Children's Communication Choices About Musculoskeletal Pain and Injury: Insights From a Public Involvement Event

Musculoskeletal pain and injury are common in childhood. To assess and manage children's pain appropriately, it is crucial to understand their perspective on how the problem started and how it feels. There are multiple barriers to children being heard. Offering visual-based communication opportunities, in addition to traditional language-based communication, could potentially help children to retell their experiences. The aim of the public involvement event was to establish how children chose to retell their experience of musculoskeletal pain or injury.

As part of the preliminary work for the design of a clinical intervention, children's opinions were sought at a public event. An interactive exhibit invited children to retell their musculoskeletal pain and injury experiences through talking, drawing, acting, writing, using a human figurine, or combining these methods. Observation and note-taking were used by exhibit facilitators to record how children chose to retell their experience.

One hundred and twelve children aged 2-17 years participated in the interactive exhibit. Most children choose to use a creative activity in addition to talking about their experience. Drawing or using a human figurine was the most frequently used creative activity. Creative methods, most often drawing, enabled some children to communicate their pain experience without talking. Age and gender differences were observed, with younger children being more likely to draw and boys using human figurines more often.

There was no 'one size fits all' approach to communication as children had different preferences. The most frequently used creative methods, drawing and the use of a human figurine, will inform the design of a tailored physiotherapy intervention developed with service users.

This public involvement event highlights the valuable role children can play in shaping research processes to inform the development of interventions. The broader research programme, including this event, was supported by the University Faculty of Medicine Youth Advisory Group, comprising nine members aged 14-18, who actively contributed by helping to determine the methods used, during two 1-h sessions.

The wider programme of research about which public involvement was informed is registered and listed on the ISRCTN registry, with study registration number ISRCTN18918987.