The impact of types of distractors on child-critical statements by a caregiver during chemotherapy injections: A case study

Although distraction is a useful strategy for reducing child distress during medical procedures, few guidelines exist for matching distraction strategies to child and parent characteristics. This case study evaluated the effects of two distractors with a caregiver observed to be critical of her child's behavior during chemotherapy injections. The participants were a 4-year-old girl diagnosed with Wilms' Tumor and her grandmother. A reversal design was employed to compare the effects of the distractors. The first, an "evaluative" distractor, required the child to perform pre-academic tasks, and the second, a "nonevaluative" distractor, was an interactive book. Caregiver critical statements were moderately high during baseline, increased with the evaluative distractor, decreased dramatically with the nonevaluative distractor, and returned to elevated levels with reversal to the original distractor. These findings suggest the potential benefit of encouraging critical caregivers to use nonevaluative distractors during invasive medical procedures.