The Teacher's Story

“What a beautiful spring day it is! Are we all ready to go outside on a nature hunt?” I asked, feeling more than ready to head outside myself. Our 3- to 4-year-olds responded in unison “YEESSSS!” All of them, that is, except one. Looking pale, Kevin seemed to be hugging himself. “My tummy hurts again,” he whispered. I immediately signaled to the aide, who walked Kevin to the nurse. For the past several weeks, the 3-year-old frequently complains about tummy aches, especially during transitions. Of course, we notify his parents each time, and they’ve even consulted their pediatrician. We’re all concerned, but no physical cause can be found. All I can say is, this certainly isn’t the Kevin we knew at the beginning of the year. Until his tummy aches began, he was a delightful child, eager to try any new activity. He has several special friends and gets along well with everyone. For some time, Kevin was excited about the fact that his mommy would be having twins after the end of the school year. However, the babies arrived early, about a month ago. And they are still in the hospital, too small to be discharged. Kevin’s frequent tummy aches began not long after the birth. Since then, he seems to have lost interest in school. On some days, he rests on a cot for as much as an hour. If rubbing his head and giving him sips of ginger ale doesn’t help, one of Kevin’s parents or grandparents picks him up. It’s awful to see him suffer. What more can we do to help?
 
The Parents’ Story
 
It’s a very difficult time for the whole family. His baby brother and sister both weighed less than two pounds at birth. It was an emergency cesarean because little Jimmy was in distress. Both Jimmy and Jodie are still in the neonatal intensive care unit. I admit I have been so stressed that I don’t always give Kevin the attention he deserves. He is still not allowed to visit the babies, but I go several times a day, at least once with my husband. We’ve taken photos of the babies to show Kevin, which may have caused more harm than good. Soon after he saw the first pictures of his sister and brother all wired up to machines, he got his first bad stomachache. He seems to get another one each time we leave him to go to the hospital or a baby-sitter appears. The doctor assures us that there is nothing physically wrong with Kevin, and that he’ll be fine when the stress eases. It could be weeks before the babies are cleared to come home, and that won’t be any picnic for our 3-year-old either. What can I do to help Kevin feel better?
 
Dr. Brodkin’s Assessment
 
Stomach aches and other somatic complaints without any apparent physical explanation are common among young children experiencing stress. Nevertheless, it is essential to rule out every possible medical cause and not assume that a child’s very real pain is entirely psychological in origin. Be thorough before concluding that a child in Kevin’s situation is feeling sick because his parents’ attention is focused on his fragile baby brother and sister.
 
What the Teacher Can Do
 
Once the school nurse has spoken with the parents and, with their permission, with the doctor who confirms that there is no physical explanation for Kevin’s complaints, the teacher’s role entails being gentle and sympathetic to Kevin. The teacher should redirect the child’s attention to happier things. Consider what used to be Kevin’s favorite activities and who his special friends were. Carefully choose a moment to try to entice him to join in with those good friends.
 
Encourage one-on-one playtime with the teacher or another staff member whom Kevin trusts. One possibility might be to focus on the dramatic-play area, allowing Kevin to reenact some of his troubled feelings. However, Kevin may elect instead to play out dramas that have no apparent connection with his current concerns. And that is just fine, too.
 
What the Parents Can Do
 
Kevin’s parents are going through rough times and deserve support. The intensive care unit staff at the hospital or their doctor may guide them to someone trained to work with parents in their situation. Other family members may be called on now and then to help with Kevin. With time and steady support, Kevin and his family will weather this storm.