Lindsey Cohen recognized with GSU Outstanding Faculty Achievement Award

12/7/2009 – Story by Jeremy Craig, GSU University Relations, 404-413-1357

It’s no secret that the insertion of IV needles, the puncture of immunizations or other necessary but invasive medical procedures can cause some children to react by screaming or sometimes by flailing.

According to Lindsey Cohen, an associate professor of psychology and recipient of the Georgia State’s Outstanding Faculty Achievement Award in 2009, medical staff and parent behavior can help but might also exacerbate the situation. For example, excessive reassurance (“don’t worry, everything’s going to be all right, don’t worry!”), giving too much control (“tell me when you are ready”) and criticism (“you are acting like a baby”) might prompt, encourage or reinforce child distress.

“We’ve videotaped children in these stressful medical situations and performed behavioral analyses, examining the interactions among discrete parent, nurse, and child behavior,” Cohen said. “Some of the findings have lead to recommendations of how adults can best coach upset children.”

Based on Cohen’s assessments, behavioral interventions to help children cope with the stress have been developed. These include deep breathing and relaxation, or distractions during a stressful procedure.

Cohen’s pediatric pain research also incorporates technology. Recently, Cohen completed work on a project funded by the National Institutes of Health (NIH) where his team developed an interactive parent training program, “Bear Essentials,” involving animated bears that teach and demonstrate for parents those behaviors that might minimize children’s distress as well as behaviors to avoid during children’s immunizations.

He also received a new grant from the NIH to develop a virtual reality biofeedback computer game that will immerse children in a distracting computer game where they guide a space ship and earn points by relaxing their body and breathing deeply. This will be evaluated with children undergoing broken limb evaluation and casting.

Cohen’s interest in the field started in the 1990s before he entered graduate school, when he worked at the former Egleston Children’s Hospital in Atlanta on a medical psychiatric unit. The unit was aimed toward children who had psychological issues in the midst of medical treatment.

Sometimes, children were brought onto his unit because they were having severe psychological reactions to medical procedures, such as lumbar punctures, bone marrow aspirations or catheter placement.

“The only instructions we had were to help hold them down,” Cohen said. “In the early 1990s, the literature was sparse regarding how to best help children during brief, painful medical procedures. It was awful to have to hold down scared kids who pleaded to be allowed up. Although it was not quite traumatic for me, I imagine it was for a child to have several large adults pin them down while another adult inserts a needle into the child’s spine. When I learned that there was research in the area, I became fascinated with the subject.”

In 2008-2009, Cohen spent a professional leave sabbatical at the University of Bath in England examining chronic pain. Cohen is now working on a project with assistant professor of psychology Akihiko Masuda, in search of approaches for acute and chronic pain and other symptoms in adolescents who have sickle cell disease.

He also has students working in subjects related to his main focus, including infant pain and how it affects people later in life. Other pediatric psychology research in Cohen’s lab examines behavioral and psychosocial aspects of medical care related to obesity, HIV and other medical conditions.

Student research, including undergraduate research, is a critical part of his students’ learning experiences.

“It’s vital that students develop critical thinking skills, which challenges students to avoid simple acceptance and memorization of ‘facts,’” Cohen said. “It is important that students learn to critically evaluate information and research helps instill a scientific approach to learning.

“Such a way of thinking is a great way to approach life, and it can be applied anywhere, from interpreting news reports to even purchasing items at a grocery store. It’s a different way of thinking and understanding the world,” he said.