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Underground Railroad by Colson Whitehead book cover

By Andrea Hunt

As any parent who’s looked after one will know, comforting or distracting a sick kid can be a challenge. And then—just when you think nothing will help relieve their misery—you pick up a book together, and it works a small wonder. For a few minutes, a sense of calm and normality returns. Maybe even a smile or two break through. 

The idea of books as medicine isn’t unique to parents. Many hospital storytelling programs share moving accounts of how they’ve boosted pediatric patient wellbeing and outcomes. And now there’s scientific research into the effects of reading stories to sick children that appears to bear that out. The results from a study in Brazil suggest that the simple act of reading is healing, at least in terms of suffering, and can serve as an effective, low-cost pain treatment for children in hospitals and beyond. 

Let’s delve into what that study found, as well as other research into the therapeutic and preventative benefits of using books as medicine with our kids—plus how to put this into practice at home.

Study: Books Reduce Kids’ Stress and Pain

The Brazil study split 81 children in hospital intensive care units (ICU) into two groups. All the kids were aged two to seven and had similar conditions. A volunteer read stories to one group—the kids were free to choose from eight books, change the story, or ask for the same one to be read again during the half-hour session. The same volunteer ran a half-hour riddle activity with the kids in the second group. 

Both groups benefited from the activities, showing reduced pain and stress, plus improvements in emotional regulation hormones and emotional states. But the kids in the story group showed significantly better results across all four of these areas.

Books Soothe Pain and Distract From Discomfort

The children in both groups rated their pain before and after the activity. Both kids showed a drop in the pain they were experiencing, but, yet again, this was greater for the kids in the story group. They registered roughly double the pain reduction compared with those in the riddle group. We don’t know why, but one possibility is that this effect was due to a story’s power to take people out of their surroundings and situation and into another—“narrative transportation.” Whatever the reason, even half an hour of unmedicated and effective pain relief is a powerful thing. 

Reading Reduces Stress and Cortisol

Cortisol is known as the “fight or flight” hormone, released in response to a real or imagined threat—and a key indicator of stress. The cortisol levels in both groups of kids dropped, but the levels in the story group again dropped by approximately twice as much. This was even though both groups had the same amount of interaction from the volunteer, for the same amount of time and at the same time of day. Good to know: just half an hour of reading can make stress hormones take a noticeable dip.  

Stories Increase Oxytocin and Bonding

Oxytocin is a hormone that plays a key role in our social interactions, strongly linked to bonding, empathy, trust, stress reduction, and emotional processing. And the kids in the story group experienced around twice as much increase in it as those in the other. If stories can help sick kids in ICU—missing family and normal routines—regulate their emotions and feel more connected to their caregivers, that’s huge. And that’s something parents can build on at home, too. 

Narratives Help Kids Integrate Experiences and Emotions  

At the end of the activity, all the kids did a free-association word quiz, responding to pictures of a nurse, hospital, doctor, sick person, book, pain, and medicine. The children in the story group responded with significantly more positive-emotion words to “nurse,” “hospital,” and “doctor,” and with fewer negative words—even though the stories they read were not about nurses, hospitals, or doctors. This effect mirrored the physical changes the study found.

Further Health Benefits of Prescribed Reading

Reading is good for your health. It can help alleviate depression, lower blood pressure and heart rate, and help chronic pain sufferers, according to research. 

And there is lots of evidence showing that bibliotherapy—reading books on specific themes and topics—can help children who have experienced trauma. The American Academy of Pediatrics also advocates shared reading, such as Reach Out and Read campaigns that integrate early literacy into pediatric care, as an effective and positive early intervention to promote health, wellbeing, and development while preventing childhood toxic stress

Reading stories is a great way to help children process stresses big and small—from the pain of bereavement to the challenges of visits with relatives. And read our earlier post about how reading fiction has shown to help kids develop emotional intelligence, a building block of good mental health.

Most importantly? Kids who’ve needed relief agree that reading is healing. In one impact report on a reading program in UK hospitals, 99 percent of participating children said that books made them feel better.  

Therapeutic Reading: Tips For Parents       

So what are the takeaways for parents wanting to help their kids through illness, pain, or stress via healing stories? 

The study’s authors highlighted two. Firstly, the type of story doesn’t have to be special or related to illness to have a positive effect. In fact, they deliberately chose titles that were commonly available and light-hearted. Secondly, let children choose the story. Kids in an ICU or hospital setting have especially little control over their lives, but the idea holds true for any child. 

That’s not to say that targeted reading doesn’t have value here. For children preparing for or experiencing a hospital stay, bibliotherapy may help them understand what’s happening and what to expect. Books about illness, the human body, injury, or hospitals can work really well (provided they’re engaging to the child), alongside “medical play,” such as doctor or nurse roleplay.  

But does the idea of healing reading apply only to hospital stays and illness? There are so many life situations that can trigger stress responses in children—sometimes showing up as mystery aches and pains, or with these symptoms in tow. 

Take the pandemic, for one. As the lead author of the study on storytelling in ICUs noted in Portuguese (we’ve translated for you), being in an intensive care unit shares “a lot of similarities with the reality that many children may be experiencing now with the COVID-19 pandemic: the social isolation; the degrees of stress and tension caused by an illness; the boredom of being in the same room for too long; the negative emotions like fear, sadness and anger. The practice of storytelling by parents can be a simple and effective way to improve the child’s wellbeing.” 

Have your kids got favorite sick-lit picks for those under-the-weather days? Let us know!   

Andrea Hunt is a writer, editor, and storytimer who shares and reviews picture books in the margins of work and family life (@hellobookcub on Instagram).