Introduction
When we first approached Rosamund Kissi-Debrah to ask her thoughts on how child health professionals could better communicate with CYP about air pollution she advised: ‘you just need to talk to them’. She talked about meeting them where they are, on common ground.
We realised that, for many of us, before we can talk about ‘tricky’ subjects like air pollution, we need to get the basics right and engage with CYP in everything that we do.
What do children and young people think?
What children think is different to adults. Children have good ideas, children have bigger imagination.
When we talked to CYP they told us that they already know a lot more than we give them credit for and that they often think in more dynamic creative ways. So not only should paediatricians be unafraid to broach topics with them, but actually a lot could be learnt from having that conversation.
The RCPCH &Us team do a fantastic job working with young people and has already created many useful tools for engagement. See their web page on communication.
Word has it that the RCPCH &Us Climate Changers are working on some updated top tips for clinicians, but in the meantime check out one of the existing leaflets from RCPCH &Us, available below or on this page.
Fifteen-minute consultation: Guide to communicating with children and young people
This article by Gail Davison et al has some useful strategies for child-centred care. They summarise it: ‘help children be active agents in their own care by asking, listening well, being curious and explaining things clearly in an accessible but not condescending way.’
Some key takeaways are:
- Always say hello! Use your first name if possible, and say what your job is in simple language
- Be mindful of nonverbal communication such as waving (especially if a mask is obscuring your mouth) or if the room needs to be set up to be more inviting
- CYP say we are better at asking questions than listening to their answers – make sure you actively listen and respond
- Engaging young children or nonverbal young people in an activity may be more effective than conversation
- Make sure children are included in clinical decision-making
- Tell the truth
Children, though, are very perceptive and pick up non-verbal cues and what adults do not say. If we keep them in the dark, they tend to think the worst. The authors’ opinion, backed up by evidence, is that keeping secrets from children is futile; it is better to be honest than make them think twice about trusting you again.
Resources: RCPCH
There are some great examples within the RCPCH of how to have conversations around challenging topics. For instance the Health inequalities tool on developing clinical skills for talking to families.
If we stop thinking about smoking, housing, food, and air quality as “wider determinants” of health – and start considering them “core determinants” – then it doesn’t just become easier to ask about them: it becomes imperative.
This podcast between two of the toolkit's authors, Ian Sinha and Alice Lee, and Helen Stewart (RCPCH Officer for Health Improvement) also provides some helpful practical insights about starting conversations with patients and their families.
Resources: External
MeFirst is a super website that helps health and care professionals communicate more effectively with children and young people. It offers themed training modules and resources co-designed by children and young people.
AYPH (Association for Young People’s Health) work to meet the particular health and well-being needs of 10-25-year-olds. Their approach is rights-based and they have useful research on engagement such as their paper ‘How to talk about health inequalities in the context of young people’.
Want to learn more? Explore how to talk with CYP and families about this topic
- 1RCPCH (2024), RCPCH &Us Voice Bank, London: RCPCH (unpublished, available via and_us@rcpch.ac.uk)