Synergy in Child Neurology: Science, Collaboration, and Leadership - The 2024 Hower Award Lecture.

Effective communication in pediatric urology is fundamental to the diagnostic process and therapeutic adherence. Diagnosing urological conditions requires gathering information based on reports of elimination and lifestyle habits, such as urinary and fecal frequency, physical aspects of urine and feces eliminated, urinary stream, elimination behaviors (delaying urination and/or defecation, holding maneuvers), dietary and fluid habits, among others. Both diagnosis and treatment are based on the child’s and family’s reports. Therapeutic adherence involves self-management strategies implemented by the child and family, supported by a specialized professional, with communication being a constant mediator in this process. Regarding therapeutic options, standard urotherapy stands out as a first-line treatment for functional disorders, such as lower urinary tract dysfunctions. Composed of five components, standard urotherapy includes information and demystification, modification of voiding and bowel habits, lifestyle counseling, recording of symptoms and voiding habits, and finally, support and encouragement. In this context, even with the possibility of gathering information from primary caregivers, children are an excellent source of health information, requiring communication strategies adapted to their age group. Giving children an active voice within healthcare settings is challenging and rarely implemented. In an analysis conducted, children between 5 and 11 years old mostly stated that professionals did not even introduce themselves before starting care in an inpatient setting, and 72.70% of this age group reported not understanding the health information provided, reflecting an inadequate communication strategy for this age group. This type of professional conduct restricts the children’s right to be informed about their health in appropriate language and to have their doubts and fears addressed by a healthcare professional. Communication with children requires multiple factors to be clear and effective. Professionals’ communication skills, caregivers’ involvement in the exchange of information, and the use of communication strategies that adapt the message to recipients’ cognitive development level are examples of fundamental elements for successful communication between professional and child. In this context, it is observed that healthcare professionals need internal skills and communication tools for effective interaction. Communication skills begin during professional training and are honed through practice, while tools are often developed on-the-job and end up being restricted to the workplace.