Connecting With Child Callers

*To take the corresponding CDE quiz, visit the College of Emergency Dispatch.*

Perhaps in the middle of a routine shift, you encounter an unexpectedly young voice on the line. You hear fumbling hesitation, a rustling echo, and audible breaths as you repeat, “What’s the address of the emergency?” You await their small reply: “I … I don’t know.” Rapidly, your mind begins accessing what you know about dealing with child callers, hoping to help both of you through whatever is happening on the other end.

You may feel a bit nervous, but experience shows that child callers typically aren’t. At least, they often act calmer than adults four or five times their age. Perhaps this is due to not fully appreciating the gravity of the situation they are facing. Or perhaps they are relieved that a trusted adult will now take over. Matching that energy with a light, clear tone creates a trusting foundation for the child to keep talking and for the Emergency Dispatcher to keep listening.

Caller considerations
Your first inclination may be to ask to speak to an adult, if possible. However, often a child is calling because a caregiver has become unconscious or incapacitated. This was the case for a four-year-old girl whose mother fell unresponsive in their Franklin Township, New Jersey (USA), home. While calmly reporting, “My mommy fell down and she can’t talk,” the girl stayed on the line while watching over her three younger siblings, a 2-year-old sister and 1-year-old twin brothers, until help arrived.¹

Sometimes older children are alone when an emergency occurs, like 9- and 10-year-old siblings who called 911 while hiding in the bathtub to report an armed intruder burglarizing their Tarrant, Alabama (USA), home, leading to the suspect’s apprehension.²

Adults may also rely on children to act as a translator in the face of a language barrier, like an 8-year-old Avon, Indiana (USA), girl whose mother asked her to call 911 on behalf of her older brother who was experiencing a medical episode, ultimately saving his life.³ 

Child callers sometimes call a parent or relative before 911, which may result in a frantic call from an adult who is removed from the scene but emotionally invested. Parents may encourage the child to hang up and call 911 or ask the Emergency Dispatcher to dial the child. In any case, actively listening to get a feel for the situation may aid your decision of whether to ask to speak with an adult or remain focused on the child caller.

Protocol clarification and emotional cooperation 
When an adult is not present (or not the best option), it’s best to move forward while keeping the conversation on the child’s level.⁴ But what do you do with the Priority Dispatch System^™ interrogation if you doubt a child could answer the protocol questions as they are written?

As is the case with any caller who may not initially understand, the Emergency Dispatcher should first ask the questions and instruct callers with the verbiage provided, then clarify as needed to meet the child on their level of understanding.

For very young children, the level of comprehension may depend greatly on their age and their grasp of what is happening around them. You may need to decipher what is meant by a child’s description, such as a report that “Grandma might be ‘dead’ or might be ‘lying’ … she’s ‘fake sleeping.’” A young child may not know how to check for breathing, so you may need to add details to instructions like “Look at her chest and watch to see if it’s going up and down.” 

A child’s emotional state is another influence that affects their ability to listen and communicate. Though they may behave calmly, they may be scared or confused by the event. Do they feel stuck or overwhelmed, not knowing what to do next? 

If possible, use the child’s name to connect with and direct them. Then reassure the child of the importance of their role to keep them focused on the task and set the tone for the rest of the call. “I want to help you help your [loved one]. Let’s do this together as a team. I’m going to ask you some questions, but it’s OK if you don’t know every answer.”

Obtaining address information and utilizing creativity 
It’s sometimes possible to use technology such as ANI/ALI information or GPS coordinates to trace a caller’s contact information and location, but if that’s unavailable, it may be difficult to ask a young child to provide or verify these details, especially if they are in an unfamiliar place.

These details are essential for the Emergency Dispatcher to send help, but it can feel frustrating to sense the urgency of the situation with no known address to send responders. If the child doesn’t initially know how to describe where they are, reassure them that it’s OK so they can try their best with a different approach. 

You may need to provide the child with options, such as, “Are you in a house?” If so, you may ask, “Are you at your house/your grandma’s house/a friend or neighbor’s house?” 

Suggesting that a child read an address from a piece of mail or from the outside house number can be a great solution, but keep in mind that it can also create confusion if the child reads the numbers in the wrong order (right to left, bottom to top) or reads the wrong address (return address or non-address information).⁵ 

The child may also provide their memorized home address without considering that they are in another location. Or perhaps they are in the car after a driver has passed out from a medical event or at a playground with no other people around. In these cases, the Emergency Dispatcher becomes a description detective, asking the child to name landmarks around them (like schools, stores, restaurants, or playgrounds).

In one situation described in the Principles of EMD textbook, a 2.5-yearold child called 911 because the babysitter was unconscious and bleeding from the head. The emergency dispatcher worked with the child for 20 minutes before discovering the address.⁶ 

Without a doubt, patience, creativity, and reassurance are vital in this complex teamwork, especially when lives are on the line.

