Is Your Child Faking Illness?
By Teri Cettina
My youngest daughter has long been a frequent visitor to the school nurse (tummy aches) and to the first-aid box in our hall closet for invisible cuts. If a little friend comes down with an intriguing ailment (walking pneumonia was the latest one), my daughter is likely to limp dramatically and claim that she has it too.
It turns out, many kids go through a “hypochondria” phase around age five or six—just as they’re getting used to being in school full-time and separating a bit more from mom and dad, says Michelle Macias, MD, a developmental behavioral pediatrician at the Medical University of South Carolina in Charleston. This period of time is a major transition, she explains, and anxiety often peaks and reveals itself in symptoms like a suddenly sour stomach and mysterious headaches. “Many kids this age can’t express uncomfortable feelings in words, so they express them through their behavior by ‘feeling sick,’” says Dr. Macias. (Fortunately, few kids are true hypochondriacs, which is actually a clinical term for a much more serious disorder.)
How do you separate real health crises from imagined ones? And should you offer your dramatic limper and bandage-collector extra hugs—or a blind eye? Try these triage tips from the experts.
Your child is a veritable boy crying wolf. So much so that you’re concerned you’ll miss the clues when he actually is sick.
Treatment Plan: If your child is really ill, you will know, says Dr. Macias. He’ll have clear symptoms (like fever or vomiting), won’t be interested in doing his favorite activities, or will just look “off” to you. Because of COVID if your child has iffy symptoms it’s better to just keep them home until you can rule out COVID with a test. If the doctor can’t find anything wrong, you might send along a note to your child’s teacher or the school nurse so they’ll be on the lookout for possible problems and can help you assess the situation.
When you let them stay home, don’t make the day too pleasant, says Penny Donnenfeld, PhD, a private-practice psychologist in New York. “If sick days are too much fun, your child might angle for more of them.”
When your kid hears someone is sick, he’s convinced he’s next. In general, he’s an all around germaphobe. He even frets about “catching” cancer.
Treatment Plan: This behavior may be a sign of anxiety, says Dr. Donnenfeld. It’s likely that your child is becoming more aware of “bad things” that happen in the world and may go through fearful stages. Education and reassurance can help. If someone you know has cancer, for instance, talk about how people get sick and why he can’t catch certain diseases. Stress that if he were ever truly sick, you would take him to the doctor.
Also, consider how you would handle health issues: Do you nervously whip out the antibacterial gel when your child’s hands are even slightly dirty? Do you often talk about the dangers of the flu or whatever is in the headlines lately? You could be transmitting a “health problems are terrifying” message. “If your child’s worry persists for more than a few weeks, see your pediatrician,” says Dr. Macias. “He may need to learn self-soothing techniques (see ‘Less Stress, Less Sickness,’ above) or, if he has more persistent and significant worries, even get short-term counseling.”
There’s no chance your kid is sick. Why is she faking it?
Treatment Plan: Actually, she’s probably not. A stomachache or a headache may be triggered by your child anticipating something she finds stressful. Young kids don’t always realize or can’t verbalize that they are worried about an intimidating schoolmate or a sibling who’s getting more attention, explains Dr. Donnenfeld. Instead, they’ll simply “feel sick.” A good way to sleuth out what’s bugging your child is to play the “High-Low” game. Every day, each family member shares both a good (high) and not-so-good (low) moment from his/her day. You’ll get clues about what’s worrying your child. Also, be sure to keep in touch with your child’s teacher or the school nurse. These pros may have insights about her friendships, schoolwork, and what’s happening on the playground.
Your child actually is hurt or sick, but the excessive antics (non-stop sobbing, pleas for new band-aids, and expectation of special treatment) are driving you nuts and it’s becoming way too hard to manage all the whining, complaints, and requests.
Treatment Plan: “Children like this usually just want you to acknowledge that they’re feeling pain,” says Sandi Delack, RN, president of the National Association of School nurses. Saying, “Wow, that really hurt.” and giving your child a kiss on the injured spot says, “I care what happens to you.” But once you know that she’s absolutely fine, shift the focus to admiring her abilities, and do your best to ignore the ongoing dramatics.
If your child regularly begs for extra bandages or an arm sling, briefly indulge her fantasy with a silly “what-if” discussion: “If your arm was in a sling, would your teacher or the principal have to carry your cafeteria lunch tray for you? How funny that would be!” This kind of imaginary talk will help get the “want” out of your child’s system. #