As a Child Life Specialist, I often joke about the proverbial “toolkit” that I always seem to have ready in my mind when I work with children. In it, there are a variety of ideas, books, toys, and other items that I have used in the past that can benefit children as they go through painful procedures or times in the hospital that are particularly stressful. One of my best “tools” in this kit of mine is distraction.
Distraction is simply exactly what it sounds like—utilizing age appropriate items to provide an alternate focus for the patient. Like adults, children do have particular coping styles that they utilize during times of stress. The two most common types of coping styles are active and passive/or avoidant. Distraction can be a very useful tool to complement children utilizing either of these coping styles.
For example, iPads are very commonly used these days for children to watch movies or play some of their favorite games during procedures, but I also tend to favor good old fashioned I Spy books, bubbles, distraction wands, and music, just to name a few. I often encourage families to bring items from home that can not only aid in distraction, but in comforting the child as well.
Make no mistake about it—I don’t use distraction as a way to help children avoid the situation—unless that is what they need. I tend to think of distraction as another form of positive coping. Distraction allows a child to make a choice, and during a time of stress, that alone can be an empowering experience. The capability to simply choose how to cope—and have that respected—can give some control back to a child during a time they may feel particularly helpless.
Children who are active copers are information seekers. They seem to benefit with a great deal of information for them to process in developmentally appropriate ways. These kids are likely to ask multiple questions and often, much to their parents’ dismay, want to watch when a procedure occurs. Both of these actions—with appropriate boundaries and structure in place around them—are typical of children who are active copers. Even still, having distraction items available is important in case the child changes his or her focus and wishes to take a break from the active participation. Distraction remains a choice for the child to embrace.
Passive or Avoidant Copers may resemble the ‘less we know, the better’ type. Information, in fact, may raise their anxiety. They often don’t ask questions and may even shut down a Child Life Specialist’s attempt at preparation. Many times, passive/avoidant copers may appear not to be coping well with stress at all, when in fact, they are just not directly or verbally. Passive/avoidant copers may engage in distraction very easily, as it provides an alternate place for their mind to wander instead of focusing on what is occurring around them. As with their actively coping counterparts, sometimes avoidant copers do decide that they do want to know what is occurring around them, but still keep the distraction items close by.
Being mindful of these alternate coping styles is just as important for families to notice as it is for medical professionals that are supporting them. Parents sometimes experience challenges if their child copes differently than they do. For example, I frequently see children actively trying to watch a procedure and the parent is trying to turn their face away because it makes the parent uncomfortable to watch. While it can be sometimes unsettling to realize that the child does in fact want to see something that may turn Mom or Dad’s stomach, the child is actually teaching their family about the type of coper that they are, and that can be valuable information for many life situations going forward. Noticing and respecting a child’s coping style, while having the personalized distraction aids that the child can choose for themselves, can provide comfort for everyone in the family.