Establishing background and assessing priority 
Sometimes children don’t have a background on the type of emergency they’re experiencing. For instance, they may say that “the house smells funny” because they’ve never smelled natural gas before. They may also skip giving any background information, saying simply, “Jane is not waking up,” with no concept of who this person is in relation to the caller (family member, babysitter, or neighbor) or why she is in this state (exhaustion, overdose, or medical episode).

Similarly, young children often have very little concept of age in numbers, so you may have to provide a descriptive range like “old vs. young” or “grandparent vs. teenager” to gain a clearer picture. The child’s uncertainty often shows in their language and tone, nearly asking the Emergency Dispatcher if what they’re seeing is correct: “It’s almost, like maybe he’s turning blue?”

As with all callers, avoid judging, questioning, or doubting a child’s observations. A child saying “He can’t hardly breathe” is considered an emergency, just as if an adult were reporting a breathing difficulty. In fact, according to Principles of EMD, “It may be justifiable to select a higher level of response if key information is missing. In some instances, a DELTA-level response may be warranted as an ‘unknown’ default when the nature of the information requested is of life-threatening importance.” (Always err in the direction of patient safety.)⁷

Trusting child callers with protocol instructions
Anyone who has spent much time with children knows that they end activities on their own terms, whether it’s abandoning a half-eaten snack or closing the book in your hands because it’s cartwheel time.

With that spirit and stamina in mind, remember to use repetitive persistence to instruct the child to “Stay on the line with me and keep talking so that we can help [the person].” Keeping young children focused not only helps with the needs at the scene, but it also provides some reassurance of the child’s safety while otherwise unsupervised.

With today’s cellphone use, it’s possible for the child to take the phone with them, keeping the line open, while carrying out whatever tasks the Emergency Dispatcher asks them to do (like checking to see if their loved one is breathing).

Trusting older children with Pre-Arrival Instructions (PAIs) such as CPR could be lifesaving, and even young children can get a clean towel to help with an unexpected baby delivery. Don’t assume that children can’t handle responsibilities because of their age. What children lack in life experience does not detract from their ability to help, especially when a committed, confident Emergency Dispatcher is guiding them.

Giving child callers even seemingly small Post-Dispatch Instructions (like putting away pets, turning on lights, or watching for responders) helps them feel prepared, valued, and focused on something they can control in a situation very outside of their control. Just like adults, children need to feel useful and trusted.

Supporting the child caller
While carrying out these instructions, children may feel the heaviness of the emergency. One 7-year-old boy in Miami, Florida (USA), knew to call 911 when he observed his mother having a seizure, but he shared his deepest fears during the call, crying, “I don’t want my mommy to die.”⁸ In her recovery, his mother called her cherished son her hero, though Emergency Dispatchers know that not every event ends so happily.

While meeting the heartfelt fears of children facing their hardest moments, you have a critical role to help them understand that the situation is not their fault, regardless of the outcome.

You might say, “You’ve done all the right things. You’re a great teammate.” However, be careful not to make promises like “Don’t worry. Your little sister is going to be OK.” Instead, bolster the caller’s confidence by saying, “I can feel how much you care, and I’m with you. Just keep going.”

When everything pertinent has been handled and you await responders’ arrival, you may encourage the child to keep talking about routine topics (their school class or favorite activities) to provide a sense of familiarity through the chaos. As a newly formed friend and their calm in the storm, the Emergency Dispatcher should stay on the line with the child until the promised help arrives.

Conclusion
Children often prove themselves incredibly capable in the face of emergency situations, but it’s helpful to understand how to best guide them through the unexpected. For more information on how to prepare children to use 911, see our accompanying tips. 
 

Sources 
1. Bernabe AJ. “4-year-old being called a hero for calling 911 and saving her mom's life.” Good Morning America. 2019; Dec. 19. goodmorningamerica.com/family/story/year-called-hero-calling-911-saving-moms-life-67817056 (accessed Dec. 3, 2024). 
2. Jacobo J, Katz R. “‘Can you please hurry up?': 9-year-old hides in bathroom, calls 911 to report home invasion.” ABC News. 2018; Dec. 20. https://abcnews.go.com/US/hurry-year-hides-bathroom-calls-911-report-home/story?id=59937454 (accessed Dec. 3, 2024). 
3. Glaros G. “Avon honors 9-year-old with hero award for 911 call.” WTHR. 2022; March 11. wthr.com/article/life/heartwarming/avon-honors-9-year-old-girl-with-hero-award-for-911-call/531-6ca81d07-350f-4919-9c8f-f61a2d041ba9 (accessed Dec. 3, 2024). 
4. Clawson JJ, Dernocoeur KB, Murray C. Principles of Emergency Medical Dispatch. Fifth Edition. International Academies of Emergency Dispatch; Salt Lake City. 2014. 
5. See note 4. 
6. See note 4. 
7. See note 4. 
8. “7-Year-Old Hero Saves Mom's Life By Calling 911.” CBS News Miami. 2021; Nov. 18. cbsnews.com/miami/news/7-year-old-hero-saves-moms-life-by-calling-911 (accessed Jan. 16, 2025).