Cartoons to improve young children's cooperation with inhaled corticosteroids: A preliminary study.

INTRODUCTION: The objective of this pilot study was to evaluate if animated cartoons could increase the cooperation of young children with asthma during the delivery of their inhaled corticosteroids (ICS).

METHODS: Subjects were children aged 6-47 months having a physician diagnosis of asthma, who required an ICS therapy delivered through a pMDI/spacer twice a day for at least 2 months. Families who reported on a questionnaire that their child was frequently crying or moving during treatment delivery were asked to participate in a prospective, cross-over, randomized study. After a first week of run-in, children watched alternatively, during the delivery of ICS, either an animated cartoon for 7 days and a black screen video for another 7 days. The main outcome was the median percentage of time of non-cooperation, defined by the length of time the child was crying and/or moving divided by the length of time required for delivering ICS.

RESULTS: Parents of 50 children out of 113 (44%) reported that their child was frequently crying or moving during treatment delivery. Among these 50 children, 11 (22%) completed the study. The median percentages of time of non-cooperation (IQR 1-3) were 0% (0-3) and 56% (40-97) during the distraction and control periods, respectively, in the first group, and 100% (98-100) and 0% (0-5) during the control and distraction periods, respectively, in the second group. Animated cartoons increased cooperation up to 97% (55-100%) (P = 0.008).

CONCLUSIONS: Bad cooperation among young children with asthma during the delivery of their treatment can be dramatically improved by the use of animated cartoons.