To optimally pull a child's attention away from a painful procedure, Child Life therapists use a variety of techniques, from blowing out (pinwheels, balloons, deep breathing) to visual distractions, both passive (videos) and active (Where's Waldo??). Pulling from the distraction pain literature, I distilled the elements that seemed to be most helpful. In a stressful situation, too much difficulty (math problems) can be counterproductive. This is why "Where's Waldo", while a good active distraction, is actually less effective for most medical situations: he's just too hard to find. The concept, though, is useful - visual active tasks like finding work well. Adding rote elements like counting can be good, but it depends on how hard it is to find something. "How many of something can you find" can be too easy if they're right there - you could stop after one. "Find 6 of something", however, is a concrete task which adds visual input to the cognitive task and gives the comfort of rote familiarity. The trick is distracting effectively for the right situation, giving just the right amount of challenge with the comforting ritual of counting. It's that simple.purple cowDistrACTION cards have 10 questions on the back of each one, stratified by age groups.They include questions that require simple finding for younger kids (Where is a purple cow?) with some questions that only adults could get (Can you find all the suits in a deck of cards?) Classic counting, how many cows?, was found to be too easy for older kids, so questions add difficulty by asking "How many cows are wearing a costume?").. The DistrACTION cards have now been clinically proven in three studies to be even better than other distractors in hospitals.
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