In adults, pain is one of the most common physical complaints. For example, a comprehensive review of available epidemiological studies yielded a median point prevalence of chronic benign pain of 15% in adults, with individual study values ranging from 2–40% (Verhaak, Kerssens, Dekker, Sorbi, & Bensing, 1998). Unfortunately, pain is not limited to the adult years, as estimates of pain complaints in childhood and adolescence typically range from 15–20% (Goodman & McGrath, 1991), a level surprisingly similar to that for adults. The pain experienced by children and adolescents is sufficiently intense to require medical consultations by a large percentage of those so affected. Of the 25% of individuals aged up to 18 years studied by Perquin, Hazebroek-Kampschreur, Hunfeld, van Suijlekom-Smit, Passchier, and van der Wouden (2000) who had complaints of chronic pain (defined as continuous or recurrent pain occurring longer than three months), 57% had visited a physician and almost 40% had taken medication. The major types of pain experienced by children and adolescents are listed in Table 15.1, although in practice the pain presentations often overlap, with boundaries being less distinct (McGrath & Finley, 1999).
In the not too distant past pain was not viewed as a serious problem in children and adolescents. However, it is now clear that pain is a significant condition in childhood and adolescence and, when it is chronic or recurrent, it is unlikely to be outgrown (McGrath & Finley, 1999). Several findings highlight the seriousness of pain in children and adolescents.
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References
Ambuel, B., Hamlett, K. W., Marx, C. M., & Blumer, J. L. (1992). Assessing distress in pediatric intensive care environments: The COMFORT scale. Journal of Pediatric Psychology, 17, 95–109.
Anand, K. J. S, & Craig, K. D. (1996). New perspectives on the definition of pain. Pain, 67, 3–6.
Andrasik, F., Burke, E. J., Attanasio, V., & Rosenblum, E. L. (1985). Child, parent, and physician reports of a child's headache pain: Relationships prior to and following treatment. Headache, 25, 421–425.
Andrasik, F., Lipchik, G. L., McCrory, D. C., & Wittrock, A. A. (2005). Outcome measurement in behavioral headache research: Headache parameters and psychosocial outcomes. Headache, 45, 429–437.
Andrasik, F., & Schwartz, M. S. (2006). Behavioral assessment and treatment of pedi-atric headache. Behavior Modification, 30, 93–113.
Applegate, H., Matson, J. M., & Cherry, K. E. (1999). An evaluation of functional variables affecting severe problem behaviors in adults with mental retardation by using the Questions about Behavioral Function Scale (QABF). Research in Developmental Disabilities, 20, 229–237.
Baccei, M., & Fitzgerald, M. (2006). Development of pain pathways and mechanisms. In S.B. McMahon & M. Koltzenburg (Eds.), Wall and Melzack's textbook of pain (5th ed., pp. 143–158). Amsterdam: Elsevier.
Baldridge, K., & Andrasik, F. (2008). Barriers to effective pain management in people with intellectual/developmental delays. Manuscript submitted for publication.
Beyer, J., & Aradine, C. (1986). Content validity of an instrument to measure young children's perceptions of the intensity of their pain. Journal of Pediatric Nursing, 1, 386–395.
Bieri, D., Reeve, R. A., Champion, D., Addicoat, L., & Ziegler, J. B. (1990). The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain, 41,139–150.
Bodfish, J. W., Harper, V. N., Deacon, J. M., Deacon, J. R., & Symons, F. J. (2006). Issues in pain assessment for adults with severe to profound mental retardation. In T. F. Oberlander & F. J. Symons (Eds.), Pain in children and adults with developmental disabilities (pp. 173–192). Baltimore, MD: Paul H. Brookes.
Bosch, J., Van Dyke, D. C., Smith, S. M., & Poulton, S. (1997). Role of medical conditions in the exacerbation of self-injurious behavior: An exploratory study. Mental Retardation, 35, 124–130.
Bottos, S., & Chambers, C. T. (2006). The epidemiology of pain in developmental disabilities. In T. F. Oberlander & F. J. Symons (Eds.), Pain in children and adults with developmental disabilities (pp. 67–87). Baltimore, MD: Paul H. Brookes.
Breau, L. M., Camfield, C. S., McGrath, P. J., & Finley, G. A. (2003). The incidence of pain in children with severe cognitive impairments. Archives of Pediatric and Adolescent Medicine, 157, 1219–1226.
Breau, L. M., Finley, G. A., McGrath, P. J., & Camfield, C. S. (2002). Validation of the non-communicating children's pain checklist-postoperative version. Anesthesiology, 96, 528–535.
