Pain behaviour is associated with increasing the areas in the brain that are responsive to pain, thereby increasing sensitivity to pain.  In other words, decreasing pain behaviour decreases the experience of pain.

Positive reinforcement is a response to your child’s behaviour that will increase the likelihood of the behaviour occurring again.  Attention for pain behaviour is a very powerful reinforcer for children.

• Emphasise that you are unable to take your child’s pain away, but say that she/he will receive lots of love and attention (not about pain or pain behaviour) and given rewards for coping.
• Ignore any pain behaviours exhibited by your child (verbal groaning, crying, guarding).
• Give special attention and praise for coping behaviours

               (Relaxation and breathing techniques have been taught, along with visualisation).

• Do not enter into a discussion with your child regarding they’re pain and function, e.g. walk away.

Do . . .

• give attention during symptom-free periods (e.g. you are working well’, and you are doing well’)
• be aware of demands for positioning; they are probably requests for attention.
• expect your child to function in spite of physical distress (this is not cruel but actually therapeutic as your child will be convinced of their ability to manage by the experience of success).
• be firm – this communicates the conviction that your child is strong enough and competent enough to overcome this distress
• believe that your child can increase her functioning
• treat your child as an active agent in her treatment
• help your child to problem solve about how to actively change things, e.g. ‘what can you do about this?’
• reduce parental concern if the opportunity arises
• be aware of how you feel towards your child
• follow through with times and expectations put into place
• support all member of the treating team

Do not. . .

• assume responsibility for anything your child can do themself
• use punishment or assess their progress negatively in front of your child
• focus on the illness behaviours or give attention for pain behaviour
• ask how she/he is feeling or how much pain she/he has
• give excessive reassurance
• focus attention on the symptoms or show concern (even though you may feel it!)
• attend to your child when she/he is in pain or in discomfort
• believe your child is vulnerable and unable to cope.

(Courtesy of Sophia Franks)