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The incidence of pain in children with severe cognitive impairments

Lynn M Breau1, Carol S Camfield, Patrick J McGrath

  • 1Pediatric Pain Research Laboratory, IWK Health Centre, Halifax, Nova Scotia, Canada. lbreau@ns.sympatico.ca

Archives of Pediatrics & Adolescent Medicine
|December 10, 2003
PubMed

Insights

Children with severe cognitive impairments frequently experience pain, often not from accidental injuries. Those with the least ability report the most pain, highlighting a critical need for better pain management strategies.

Area of Science:

  • Pediatric Health
  • Pain Management
  • Cognitive Impairment Research

Background:

  • Children with severe cognitive impairments are presumed to experience frequent pain.
  • Understanding the prevalence and characteristics of pain in this population is crucial for effective care.

Purpose of the Study:

  • To quantify the frequency, duration, and intensity of pain in children with severe cognitive impairments.
  • To identify potential causes and contributing factors of pain in this vulnerable group.

Main Methods:

  • A prospective cohort study was conducted over one year at a tertiary-care pediatric center.
  • Caregivers of 94 children and adolescents (aged 3-18 years) with moderate to profound intellectual disability completed semistructured telephone surveys.
  • Pain episodes were documented, including cause, duration (minutes), and intensity (0-10 scale).

Main Results:

  • A significant majority of children (78%) experienced pain at least once during a 4-week period, with 62% reporting nonaccidental pain.
  • Common pain sources included accidental injury, gastrointestinal issues, infections, and musculoskeletal problems.
  • Children with fewer abilities reported more nonaccidental pain, while those with greater motor function experienced more accidental pain.

Conclusions:

  • Children with severe cognitive impairments endure frequent pain, with nonaccidental causes being predominant.
  • The severity of cognitive impairment is linked to increased nonaccidental pain, underscoring the need for tailored pain assessment and intervention.
Abstract

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