Distraction, exposure therapy, counterconditioning, and topical anesthetic for acute pain management during needle sticks in children with intellectual and developmental disabilities

Keith J. Slifer, Jessica C. Hankinson, Melissa A. Zettler, Robin A. Frutchey, Melissa C. Hendricks, Cynthia M. Ward, Jennifer Reesman

Research output: Contribution to journalArticlepeer-review

Abstract

A behavior therapy approach for obtaining cooperation during needle sticks was provided to 8 pediatric patients with intellectual and developmental disabilities. Therapy was provided during mock needle sticks. Hand lotion was applied to simulate topical anesthetic. Distracting activities established relaxation while needle stick materials were gradually introduced. Positive reinforcement was provided for cooperation. Behavioral distress was ignored, blocked, or redirected. After cooperating with mock needle sticks, needle sites were prepared with topical anesthetic (EMLA), then therapists and medical staff implemented the behavioral protocol while completing the actual needle stick(s). Observational measures of cooperation and interfering were obtained. Results were replicated across 8 children and evaluated using paired samples t tests. Initially, all children were uncooperative with needle sticks. With treatment, behavioral distress decreased, and patients cooperated with mock and actual needle sticks. Results support the effectiveness of behavior therapy for promoting cooperation in children with intellectual and developmental disabilities during needle sticks.

Original languageEnglish (US)
Pages (from-to)688-697
Number of pages10
JournalClinical pediatrics
Volume50
Issue number8
DOIs
StatePublished - Aug 2011

Keywords

  • behavior
  • exposure therapy
  • intellectual and developmental disability
  • pediatrics
  • venipuncture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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