Distraction for Pain Management in Young Children: Understanding the Role of Selective Attention and Development

Distraction has been shown to successfully decrease pain and behavioral distress in children experiencing invasive medical procedures and to increase children's pain tolerance during experimental pain exposure. Considering that attention plays an integral role in engaging in distraction, it is likely that developmental differences in selective attention skills, including inhibition and set shifting skills, influence children's differential response to interactive and passive distraction. Sixty-five 3- to 6- year old children were recruited to participate in this study. Children underwent three cold pressor trials: while receiving no intervention, playing a videogame or watching a videogame. Parents completed questionnaires and children completed a subscale from the NEPSY. The results of this study support the utility of distraction as a pain management technique for preschool and young school aged children. Both younger and older children benefited more from interactive distraction than passive distraction. Although older children demonstrated superior pain tolerance overall, age and selective attention skills did not moderate children's responses to the videogame distraction intervention. This lack of moderation may reflect the fact that the distraction task used in this study was carefully selected to be developmentally appropriate for preschoolers. Developmental issues may be more crucial moderators of children's responses to distraction when the task demands of the distraction intervention are more challenging--e.g., when the distraction task itself is more difficult or when the competing environmental pain stimuli are more intense or distressing