Making the system work. Training pediatric oncology patients to cope and their parents to coach them during BMA/LP procedures.

The team worked with preschoolers who needed bone-marrow tests. These tests hurt and scare young kids.

In one short session they taught each child two tricks: blow a party blower for slow breaths and look at a toy for distraction. They also trained parents to remind the child to use the tricks right before the needle stick.

The researchers watched the kids across several hospital visits to see if the tricks stuck.

Every child showed more calm behavior and less crying after the single training visit.

Two children kept the gains at later tests. One child slipped back, but all parents kept giving clear cues.

The simple combo—toy plus party blower plus parent prompt—cut distress fast.

Bustos et al. (2008) ran a similar idea with babies getting shots. They swapped the party blower for calm parent talk and still saw less crying. Together the studies show the method works across ages and procedures.

McMullen et al. (2017) moved the same coping logic to the dental chair. One boy with developmental delay learned to predict and practice steps ahead of time. He stayed calm for three years. The pattern repeats: teach a small skill, let the child use it, and pain behavior drops.

Koudys et al. (2025) and Exline et al. (2024) prove parents can learn the coaching role through Zoom. Their sleep and communication studies used the same single-case design and got positive results. The oncology study did it face-to-face, but the telehealth cousins say you can train parents without making them come to the hospital.

You can copy this package in any clinic. Bring a party blower and a small toy. Show the child how to blow slowly and look at the toy. Tell the parent exactly when to say, "Blow and look." One rehearsal is enough for most kids. If distress creeps back, run a quick booster and check parent cues. The whole training takes ten minutes and costs pennies.