Dispensing for children can be a challenging – and equally rewarding – part of the job. ACOD trainer ELIZABETH CASSIDY outlines where extra care is required for these patients.
Paediatric patients require certain dispensing techniques and a different approach for their little faces. But too often they are treated the same as adults, resulting in inappropriate outcomes. In this two-part series, I’ll reiterate the importance of paying extra attention with this group.
Communicating
The way you approach a paediatric dispense will set the tone. It’s important to include the child in the discussions and speak in a way they understand. Squat or kneel at eye level, use eye contact and body language so the child feels at ease.
It’s common to be treading a fine line communicating with both the child and guardian. Normally, their needs and wants differ. For example, it’s more likely the child will be more concerned with the colour, shape and brand while the parent may be looking more at functionality, cost and warranties. Prioritising what’s most important can be tricky, but remember a child won’t wear uncomfortable glasses, or specs they don’t like.
In addition, you may come across dominant parents. If they use phrases such as: “Mum and dad are the ones that need to like the frame as we are the ones looking at you”, or “we are the ones paying for it, you have to wear it”, then you may need to have a quiet word reminding them of the need for the child to be involved and happy with the final choice. We want to remain respectful and professional when doing this, ensuring the parents are on board, and not contradicting them in front of the child.
Frames
It pays to be mindful of a few points when choosing frames specifically for kids.
Firstly, if it’s their first pair, they may still be processing the news and react in several ways. Some older children or teens may see specs as an accessory in today’s culture, but others may understandably be upset and anxious about being teased. We need to avoid negative stigma around glasses and try and make the process fun and enjoyable, keeping in mind it may simply take time for them to come to terms with it.
For first-time wearers, it’s likely they won’t have a strong preconceived idea about their image. Therefore, encourage trying on what fits them, allowing them to experience a range of styles. We can use phrases like: “that looks cool” or “does this go in the good pile or the bad pile?”. Use relatable and age-appropriate language.
Specifically, the frame fit for children requires utmost attention. It’s important not only that the frame can support the lenses and prescription, but that it’s comfortable. A child won’t want to wear a frame otherwise.
In years gone by, kids frames were simply small adult frames. Today, we have frames much more appropriate to children’s faces. Remember their anatomy is still growing. Younger children will not have a developed bridge. That means we want frames with low crest heights, larger frontal angle, larger splay and flatter pantoscopic angle. Often we will require nose pads, or some ability in adjusting the bridge.
The temples should also be paid special attention. An inappropriate dispense occurs when a frame is chosen where the temple tip is behind the ear, and the metal part of the arm is sitting on the child’s ear. This would be difficult to adjust, and cause pain, discomfort and slipping of the frame. A good frame characteristic would be the ability to shorten the temple tips.
Durability is an important factor for paediatric dispenses too such as spring hinges. Most frames for children are typically a metal frame. We should be ensuring these meet the previous requirements, and don’t have sharp edges that could injure them if struck with a ball. Titanium or a flexible metal are the ideal metal materials for kids. Something to avoid is demonstrating the flexibility of a frame to the child. This can could encourage them to bend, and possibly break the frame.
Finally, we should not be dispensing frames that the child will “grow into”. Having wider frames means they can be knocked off, affects the lens choice, increases aberrations, thickness and weight. It also impacts the basic fit of the frame, and typically kids won’t want to wear oversized frames.
Part two of this series will cover lenses and measurements when dispensing for children, and a few pointers on how to approach collection time.
ABOUT THE AUTHOR: Elizabeth Cassidy, who started working in optics in 2015, is an optical trainer and compliance officer for the Australasian College of Optical Dispensing (ACOD). She has completed a Cert IV in optical dispensing and a Cert IV in Teaching and Assessing. She has worked at numerous practices across Australia, as a senior dispenser and training other staff.
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