Participants
intellectual disabilities
Children who needed to undergo venipuncture at the outpatient clinic were asked to participate in this study. Inclusion criteria were age between 5 and 18 years, use of topical anesthesia on the presumed needle insertion site (EMLA, Aspen, The Netherlands), and the ability to communicate in Dutch language by child and parent or guardian. Written informed consent was obtained prior to the study. For children in the age of 5 to 12 years or children with intellectual disabilities, informed consent was provided by parent or guardian. For children aged 12 to 16 years, it was provided by the child and parent or guardian, and for children up to and including 16 years, it was provided by the child.