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Published on: November 29, 2017
Preschool Needle Pain Responding: Establishing 'Normal'
Jordana A Waxman1, Miranda G DiLorenzo1, Rebecca R Pillai Riddell2
1Department of Psychology, York University, Toronto, Ontario, Canada.
Insights
A significant minority of preschoolers show poor pain regulation during vaccinations. Pain responses in infancy do not predict preschooler pain regulation, highlighting developmental changes.
Area of Science:
- Pediatric pain research
- Child psychology
- Developmental science
Background:
- Vaccination pain is a common and distressing experience for young children.
- Understanding pain response patterns in early childhood is crucial for developing effective interventions.
- Previous research has not fully characterized longitudinal pain responses from infancy to preschool age.
Purpose of the Study:
- To describe pain response patterns in preschoolers during vaccinations.
- To examine the longitudinal relationships of pain responding from infancy to preschool age.
- To identify subgroups of children with distinct pain response trajectories.
Main Methods:
- Longitudinal cohort study (Opportunities to Understand Childhood Hurt [OUCH] cohort, N=302).
- Growth mixture modeling to identify preschooler pain response subgroups.
- Parallel-process growth curve modeling to assess longitudinal stability of pain responding.
Main Results:
- Three distinct groups of preschoolers based on pain response patterns were identified.
- A notable minority (25%) showed suboptimal pain regulation by 2 minutes post-vaccination.
- No significant associations were found between pain responses at 12 months and preschool age.
Conclusions:
- Preschool vaccination pain responses exhibit significant variability and developmental shifts from infancy.
- A substantial proportion of preschoolers exhibit concerning pain regulation difficulties.
- These findings underscore the need for targeted strategies to manage vaccination pain in early childhood.
Abstract:
The current study sets forth to provide descriptive data for preschool vaccination pain responding as well as examine longitudinal relationships over early childhood. Growth mixture modeling was first used to describe stable subgroups of preschoolers on the basis of their pain response patterns over 2-minutes post-needle. Secondly, a parallel-process growth curve model was used to assess the stability of acute pain responding from 12 months of age to preschool age. Specifically, we examined whether preschool pain-related distress or regulation could be predicted from 12-month acute pain responding. Preschool participants were part of a Canadian longitudinal cohort (The Opportunities to Understand Childhood Hurt [OUCH] cohort; N = 302). Growth mixture modeling analyses discerned 3 distinct groups of preschoolers, with an important minority not regulating to low-no pain by 2 minutes post-needle. There were no significant associations between 12-month and preschool pain responding. These results highlight the steep trajectory of development between these different stages of early childhood and the variability of pain responding at the preschool vaccination.
Perspective:
This study provides descriptive data for preschool vaccination pain responding as well as examines longitudinal relationships over early childhood. Demonstrating significantly different pain patterns from infancy, 25% of preschoolers are displaying suboptimal regulation trajectories. This considerable minority poses a significant concern because of the established trajectory of phobia onset in middle childhood.
