When a child or young person shows discomfort by crying or shouting, it is not only distressing for them, but also parents and caregivers, as well as the staff attempting treatment. Children and young people can be helped through painful or difficult procedures using distraction therapy. This information sheet explains about distraction therapy and how it is used at Great Ormond Street Hospital (GOSH).
Distraction therapy is a way of helping a child cope with a painful or difficult procedure. It can also be used if a child is in pain or discomfort. It aims to take the child’s mind off the procedure by concentrating on something else that is happening.
There are various methods of distraction therapy - some very simple to do, and others that need more practice.
What happens before distraction therapy can start?
At GOSH, qualified hospital play specialists usually carry out distraction therapy, although any member of staff who has had training from the play specialist can do it.
Before the procedure starts, we will spend time with you and your child, to get to know your child better. We will explain the procedure, maybe using dolls, DVDs or books to explain further. It also allows us to find out if there is a particular aspect of the procedure worrying your child. Some children may be afraid of needles, whereas others are worried about anaesthetics.
We will also work with your child and the medical team to see if an element of choice can be brought into the procedure. This could including choosing which hand a blood sample is taken from or the colour of a plaster cast. Offering choice can allow a child an element of control over the situation.
It can also be helpful to plan in advance if a reward would be helpful. A reward can be something small, such as a sticker or balloon, or larger, such as an outing. Rewards can be useful for providing a focus for after the procedure and thinking about it can be a distraction in itself.
Once we know a little more about your child, we will be able to tailor the particular type of distraction therapy to your child.
Types of distraction therapy
There are many different methods of distraction therapy - some are more suitable for younger children, others work better for teenagers.
This can be used for all ages and involves the child blowing an imaginary balloon or feather up in the area. Other things can also be used, like party blowers or blowpipes. Older children might want to just concentrate on their breathing.
There are lots of different books that can be used for distraction therapy - the type depends on your child’s ages. For instance, a younger child may enjoy a pop-up book or a musical book, whereas an older child or teenager may prefer to listen to a CD.
Games and puzzles
These are suitable for all ages, but the game or puzzle will need to be appropriate for your child’s age. Younger children may prefer counting games, whereas older children or teenagers may be happier with a hand-held computer game.
Listening to or singing along with music can also be used successfully with all age groups. There are also ‘therapeutic’ music CDs available that use sounds from nature to give a calming effect.
Touch and feel toys
These are suitable for all ages and can work very effectively for children with special needs. Playing with textured toys like squashy plastic balls or their own cuddly toys can be helpful. Toys that are attractive to look at, such as kaleidoscopes, mirrors or bubbles tubes can also work well.
This can be used to distract a child from pain, for example, after surgery. Manipulating dough or slime can be very calming.
Make believe toys
These can work very well with younger children who can use them to act out a story during the procedure. For instance, hand or finger puppets, dolls, soft toys or toy cars can all be used.
Older children and teenagers may prefer to talk through the procedure as it happens, or otherwise just talk about things that interest them. By concentrating on carrying out the conversation, their mind might be distracted from the procedure itself.
Guided imagery is another distraction technique used to give the child an element of choice and control.
During the procedure
Once your child has decided which type of distraction therapy to use, we will start. During the procedure it is very important we are the only one trying to distract your child. If other people are also trying to distract your child, it will take his or her concentration away from us.
After the procedure, we will discuss with you and the team, the type of distraction therapy used and whether it has worked or not. This will be useful for planning future procedures.
What happens if distraction therapy does not work?
Distraction therapy does not work for every child. If a particular type of distraction therapy does not work for your child, we can suggest alternative types.
Some children cannot take their mind off the procedure, no matter what else is happening around them, in which case, a different approach needs to be used.
It can help to ask your child before the procedure to plan what they would like to do when it has finished. The child can then try to focus on that, for example, a trip to the shops, during the procedure, which may help take their mind off what is happening. If this method is used, it is very important your child is able to do what he or she planned, or this may make the situation worse for the next procedure.
‘Time out’, preferably away from the treatment area, will give your child a chance to calm down before trying distraction again.
How can I help?
You can help by supporting us during distraction. If you are worried about the procedure, for instance, if you are worried about needles, it can help you to focus on the distraction too. If you think you may be too upset to help, sometimes it is better that you are not in the room when the procedure is happening.
After the procedure, your child will need lots of praise. Even if he or she was still distressed, focus on one aspect that your child did well.
It also helps us if you tell us about any techniques that have worked well previously so that we can focus on these for future appointments.
Can I use distraction therapy at home?
Yes, you can. Distraction therapy can be very useful if your child needs to have treatment at home or even before visits to the dentist or other stressful events. Talk to your play specialist and watch him or her during distraction. He or she will be able to suggest ways you can incorporate distraction therapy into future hospital visits.
Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.