Breau, L. M., MacLaren, J., McGrath, P. J., Camfield, C. S, & Finley, A. F. (2003). Caregivers' beliefs regarding pain in children with cognitive impairment: Relation between pain sensation and reaction increases with severity of impairment. The Clinical Journal of Pain, 19, 335–344.
Breau, L. M., McGrath, P. J., Camfield, C. S., & Finley, G. A. (2002). Psychometric properties of the non-communicating children's pain checklist-revised. Pain, 99, 349–357.
Breau, L. M., McGrath, P. J., Camfield, C., Rosmus, C., & Finley, G. A. (2000). Preliminary validation of an observational pain checklist for persons with cognitive impairments and inability to communicate verbally. Developmental Medicine & Child Neurology, 42, 609–616.
Breau, L. M., McGrath, P. J., & Zabalia, M. (2006). Assessing pediatric pain and developmental disabilities. In T. F. Oberlander & F. J. Symons (Eds.), Pain in children and adults with developmental disabilities (pp. 149–172). Baltimore, MD: Paul H. Brookes.
Carter, B., McArthur, E., & Cunliffe, M. (2002). Dealing with uncertainty: Parental assessment of pain in their children with profound special needs. Journal of Advanced Nursing, 38, 449–457.
Chambers, C. T., Giesbrecht, K., Craig, K. D., Bennett, S. M., & Huntsman, E. (1999). A comparison of faces scales for the measurement of pediatric pain: Children's and parents' ratings. Pain, 83, 25–35.
Chambers, C. T., Hardial, J., Craig, K. D., Court, C., & Montgomery, C. (2005). Faces scales for the measurement of postoperative pain intensity in children following minor surgery. The Clinical Journal of Pain, 21, 277–285.
Chambers, C. T., Reid, G. J., McGrath, P. J., & Finley, G. A. (1996). Development and preliminary validation of a postoperative pain measure for parents. Pain, 68, 307–313.
Cook, A. K. R., Niven, C. A., & Downs, M. G. (1999). Assessing the pain of people with cognitive impairment. International Journal of Geriatric Psychiatry, 14, 421–425.
Davies, D., & Evans, L. (2001). Assessing pain in people with profound learning disabilities. British Journal of Nursing, 10, 513–516.
Defrin, R., Pick, C. G., Peretz, C., & Carmeli, E. (2004). A quantitative somatosensory testing of pain threshold in individuals with mental retardation. Pain, 108, 58–66.
Dworkin, R. H., et al. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113, 9–19.
Eccleston C., Jordan, A. L., & Crombez, G. (2006). The impact of chronic pain on adolescents: A review of previously used measures. Journal of Pediatric Psychology, 31, 684–697.
Fanurik, D., Koh, J. L., Schmitz, M. L., Harrison, R. D., & Conrad, T. M. (1999). Children with cognitive impairment: Parent report of pain and coping. Journal of Developmental and Behavioral Pediatrics, 20, 228–234.
Fanurik, D., Koh, J. L., Schmitz, M. L., Harrison, R. D., Roberson, P. K., & Killebrew, P. (1999). Pain assessment and treatment in children with cognitive impairment: A survey of nurses' and physicians' beliefs. The Clinical Journal of Pain, 15, 304–312.
Fitzgerald, M., & Walker, S. (2006). Infant pain traces. Pain, 125, 204–205.
Flor, H., & Andrasik, F. (2006). Chronic pain. In M. E. Selzer, S. Clarke, L. G. Cohen, P. W. Duncan, & F. H. Gage (Eds.). Textbook of neural repair and rehabilitation: Volume II: Medical rehabilitation (pp. 219–230). NY: Cambridge University Press.
Foley, D. C., & McCutcheon, H. (2004). Detecting pain in people with an intellectual disability. Accident and Emergency Nursing, 12, 196–200.
Gauntlett-Gilbert, J., & Eccleston, C. (2007). Disability in adolescents with chronic pain: Patterns and predictors across different domains of functioning. Pain, 131, 132–141.
Gilbert-MacLeod, C. A., Craig, K. D., Rocha, E. M., & Mathias, M. D. (2000). Everyday pain responses in children with and without developmental delays. Journal of Pedi-atric Psychology, 25, 301–308.
Giusiano, B., Jimeno, M. T., Collignon, P., & Chau, Y. (1995). Utilization of a neural network in the elaboration of an evaluation scale for pain in cerebral palsy. Methods Information in Medicine, 34, 498–502.
Goodman, J. E., & McGrath, P. J. (1991). The epidemiology of pain in children and adolescents: A review. Pain, 46, 247–264.
