Harnessing children’s picture books to socialize children about pain and injury: a qualitative study

Pain experiences are common during childhood (e.g., ‘everyday’ pain, vaccine injections) and are powerful opportunities for children to learn about pain and injury. These experiences likely inform fundamental and life-long beliefs about pain. There is scant research investigating the sociocultural contexts in which children learn about pain and injury. One unexplored context is shared reading of picture books (e.g., between parents/caregivers and children). In this study, we investigated whether shared reading of picture books that included depictions of pain and/or injury prompted parent/caregiver-child interactions. If interactions were observed, we explored what those interactions entailed. Twenty parent/caregivers (8 men, 12 women) and their children (n=27; 10 boys, 17 girls) were recruited from libraries in South Australia. Parent/caregiver-child families chose from 8 books (7 fiction, 1 non-fiction) with varying amounts of pain/injury-related content. Shared reading interactions were video recorded, transcribed, and analysed alongside analysis of the picture books using reflexive thematic analysis. Pain/injury-related interactions were observed between parents/caregivers and children during shared reading of picture books. Qualitative analyses generated one main theme and three sub-themes. Findings identified that shared reading presented an opportunity for children’s understanding of pain and injury to be socialized through discussion of characters’ experiences. This included teaching children about pain and injury, as well as promoting empathy and emotional attunement towards characters who were depicted as being in pain. Finally, parents/caregivers often responded with observable/expressed amusement if pain/injury was depicted in a light-hearted or unrealistic way. Overall, shared reading of picture books presents an untapped opportunity to socialize children about pain and injury. Perspective Shared reading of picture books that have depictions of pain and/or injury can prompt parent/caregiver-child interactions about pain and injury. These interactions present critical opportunities that can be harnessed to promote children’s learning of adaptive pain-related concepts and behaviours during a critical developmental period.