Healthcare improves when children get to have their say

Every year, healthcare professionals meet thousands of children who need support or treatment, and for many, healthcare is a recurring part of life. But despite good intentions, many healthcare encounters are still shaped by adults’ ways of seeing and thinking.

“If children had more tools and more ways to influence their care, it would strengthen their participation, well-being and independence. I wanted to both address the lack of such tools and highlight the norms that often stand in the way of children being able to make their voices heard”, says Britta Teleman, who recently defended her thesis at Halmstad University.

When norms shape the healthcare encounter

In her thesis, Britta Teleman analyses how norms – both in healthcare and in the technologies used – affect children’s opportunities to express themselves. The research, which has involved healthcare providers in different regions, shows that adults often interpret barriers to participation as something that lies with the child, while children and young people themselves point to environmental and situational factors as equally important.

In five studies, Britta Teleman has investigated what happens when tools and methods are instead developed to challenge the norms that limit children’s participation.

“My focus has been to shift the perspective: How can we as adults back off a bit, listen more and create space for children to express themselves in their own way?”

Design that makes a difference

One of the studies – a scoping review – shows that research and design that use norm-critical approaches often have higher levels of participation. When the children’s perspectives influence the results or solutions, the likelihood that they will actually work in practice increases.

Another study followed an app for children in healthcare that Britta Teleman herself has been involved in developing, together with colleagues at Halmstad University and in collaboration with Region Skåne. The app offered the children new ways to describe how they feel and what they think – something that changed the dynamics of the meeting.

“The staff immediately saw more opportunities to include children who had not previously spoken very much. Parents became more passive because the children themselves could control the app. And important information, which otherwise risked disappearing, came to light”, says Britta Teleman.

The thesis shows that norm-critical design can contribute to change in four ways:

• Redirecting the gaze – by getting adults to look beyond biomedical explanations and understand social and technological barriers.

• Nudging – through tools that make participation easier and more attractive for both children and staff.

• Disrupting gatekeeping – by giving children control over information and communication.

• Increasing accessibility and choice – by offering alternative ways for children to express themselves, participate and influence.

Strengthens children’s independence

Increasing participation early on has an impact far beyond healthcare. Learning to influence counteracts marginalisation for this group of children because it strengthens their independence – something that benefits both the individual and society.

“Norm-critical design has great potential in healthcare. When we address norms, lift children’s voices and take their rights and experiences seriously, we can create better care and greater opportunities for children to develop and thrive”, says Britta Teleman.

Text: Lovisa Essunger
Photo: Dan Bergmark