Predicting children's response to an invasive medical investigation: the Influence of effortful control and parent behavior.

Objective: To investigate the relative contributions of effortful control (reflecting the child's ability to shift and refocus attention) and parental coping- and distress-promoting behaviors to children's coping and distress during the voiding cystourethrogram (VCUG, X-ray of the kidneys).

Method: Thirty-two children between ages 2 and 7 years were videotaped undergoing the VCUG. Parent and child behaviors were coded according to the CAMPIS-R (Blount et al., 1997), and parents completed a temperament inventory assessing effortful control across a range of everyday situations.

Results: Children manifested relatively high rates of distress and low rates of coping. Their coping attempts were not associated with reduced rates of distress. The most frequent child coping behavior was distraction. Both effortful control and parent coping-promoting behavior (particularly talk about topics other than the VCUG) made independent contributions to child coping behavior. Parent distress-promoting behavior (particularly reassurance) made a strong contribution to child distress behavior.

Conclusions: Factors relating to the child (effortful control) and parent (coping and distress-promoting behaviors) both contribute to children's response to an aversive medical procedure. Interventions that facilitate parent coping and promoting behavior, reduce their distress-promoting behavior, and compensate for children's infrequent and ineffective use of coping strategies (such as distraction) may be optimal for young children, particularly those low in effortful control.