In some EDs, child-life specialists help children with nonpharmacologic methods for pain management including psychological preparation for procedures, “comfort” holds, distraction, and educating staff (and sometimes even families) about the most appropriate language to use for a specific child The strategies employed by child life have a positive impact on patient and family satisfaction, staff satisfaction, and cost Sinha found that for laceration repair, the use of child-life specialists was associated with a reduction in parental perceptions of pain in younger children and a decrease in self-reported anxiety for older children In a 2014 policy statement, the AAP concluded that hospitals should use child-life services as a quality indicator and strive to have child life as part of an integrated family-centered care model Most pediatric centers advocate family member’s presence during painful procedures Research demonstrates that family presence does not increase the pain or distress of the parent or child, nor does it adversely affect the clinicians’ abilities to provide safe and effective care Giving the family the option to remain in the room during procedures and resuscitations increases the family’s overall satisfaction with the visit, and should be incorporated into the plans for PSA Distraction of a child during a painful procedure may help reduce pain and distress This includes having the child perform rhythmic breathing or blowing bubbles Age-appropriate distraction reduces self-reported anxiety and parental perception of pain in children during laceration repair For younger children, parents can also help with singing and storytelling Visually intriguing toys, paintings on the walls or ceiling of a procedure room, and music or videotapes may also distract a young child Music therapy is effective in reducing anxiety and pain for children undergoing procedures, and recent work has also used virtual reality goggles to distract older children during procedures Guided imagery, in which children are coached to imagine a pleasant memory or scenario, may also be helpful For example, one could ask the child to think of the funniest movie he or she has ever seen and to imagine the pain getting less intense with each laugh Or, the child could be asked to imagine the pain as a color that is fading away and is painted over with the child’s favorite color Hypnosis has been used to treat pain in children for several years, and it has been successful in children as young as years of age Hypnosis has proven value for chronic pain