The ability to draw inspiration from the verbal, non-verbal and emotional communication of significant adults (parents or caregivers) is essential in children's social adjustment. This process, called social referencing, allows children of any age to cope during new situations in the everyday life (Walden et al. Ogan, 1988). Knowing that children turn to their parents (or caregivers) to learn how to modulate their responses to their environment or situation, this cross-sectional and secondary analysis aimed to examine the relationship between parents' and children’s behaviors in the recovery room following a same-day surgery. 

This study's data was retrieved from a randomized controlled trial which examined the effect of a pre-operative DVD on parents’ knowledge, participation and anxiety and on children’s distress, pain, analgesic requirements and length of recovery after a same-day surgery (Chartrand et al., 2017). The original study included 105 French and English-speaking parent-child dyads whose child was aged between 3 to 10 years old and underwent an ear-nose-throat or a dental same day surgery at a Canadian pediatric hospital. Parents and children were observed in the recovery room using a video camera; parents' and children's behaviors were measured using the Child Behavior Coding System-PACU (Chorney et al., 2013). Only video footages in which children were awake and there was at least one interaction between the child and the parent were kept for this secondary analysis. Therefore, 392 video footages and 71 dyads were included. Descriptive and inferential analyses using SPSS were conducted.

When parents create a warm, peaceful, and comfortable setting by using procedural humor, non-procedural humor, procedural speech, or non-procedural speech it has been show that children are going to produce similar behavior such as procedural speech, non-procedural speech or positive emotional state (APE). On the other hand, when a parent verbalizes excuses regarding the procedure, more cries, tears and pain are observed from the child. A discussion filled with praise has showed a positive effect on the child. Although every child reacts differently, parents’ use of certain behaviors such as reassuring or positive verbal feedback can be more beneficial than harmful for the child, depending on how they are used in the interaction. 

These findings suggest that there is a strong and positive relationship between parents’ behaviors and those of children in the recovery room after a same-day surgery. Since a causality between these behaviors was not established, it is unclear if the parents' behaviors influence their child's behavior and vice versa. Thus, adequately preparing both is essential to ensure children's adaptative behaviors in the recovery room and children's optimal post-operative recovery. Strategies, such as offering children and parents a pre-operative educational intervention (video via YouTube or an App) and offering parents guidance and coaching in supporting their child in the recovery room should be implemented in the future.