How To Get Your Nervous Kid To Let You Put A Covid Test Up Their Nose
As we head into the holidays, with Gramps and Gran around the dinner table and Omicron banging on the doors, here are some helpful tips for acclimating our squirmy little kids to the testing process.
How to describe the experience of restraining your child, as they flail and holler, so that someone can stick an impossibly long cotton swab up their nose, far enough to collect the necessary germ-gunk but not too far as to cause brain damage? Like many, many parents of young children, this was the joy that greeted us every single time we tried to test our three-year-old daughter, Ramona.
When massive improvements in the availability and cost of testing combined with the new Delta variant, our family saw regular testing as the means to a slightly more normal end. Weekly testing came to our son’s elementary school, at-home rapid tests were intermittently available at the local Walgreens (and, btw, 98% effective in detecting contagious cases), a new spot had opened up in our city that offered free PCR tests with a 12-hour turnaround. We felt that we had no good reason not to test weekly or none aside from Ramona. But even when she seemed perfectly happy the second it was over and gave us a look that seemed to say, “All will be forgiven as long as you take me out for ice cream this minute,” it was an ordeal to undertake.
Then, after one particularly disturbing wrestling match, it occurred to me that I could do better. I had been working with children, most of them more prone to anxiety than my own, for years. I once convinced a child to take an IQ test by communicating solely through a duo of plastic palm trees named “Alm” and “Palm,” I could get creative. I could get my kid to take a frickin’ Covid test. And it turned out, I was right. I think you can do it too, and, going into the holidays, with Gramps and Gran around the dinner table and Omicron banging on the doors, likely you will need to.
Explain the process to your kid, in detail
The first step is to talk explicitly with your child about the why, how, and what of Covid testing. Any child with language should be capable of engaging in this, and even those who understand much but say little can probably get something out of it. For many parents, talking directly about something hard, like getting a Covid test, feels scary. What if naming it makes it worse? Well, though it may seem counterintuitive, people who have degrees in all-things-kids agree that it actually helps enormously. When kids don’t know why something is happening or what to expect, they fill in the gaps with their own, often larger, fears. That is why telling a kid that “Daddy is just trying out a different house” doesn’t set them at ease, it just makes them wonder if something much worse than a divorce might be afoot. If the pandemic has taught us anything, it’s that kids can handle developmentally appropriate versions of the truth and the change that comes with them and handle it well. (The children at my daughter’s preschool are more diligent mask-wearers than the average crowd of adults.) Eventually, avoiding the topic of tests and then panic-bombing toward one every once in a while will exhaust your family’s emotional resources and limit your options, just like telling kids that coronavirus was just a little cold that would pass soon quickly became untenable.
Use books or “social stories”
The best way to broach hard topics with kids is through books. Reading about a situation introduces a third party to your child, one that is not their parent, who they are often conditioned to rebel against, but is knowledgeable and safe. “Social stories,” originally created for autistic children, do this beautifully. Like many things made to support neurodivergent children, they actually support all children. A social story takes an everyday experience (using the bathroom, going to a different school) that for whatever reason may be new or confusing to a child and lays it out matter-of-factly, detailing what will be expected of them and why. If you play around on the interwebs, you will find all manner of social stories about getting a Covid test, but my favorite one for preschoolers comes from speech pathologist Tara Tuchel of Autism Little Learners. You can download it and print it (ideal for repeated readings) or share it on your computer (works in a pinch). I added a few personal touches (“I can count to 10 and it will be over”) and presented it to my daughter, saying “you know how we have to get Covid tests sometimes and you really don’t like them?” — see how I named the scary problem there? — “Well, I found this cool book about it; want to read it with me?” We read the book a few times, and I invited her questions and let her color in the pages. If I had a kid who was loath to sit down and read a book printed off of the internet with me, I might have added a cookie or a cup of hot cocoa to the mix for good measure. Put the book in a high traffic area or add it to your nightly reading, but don’t push it too hard.
The next step, after a child has learned something new, is to play. How do you play something as stupid as getting a coronavirus test? Easy. Kids love to play doctor, and they love to be in charge. I gave my daughter a plastic bag with some gloves and a few Q-tips, and she spent some time administering swabs on her stuffed tiger. Then she wanted to give me one, which provided an opportunity for modeling the steps in the book (saying out loud that I was nervous, but if I kept still and counted to ten it would be over, and feeling proud after). If your kid isn’t into it, don’t worry. Leave the supplies in a play area and let them use them as much or as little as they want.
