Where do children learn about pain? The role of caregiver responses to preschoolers' pain experience within natural settings

The preschool period is a critical stage of emotional and social development for young children (0–5 years), and socialisation methods are instrumental learning tools for the child's development during this stage. Pain experiences are common during the preschool period, including minor medical procedures (eg, immunisations), unintentional childhood injuries (eg, burns, shocks, and poisoning), and “everyday” incidents which lead to minor bumps, scrapes, and cuts. Consequently, the biopsychosocial model of pain, derived partly from social learning theory, is relevant to paediatric pain, as children's coping strategies may be inadequate, relying primarily on caregivers to interpret their distress. Furthermore, childhood pain experiences are influenced both by who is present and the responses exhibited by those present. Social learning and imitation provide a valuable source of information and children may learn how to respond to pain by observing others; eg, watching their parents respond to pain. However, this developmental period presents a unique context for pain: children have less refined motor skills, the risk of everyday pains and injuries is high, and the presence of caregivers provides opportunities to observe social influences during everyday painful moments. Given the frequency of minor pain events and their potential role in teaching children about pain management, the aims of this topical review are to (1) provide a critical reflection on the limited literature on “everyday” child pain experiences and the role of caregiver behaviour within natural contexts and (2) set out a research agenda, calling for innovative, and multimethod approaches to foster further research in this area