Child-First Language in Pediatric Care

By Tina Allen, LMT, CPMMT, CPMT, CIMT

Child-First Language in Pediatric Care

By Tina Allen, LMT, CPMMT, CPMT, CIMT

There are many times when a parent or health care provider contacts my office seeking advice on how to use pediatric massage therapy to best care for a child. They quickly introduce themselves and then proceed to run through information about the child's diagnosis, what the diagnosis entails and even specifically refer to the child by their diagnosis. They never actually tell us anything about the child's unique situation.

Throughout the world, children with a diagnosis or a different ability are among the most marginalized children in the world. It is quite common that they are the least likely to go to school or be educated, and are the most vulnerable to neglect and abuse. Due to their unique presentation, they are often the target of discrimination, exclusion and stigmatization.

Refer to the child first, not their diagnosis

It is especially important that we refer to the child first, as the way we speak about a child may greatly influence the way they feel about themselves, and change their self-belief and self-worth. Child-first language is a philosophy of identifying the individual child prior to their disability or diagnosis.

A diagnosis does not define the child, nor does it give us a clear plan of action when it comes to pediatric massage therapy treatment. Every child should be first referred to, and thought of as a child. The diagnosis can absolutely give us some information and lead us onto an assessment pathway of asking clear questions, but it does not tell us all that we need to know to make a quality treatment plan.

First, we must understand about the child, how they are feeling, why we are being asked to consider a massage therapy treatment plan, and what benefit the family or health care provider is seeking.

Unique Presentation and Considerations

There are times when I have been asked, "Can you just tell me how to provide massage for a child with autism?" My answer is always "No, not in a few minutes." This is because there is not one way to provide a massage in relation to the diagnosis of autism.

Each child is unique and has specific concerns, or reasons why massage may be beneficial. We are not providing massage therapy to "cure" or "treat" autism, but rather to help with symptom management and approaches that would be the best for each individual client or patient.

Each time we provide care for a child, we have to allow for flexibility. Flexibility to change our communication, approach and even the pediatric massage therapy techniques we are using to find the best method to treat the child.

Once we meet a child we must perform a thorough assessment of their unique presentation, behavior and mobility. In our health care intake, we should also discuss and ascertain, to our best ability, the child's tactile preferences and any sensory considerations.

We must research and understand their specific diagnosis and any extra care, precautions or contraindications. Medication and past medical history should be included, alongside a full, current healthcare intake.

Child with Autism or "Autistic" Child?

There is an ongoing conversation in relation to referencing a person with autism, as a child with autism compared to an "autistic" child. Within the autism community, there are many who prefer to advocate for their self-identity and would prefer if others embraced the terminology  "autistic" or "autistic person."

However, these self-identifying individuals are grown adults who have the ability to decide for themselves, and may inform others as to how they wish to be identified. When it comes to children, many parents and healthcare professionals use, and prefer, the terminology and reference as a "child with autism."

This is the concept behind child-first language: allowing for a child to develop their own identity without considering autism as the main defining factor to the child's identity. The preference for children is to see a child first, not their diagnosis.