It's totally normal for kids to be scared of taking nasal swab tests—aren't we all a little bit? As a pediatric health psychologist who helps children deal with medical procedures, here are my tips to making it easier and more comfortable for everyone in your family.

By Jody Thomas, Ph.D.
October 09, 2020
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A year ago, very few of us would have been concerned about making our kids comfortable with sticking a very long swab up their nose. But in the age of COVID-19, nasal swabs are definitely a thing. While it is more uncomfortable than it is actually painful, it can cause a lot of freakouts for our kids, and unwelcome stress for us adults.

As a pediatric health psychologist, I've spent more than 20 years teaching kids how to cope with medical procedures. The good news is that there are simple ways you can make it much easier for your kids, and yourself, to go through a nasal swab.

Prep Up

Parents sometimes have the tendency to avoid telling their kids about a medical procedure beforehand because they think "it will just make them nervous." Turns out that is a normal instinct but maybe not the best call. Think of it like being asked to make the clutch play of the game with no practice or game plan. Good preparation decreases anxiety and enhances the sense of control.

Before you go, talk to your child about these points:

  • What the test is. You can say something like, "It's a pretty quick test that can tell us if you have this virus."
  • Why they need it. On that note, they'll want to know why they have to do it: "We need to find out if you have the virus so we can figure out how to best take care of you and keep you healthy."
  • What will happen during the test. Avoid surprises and walk them through it. You can say, "They are going to put a swab, like a Q-tip, pretty far up your nose and rub it around for about 15 to 30 seconds or so, about the same time as singing the 'Happy Birthday' song."
  • Where the test will be. Depending on your situation that may be a medical clinic or even your car.
  • How the providers will look. Let them know that providers will likely be wearing masks/face shields. These can be scary to kids who are used to the smiling faces of nurses and doctors. Consider looking at pictures of what the providers might look like and talk through why they're wearing that equipment. You can say, "This is how they make sure that they don't share germs with you and you don't share germs with them. Isn't that cool?"

Find a Comfort Position

Comfort positioning is a way of holding children during medical procedures that keeps them safe and comforted. It is recommended by all pediatric medical organizations. This is in contrast to a kid being held down for a procedure, which years of research shows is a really bad idea that can traumatize you child.

For a nasal swab, holding your child on your lap, with their back to your chest, is the best choice. It allows you to hug them to help keep their arms and hands away from their face, while reassuring them with your calm physical presence and soothing words. This is a great strategy even for older kids, who you can position between your legs. We are never too old to be comforted by people we love and trust!

If your child is receiving the test at a drive-thru testing site, get out of your seat and go in the back of the car with them.

Practice Keeping Still

To do a nasal swab as comfortably as possible, staying as still as you can is necessary. This can be a challenge for kids, especially in an uncomfortable and unfamiliar situation. A great strategy is asking kids to imagine themselves as a statue. You can make practicing that a game by challenging them: "Who can be a statue the longest?" or "Who can be the silliest statue?"

Change Their Focus

Every parent knows what it's like to struggle to get their kid's attention when they are totally absorbed in a TV show or movie. This natural ability to focus and tune out the world is very useful when it comes to changing the way humans experience pain and distress. Have your child pick something else to focus on, like a video, favorite music, or special toy. Use this strategy before the nasal swab to keep that anxiety that creeps up pre-procedure at bay, and during the nasal swab to make it go more quickly and easily.

Have Them Use Other Senses

Engaging your child's other senses changes how they feel. Sensory experiences like music, forehead or hand massage, hugging a favorite stuffy, or even VR goggles can help them be less focused on the discomfort.

Write Down the Plan and Practice

This can have a surprisingly big impact. Remember, choice feels powerful and reduces stress, so let your kid pick the strategies they want to use. If the family is getting tested together, have them choose who goes first. The adults can model calm and good coping. It's not a bad idea to also include a reward in this case. We all need a little motivation to get through challenges, so give them something to look forward to on the other side of the swab experience.

Especially for younger kids, practicing the nasal swab plan through play can help them concretely understand what will happen and how they want to cope. Much like practice for the big game or the dance recital, practicing builds confidence and reduces anxiety. They can practice with you, on a favorite stuffy, or anything else they want to use.

Remember That Your Energy Matters

Finally, the most important piece of the puzzle is you! Your level of stress is a major predictor of your kid's distress, but the good news is that your calm is also contagious. So take a few deep breaths, relax those shoulders, and find your own happy place as much as possible as you wrap your comforting arms around your little (or not-so-little) one, and remind them that it will be over soon!

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