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Taking the fear out of medical tests

Magnetic resonance imaging (MRI) provides a safe and effective way to study brain activity — and offers considerable potential for understanding how the brain develops throughout childhood.

“Unfortunately, young children are often excluded from MRI research and its benefits because research ethics boards are concerned about the potential psychological risks,” says Dr. Krisztina Malisza of NRC. “Ethics boards are worried that kids might be pushed into situations that make them frightened or uncomfortable.”

Researchers and ethics boards both require data about how probable these risks are before they can judge whether children should be allowed to participate in a study, and how large a sample size would be needed for the results to be valid.

To address these concerns, Dr. Malisza and colleagues in Halifax and Winnipeg are studying how children react to an MRI environment. Their goals are to find out what proportion of children are afraid of having an MRI scan, so researchers will know how many children are needed to conduct a successful study. The team is also exploring ways to reassure children that an MRI is neither painful nor scary.

The study involves showing healthy two to seven-year-old children a real MRI, and then slowly inviting them to go inside the device. “If a child says: ‘I don’t want to go near the magnet,’ or ‘I don’t even want to go inside the room,’ the study stops,” says Dr. Malisza. “These are the points where we need to focus our efforts to teach kids how to overcome their fears.”

To help overcome children’s anxiety, NRC built a pretend MRI, consisting of a wooden frame covered with canvas and a large plastic tube. The mock MRI is completely safe and does not contain a magnet. Children who don’t want to enter a real MRI are invited to go into the mock scanner, where they are gradually exposed to a virtual MRI experience.

The researchers have found that about 50 percent of kids between two and five years of age are initially afraid of entering an MRI, versus about 35 percent of six and seven year olds. However, gradual exposure to a mock scanner appears to help many kids lose their fear of a real MRI. The techniques they learn in the mock scanner can be applied to many everyday situations to help children overcome fear and anxiety in new settings. End