Boo-boos as the building blocks of pain expression: An observational examination of parental responses to everyday pain in toddlers

Background: Everyday pain experiences (minor bumps/scrapes) are common in early childhood and create frequent opportunities for socialization of pain behaviors. Nevertheless, everyday pain during the formative toddler period has been largely overlooked. Aims: The aim of the current study was to describe the frequency and nature of toddlers’ everyday pain experiences, child and parent responses, and the relationship between child characteristics (age, sex, temperament) and responses. Methods: Fifty-two children aged 12–32 months and their parents were observed at an indoor play facility. Using an observational checklist, trained observers recorded children’s everyday pain incidents and associated child and parent responses. Results: Overall, 101 pain incidents were observed, the majority of which evoked low levels of pain and distress, which resolved after 1 min. Pain incidents occurred at a rate of 1.02 incidents/child/hour, with 81% of children experiencing at least one incident, which is higher than previous research with preschoolers and daycare staff. Common parent responses included a range of verbal (reassurance) and nonverbal (staying closer, hugging/kissing child) behaviors. Boys were more likely to not exhibit any protective behaviors. Parents were more likely to pick up older toddlers. Conclusions: Future research should examine the link between self-reported and observed parent responses to child pain in everyday and clinical contexts.