Chronic abdominal pain affects an estimated 10–15% of children and is a leading cause of school absence and daily disruption for families. For many children, the experience does more than hurt—it teaches them something potentially harmful: that their bodies cannot be trusted.
A new study by researchers at Duke University challenges that assumption, suggesting that how children learn to relate to their bodies may be just as important as how their symptoms are treated.
Led by Nancy Zucker, PhD, professor in psychiatry and behavioral sciences at the Duke University School of Medicine, the research team investigated the effects of two interventions for chronic abdominal pain in children.
One cognitive-behavioral therapy, Feeling and Body Investigators (FBI), frames sensitivity to pain as a superpower rather than a vulnerability. Developed by Zucker, FBI encourages children to approach bodily sensations with curiosity—treating pain, hunger, and emotional signals as information to be explored rather than avoided.
The other cognitive behavioral treatment, Caregivers in Action (CIA), reflects a more traditional model, helping children shift attention away from pain and manage symptoms through distraction and coping strategies.
Tested in a randomized trial of 107 children aged 5 to 9, both approaches resulted in meaningful reductions in pain duration and intensity. The interventions also decreased the interference pain had on families’ lives.
“Children with pain can come to see their bodies as something to fear. Our treatments show them something else—that their bodies are powerful and understandable. When that shift happens, their trajectory of chronic pain and future mental health difficulties may change.”
— Nancy Zucker, PhD, senior author of the study
The findings point to a broader shift in how clinicians think about attention and pain. For decades, many treatments have focused on helping children move their attention away from discomfort. This study suggests another viable approach—changing the quality of attention itself—that helps children engage with their internal experiences in ways that reduce fear and increase understanding.
The implications may extend beyond abdominal pain. Early childhood is a critical period for learning how to interpret our physical and emotional signals. Intervening during this window may influence how children respond not only to pain, but to stress, emotion, and bodily sensations more broadly over time.
For parents, the takeaway is both practical and reassuring: there is more than one effective way to help a child with chronic pain. Some approaches teach children how to redirect their attention. Others teach them how to face sensations differently. Both can lead to meaningful improvement.
And importantly, 97% of parents reported that the treatments were fun. When asked if their child enjoyed the treatment, one parent in the FBI arm stated, “I do. She even tried to teach her friends how to diagnose their stomach pain,” while a parent in the CIA arm replied, “She wanted to like keep coming forever.”
The study was published in the American Journal of Gastroenterology.