Targeting Pain Science Education With a Children's Book: A Single Case Experimental Design (SCED) Study With a Sham Comparison.

Objectives: To assess perceived changes in children's understanding of the pain-damage relationship and the brain's influence on pain following exposure to sham and pain science education (PSE) books. Methods: A series of single-case experimental designs were replicated across 17 children (8-12 years), with and without chronic pain, over six weeks. Following baseline, participants received a sham book and then a PSE book. The Concept of Pain Inventory (COPI) (total and selected items) and qualitative interviews (child and interviewer) assessed conceptual change and book acceptability. Results: COPI scores for three targeted items fluctuated but generally increased after the PSE book for both groups, suggesting improved understanding. Discrepancies between COPI responses and interview data occurred in 88% of children, indicating varied perspectives on the nature and extent of conceptual change. The PSE book was found to be acceptable and was preferred by most children. Discussion: Children's understanding of core pain science concepts can improve with targeted, book-based PSE. The dynamic nature of conceptual change and observed discrepancies between quantitative and qualitative assessment methods underscore the value of using multiple approaches to evaluate learning in pediatric PSE.