Offering praise and rewards such as a sticker calendar or little treats or prizes, reinforces skill development. As in the older child, privacy is important for pre-school children so emptying the pouch should take place with that in mind.
In this age group, changing the appliance is still accomplished by the caretaker. However, the child can assist by helping to remove the appliance and by handing supplies to the caretakers. Using flashcards for appliance changes can help the child learn the steps. The caretaker can then interact and query the child for “Next step…?”
Occasionally children in this age group may still have some anxiety regarding their stoma and this is most notably seen during appliance changes. Again, using “medical play” with dolls, models, and books can be helpful in getting the child to relax and ultimately adapt. If anxiety is still at a high level, then distraction techniques with games, videos or interactive toys can be used to support the child through appliance changes.