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Pain in cognitively impaired, non-communicating children
P Stallard1, L Williams, S Lenton
1Department of Child & Family Psychiatry, Royal United Hospital, Combe Park, Bath BA1 3NG, UK. paul.stallard@awp.nhs.uk
Insights
Everyday pain is common in children with cognitive impairment, with most experiencing moderate to severe pain. However, active pain management is rarely provided for these non-communicating children.
Area of Science:
- Pediatric Pain Management
- Child Neurology
- Developmental Disabilities
Background:
- Pain is a common experience, yet assessing and managing pain in non-communicating children with cognitive impairment presents unique challenges.
- Understanding the prevalence and characteristics of pain in this vulnerable population is crucial for improving their quality of life.
Purpose of the Study:
- To investigate the daily occurrence, severity, and duration of pain in verbally non-communicating children with cognitive impairment.
- To highlight the current management strategies for pain in this population.
Main Methods:
- A prospective observational study involving 34 parents of children with cognitive impairment and verbal non-communication.
- Parents maintained daily pain diaries for two weeks, recording pain presence, severity, and duration across five defined periods.
- Data analysis focused on the frequency and characteristics of reported pain episodes.
Main Results:
- A significant majority of children (73.5%) experienced pain at least once during the two-week period.
- Moderate or severe pain was reported in 67.6% of children, with 11.7% experiencing prolonged moderate to severe pain (over 30 minutes on 5+ days).
- Notably, none of the children were receiving active pain management interventions.
Conclusions:
- Daily pain is a frequent occurrence in children with severe cognitive impairment and verbal non-communication.
- Despite the high prevalence of pain, active pain management is significantly underutilized in this population.
- These findings underscore a critical gap in care, necessitating improved pain assessment and treatment strategies for non-communicating children with cognitive impairment.
Aim:
To detail the everyday occurrence of pain in non-communicating children with cognitive impairment.
Methods:
Thirty four parents of cognitively impaired verbally non-communicating children completed pain diaries over a two week period. Each day, for five defined periods, parents rated whether their child had been in pain, and if so, its severity and duration.
Results:
Twenty five (73.5%) children experienced pain on at least one day, with moderate or severe levels of pain being experienced by 23 (67.6%). Four children (11.7%) experienced moderate or severe pain lasting longer than 30 minutes on five or more days. No child was receiving active pain management.
Conclusions:
Everyday pain in children with severe cognitive impairment is common, yet is rarely actively treated.