Allergy Testing in the Pediatric Specialty Clinic

Allergy testing may be done during your child's clinic visit.

We believe it is important to know what your child may be experiencing in order that you and your child are better able to prepare for the visit. As a parent you are best able to choose the most appropriate way to inform your child. In general, most children can be told 1-2 days before the visit. If your child is an anxious child or a very young child, you may want to wait until the day of or until shortly before the start of the procedure.

Be honest about the day's destination and purpose, and assure your child that you will be with him/her throughout the testing.

Why perform allergy testing?

An allergy test helps to identify things in your environment that may be causing your child's symptoms and enable the doctors to decide what type of medications, if any, may be needed to treat your child's condition. By identifying these things, changes can be made in your living space to potentially improve your child's health. For instance, if the test identifies your child is allergic to feathers; feather pillows could be replaced with a different type of pillow.

What happens during allergy testing?

The most common types of allergy tests used in our clinic are the puncture and intradermal allergy tests. Your child's physician will decide which type of testing will be used. In many cases, both types are combined to provide the most useful information.

* Puncture allergy testing:

A child having this test will be asked to remove his/her shirt and lie on his/her stomach while the test is applied on the back. A nurse will write letters on the child's back with an ink pen to label the areas where the test will be applied. The area is then cleaned. Drops of an allergen solution are placed on the spokes of a plastic test applicator. An allergen is a thing in your child's environment that may cause an allergic reaction. The applicator is then pressed on the child's back. Patients have described this sensation as feeling "like a hair brush being pressed on their back". Once the test is placed, each test location will have a drop of wet liquid. The patient will then be asked to lie very still for approximately 15 minutes to keep the drops of liquid from running together. This is important to keep the drops of different allergens from running together. Children may be tested for as many as 30 environmental allergens during this test. (The number could be higher if the child is being screened for food allergies in addition to the environmental allergens if food allergy testing is necessary. Individual cases vary at the discretion of the physician).

* Intradermal allergy testing:

A child having this test will be asked to remove his/her shirt, and sit upright as the test is applied to the upper arms. (If you are comfortable doing so, the child may sit on a parent's lap during the test application).

A nurse will write letters on the child's arms with an ink pen to label the areas where the test will be applied. The area is then cleaned. Small amounts of allergen are injected with a small needle syringe just below the surface of the skin. A child having this test can be tested for up to 14 allergens, each requiring individual injections.

A small reaction (similar to a mosquito bite) will appear within approximately 15 minutes if the test is positive. To be sure the test is effective, a control solution (histamine) will be applied. A positive reaction at this test site indicates the test is accurate.

A nurse will measure areas of reaction with a small ruler after test time has elapsed. Your child may experience some mild discomfort with "itching" from the testing. Applying a cool wet cloth following the reading of the test often relieves this discomfort.

What do I say if my child wants to know if allergy testing will hurt?

Each child is different in his/her ability to tolerate pain or discomfort. It is important to let your child know that they will probably experience some discomfort-especially during the intradermal testing. It is very important to be honest in answering their questions. Be honest about medical events at all costs. A child who has been deceived may lose trust with the medical team, and with you as a parent. Trust is a very difficult thing to rebuild. Finding out that testing is necessary may lead to some tears at the time of the discussion, but in the long run is healthier for your child's ability to cope.

If you would like further assistance in explaining outpatient medical events to your child, please contact Child Life at (319) 356-8904. Child Life Specialists are trained to help children and their families adjust to the medical setting.