ok” or “Fine”.
Other children try to hide their symptoms to prevent their caretakers from becoming concerned especially if you often look anxious or alarmed by their comments. If you react to your child’s reported symptoms by restricting activity or running to the phone to schedule a doctor’s appointment, your child may be concerned about reporting symptoms in the future.A child may be so accustomed to daily reflux symptoms and pain that it doesn’t even seem important to mention it.
Parents are certainly encouraged to talk to their children about symptoms using age appropriate questions and terminology. In addition, coloring and drawing are highly effective ways to find out more about reflux symptoms.
I always take a pad of paper and markers or crayons to the doctor’s office and hospital. You never know where the drawing will take you. Once I forgot to bring our art supplies so we used a pen from my purse and the roll of paper on the examination table.
Each year, TAP Pharmaceuticals Inc sponsors a National Drawing and Coloring Contest for Tummy Aches and publishes a wonderful calendar, The Art of GERD ™ Kids Create. Parents Relate. The young artists convey powerful messages about what reflux feels like.
One little girl drew a picture of a very sad looking butterfly trapped in a jar while all of the other butterflies were happily and freely flying in the sun. Another picture showed a stomach filled with bees flying around. The caption read, “A stomach ache is worse than butterflies in your stomach. It’s more like a beehive.” Other pictures showed volcanos, fire, and sadness.
At any age, children should be encouraged to draw a picture of what reflux feels like. A young child may want you to write a title for the picture or label the drawing. An older child may be encouraged to finish a sentence such as, “My reflux feels like…” The picture may lead to a conversation about reflux with your encouragement. It is important to ask open ended questions such as, “Tell me about your picture.” and clarifiying questions such as, “The girl is crying. I wonder why she is sad.” Sometimes commenting is all that is needed to encourage your child to share her feelings. Remember that commenting is just noticing something (I see she is in bed.) and does not offer opinions or your interpretation of what the picture shows. It may help to comment and then wait. Your child may need some extra time to process what you are saying and think of a comment or answer. The extra waiting may give your child the courage to bring up a sensitive topic or tell you their concerns and questions.
When Rebecca was in preschool, she expressed concern that her dad would not know her medication schedule while I was away for a rare over night trip. She decided that she needed to make a medication chart. With my help, she gathered up all of her medication bottles, inhalers and medication syringes and got to work. Before long, she had produced a very accurate picture of all of her medications and mounted it on the refrigerator for handy reference. A few weeks later, the doctor asked me what medications Rebecca was taking and we unrolled her medication picture. The doctor was very impressed and the two of them had a talk about her medications. It was clear to the doctor that she was complying with the medication schedule!
In summary, coloring and drawing offers children the opportunity to demonstrate their understanding of reflux, express their feelings and communicate with their caretakers about reflux. Parents can use drawing and coloring to open the channels of communication and offer clarification and reassurance. In addition, doctors, teachers and relatives may have a better understanding of what reflux feels like.