Give kids as much choice as you can
When it comes time to do some real-world Covid testing that does not involve a stuffed tiger, be sure to give your child lots of choice and as much control over the situation as possible. The reason kids this age can be such assholes about things like whether they eat off of the pink plate or the green one is that they are desperately trying to figure out what, if any, agency they have in the world. Imagine you are a young person who is happily playing at home one minute (in my daughter’s case, this mostly involves distributing all of her possessions into separate bags and depositing them all over the house), and the next you are stuffed into a parka, driven god knows where, and plopped in front of a lady with a face shield and a big stick, with no say in the matter. Let your child know it’s coming and let them take part in the process. For the Covid test tomorrow, do they want to walk or take the car? Who would they like to conduct the test? (The nurses usually let us do my daughter’s, and she always chooses my husband, which is fine by me.) What cherished item would they like to hold while it’s happening? What would they like to do afterward? You know your kid best and can get a sense of how these questions empower or overwhelm them, but whatever it looks like, keep them in the loop and invite them into the planning.
Do a low-stakes practice run
Finally, kids need to know that getting a Covid test is something they can and will handle by having some failproof experiences. Therapists who work with particularly anxious children call these “exposures,” and the basic idea is that, if you give the child a manageable dose of some anxiety-producing thing, they will see that it’s not so bad after all and feel successful, which will lead to less anxiety and more confidence the next time around. For my daughter, who was usually perfectly fine leading up to the test but would start freaking the F out as soon as the nurse opened the test kit, our experience was that once we go to the “freak out point,” no amount of bribery or distraction would work. She’d be just too far gone. But now that she really understood why we were testing and exactly what would happen, had gotten to play out some testing scenarios, and felt empowered by her role in the whole thing, our job was to try our best not to get to that breaking point, by making her first “new” test quick and easy.’
Kids of all ages just want to be told the truth (minus the most horrifying details), allowed to work things out in their own language (usually play), given agency, and given opportunities for success. And in the end, isn’t that all anyone wants?
We scheduled the test for a time when it wasn’t crucial whether we got results or not (you can also do a throwaway test at home), kept it light and breezy on the way there, and tried to do hers first (some kids like watching others, but for many of them, this just builds up their anxiety), and swabbed her just for a few seconds in each nostril instead of the whole recommended 10 or 15. As it turned out, and many nurses have confirmed this, you don’t really need as many boogers as you think, and the test was valid and, thankfully, negative. More importantly, she had an experience of success with Covid testing and felt proud afterward. Now, even though they are not her favorite, she can easily take a test on-demand with a little notice and choice. (“We’ve got to do a test this morning. Want it before or after breakfast?”) If she puts up a fuss, we drop the topic and revisit it, keeping calm, and she usually presents us, when she is ready, with some very reasonable demand we are happy to accommodate. “Can I listen to Chipmunks Jingle Bells after?” Yes, totally.
For kids who have more anxiety or start showing signs of fear earlier in the process, exposing them to the safety of it might look like driving by the test site one day and pointing it out to them, getting out of your car and walking up to the gate the next, going up and meeting the nurse the next time, going again and taking out the test kit and looking at it, and then finally, giving them a quick test. The important thing is to quit while you’re ahead, which is hard as a parent, give them lots of praise for their efforts, and go home feeling successful rather than pushing it. If you find yourself past the point of composure on the first try, ask your child if they’d like to do the test quickly or go home and come again (this is where the non-essential or practice exposure helps), and if you need to, return to your book, playthings, and offers of choice (“Some kids find it kind of overwhelming to go with their whole family, do you want just one person to take you next time?”).
Will this work for your 3-year-old? Maybe not in exactly the same way, but it’s sure as hell less painful than the straitjacket approach. Will it work for your 2- or 8-year-old? It just might! Kids of all ages just want to be told the truth (minus the most horrifying details), allowed to work things out in their own language (usually play), given agency, and given opportunities for success. And in the end, isn’t that all anyone wants?
Happy holidays and happy testing.