Just as kids often demand your undivided attention before they do a handstand in the pool or knock over a tower of blocks, you need to command your child’s focus if you expect him to listen. If your son doesn’t brush his teeth after you’ve told him to five times, it’s possible he didn’t even realize you were talking to him. (Hey, those toy dinosaurs are pretty engrossing.) In fact, research shows that the likelihood of a child’s cooperating depends on what he’s doing when his parent makes a request. Before I begin a physical exam, I always make sure that my patient isn’t busy with a toy or a game, make eye contact, and then speak directly to him, no matter how old he is. You can use the same strategy at bedtime. Look your child in the eye and give him a warm-up direction: “It’s getting close to bedtime.” Once he makes eye contact, quickly follow up with instructions: “It’s time to brush your teeth. Let’s head to the bathroom.”
Toddlers always surrender to a parent, or their doctor, when she’s acting ridiculous. Karen Carson, M.D., a pediatrician in Roswell, New Mexico turns the physical exam into a silly scavenger hunt: “I tell kids that I see Elmo, Dory, or Spider-Man in their ear. I continue with monkeys in the mouth and elephants in the tummy. When I’m in a hurry, my patients often get mad if I don’t see something!” You can use Dr. Carson’s trick in all sorts of scenarios, whether you’re changing your 1-year-old’s diaper or putting bug spray on a 5-year-old who is desperate to run off and play. Look for characters, sing, tell a story, or make funny noises as you wipe your child’s bottom or apply lotion.
Back in medical school, I thought it was respectful to ask preschoolers to hop up onto the exam table—and was genuinely surprised by how many didn’t comply. Eventually, I realized that unlike adults, children simply don’t understand that a polite question actually means “Do this!” So these days I rely on cheerful statements—“Climb up on the exam table,” “Open your mouth,” “Turn toward me”—and my patients are generally happy to do what I say. Science has my back: A study of 3- to 7-year-olds showed that suggestions like “Can you put your shoes on?” fail to elicit the same results as clear directives like “Put your shoes on.” Research also shows that kids don’t fully understand sarcasm or irony until they are around age 10, so using those to get good behavior isn’t likely to work either.
You can learn from the way your child communicates as well. Pay attention to the words she uses to ask a friend to do something, and compare them to how you might have expressed the same request. Then try using her exact words the next time you want her to clean up her room or put on her coat or sit down and eat her dinner. If that doesn’t work, consider whether you need to dial down your own vocabulary. When I say I’m going to use my otoscope, some kids look shocked as I place it in their ear. On the other hand, if I call it an “ear looker,” they quickly turn their head to the side to assist me. Speak in simple phrases or say the same thing two different ways; your child will understand you better and might even learn a new word!
Kids are most likely to cooperate if they don’t feel rushed, yet studies show that parents often don’t give kids enough time to respond to directions. Children don’t switch tasks easily or quickly. If you’re tired of repeating yourself, you may just need to give your child more time to respond. You’ll be surprised by how often most kids will do as you say, eventually.
Going slow is how Kristina Robert, a pediatric E.R. nurse at Johns Hopkins Hospital, in Baltimore, gets kids to take even the foulest medicine. “If a child resists, I’ll administer it one drop at a time,” she says. “A child can’t spit out just one drop.” Plus, it’s more efficient to be slow and successful than to have to start over after a patient rejects a full dose. As for me, I never dive right in and listen to an apprehensive toddler’s heartbeat or examine her injured knee. I start by using my stethoscope on her foot and work my way up to her chest, or I inspect her good knee first. Just like any of us, kids want to know what to expect, so if your child is dodging the hairbrush, you could start by using it gently on her arm or her belly. Of course, when you’re in a rush, it’s helpful to have another trick up your sleeve. Getting my own kids to walk from the elevator to the dentist’s office used to take an eternity, but now we play “Red light, green light,” a game that gives me total control over their pace.
Kathleen Romero, M.D., a pediatrician at Sinai Hospital, in Baltimore, lets her patients decide which ear they want her to look into first. The strategy also works with her 18-month-old son, Carter. “I’ll say, ‘Do you want to walk to the car, or do you want me to carry you?’ Choices work great as long as both options end in what you want your child to do,” she says. And if he refuses to pick, that’s your cue to say, “Then Mommy or Daddy will pick for you.”
When you can’t give your child an option, it helps to explain your thinking. For example, if your toddler doesn’t understand why she can’t touch the stove, tell her, “Don’t touch! Ouchy!” rather than simply, “No.” Your reasoning is most important for older kids to hear because they can actually be swayed by logic. Case in point: My patients and my own children are more willing to put on their sunscreen when I explain that we have to block cancer-causing ultraviolet rays from the sun. Encourage your kids to share their own thought processes too; it’ll help them learn to negotiate, which is a critical social skill. Let’s say your son wants to skip his piano practicing tonight. Instead of refusing his request outright, let him tell you his rationale. It’s okay to give him a pass if he provides a good argument, like wanting to spend time with the family and promising to practice extra later in the week. Just don’t relent if he begs and collapses to the floor in tears to get his way—that’s not a negotiation tactic you want to reward.
Even if a child bites my tongue depressor during her throat culture, I’ll finish the appointment by commenting on what a great job she did with, say, the ear exam. Pointing out success gives my patients confidence and pride, especially when they are nervous. When kids feel good about what they’ve done, they want to do more of it.
The key is to keep your praise specific to a task. After dinner you might say, “I noticed you put your dish in the sink right after we finished. I’m proud of you for helping without being asked,” rather than, “You’re such a great helper.” There’s no doubt that kids enjoy meeting their parents’ expectations. I’ll never forget the giant toothless grin my 7-year-old son used to flash after he picked up his toys. He was beyond proud—even if all he did was shove his stuff under the bed.