Goubert, L., Eccleston, C., Vervoort, T., Jordan, A., & Crombez, G. (2006). Parental catastrophizing about their child's pain. The parent version of the Pain Catastro-phizing Scale (PCS-P): A preliminary validation. Pain, 123, 254–263.
Hadden, K. L., & von Baeyer, C. L. (2002). Pain in children with cerebral palsy: Common triggers and expressive behaviors. Pain, 99, 281–288.
Hadjistavropoulos, T., von Baeyer, C., & Craig, K. D. (2001). Pain assessment in persons with limited ability to communicate. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (2nd ed., pp. 134–148). New York: Guilford Press.
Hennequin, M., Morin, C., & Feine, J. S. (2000). Pain expression and stimulus localization in individuals with Down's syndrome. Lancet, 356, 1882–1887.
Hermann, C., Hohmesiter, J., Demirakca, S., Zohsel, K., & Flor, H. (2006). Long-term alteration of pain sensitivity in school-aged children with early pain experiences. Pain, 125, 278–285.
Hester, N. (1979). The preoperational child's reaction to immunization. Nursing Research, 28, 250–255.
Hicks, C. L., von Baeyer, C. L., Spafford, P. A., van Korlaar, I., & Goodenough, B. (2001). The Faces Pain Scale-Revised: Toward a common metric in pediatric pain measurement. Pain, 93, 173–183.
Hodgins, M. J. (2002). Interpreting the meaning of pain severity scores. Pain and Research Management, 7, 192–198.
International Association for the Study of Pain. (1986). Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Pain (Suppl. 3), S1–S225.
Katz, E. R., Kellerman, J., & Siegel, S. E. (1980). Behavioral distress in children with cancer undergoing medical procedures: Developmental considerations. Journal of Consulting and Clinical Psychology, 48, 356–365.
Katz, J. N. (2006). Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. Journal of Bone and Joint Surgery, 88-A (Suppl), 21–24.
LaChapelle, D. L., Hadjistavropoulos, T, & Craig, K. D. (1999). Pain measurement in persons with intellectual disabilities. The Clinical Journal of Pain, 15, 13–23.
LeBaron, S., & Zeltzer, L. (1984). Assessment of acute pain and anxiety in children and adolescents by self-reports, observer reports, and a behavior checklist. Journal of Consulting and Clinical Psychology, 52, 729–738.
Malviya, S., Voepel-Lewis, T., Burke, C., Merkel, S., & Tait, A. R. (2006). The revised FLACC observational pain tool: Improved reliability and validity for pain assessment in children with cognitive impairment. Pediatric Anesthesia, 16, 258–265.
McGrath, P. A., Seifert, C. E., Speechley, K. N., Booth, J. C., Stitt, L., & Gibson, M. C. (1996). A new analogue scale for assessing children's pain: An initial validation study. Pain, 64, 435–443.
McGrath, P. A. (1999). Chronic pain in children. In I. K. Crombie, P. R. Croft, S. J. Linton, L. LeResche, & M. Von Korff (Eds.), Epidemiology of pain (pp. 81–101). Seattle: IASP Press.
McGrath, P. J., & Finley, G. A. (1999). Chronic and recurrent pain in children and adolescents. In P. J. McGrath & G. A. Finely (Eds.), Chronic and recurrent pain in children and adolescents: Progress in pain research and management (Vol. 13; pp. 1–4). Seattle: IASP Press.
McGrath, P. J., Johnson, G., Goodman, J. T., Schillinger, J., Dunn, J., & Chapman, J. (1985). CHEOPS: A behavioral scale for rating postoperative pain in children. In H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in pain research and therapy (Vol. 9; pp. 395–402). New York: Raven Press.
McGrath, P. J., Rosmus, C., Camfield, C., Campbell, M. A., & Hennigar, A. (1998). Behaviours caregivers use to determine pain in non-verbal, cognitively impaired individuals. Developmental Medicine & Child Neurology, 40, 340–343.
McGrath, P. J., & Unruh, A. M. (2006). Measurement and assessment of paediatric pain. In S. B. McMahon & M. Koltzenburg (Eds.), Wall and Melzack's textbook of pain (5th ed.; pp. 305–315). London: Churchill Livingstone.
McGrath, P. J., Walco, G. A., Turk, D. C., Dworkin, R. H., Brown, M. T., Davidson, K., Eccleston, C., Finely, G. A., Goldschneider, K., Haverkos, L., Hertz, S. H., Ljung-man, G, Palermo, T., Rappaport, B. A., Rhodes, T., Schechter, N., Scott, J., Sethna, N., Svensson, O. K., Stinson, J., von Baeyer, C. L., Walker, L., Weisman, S., White, R. E., Zajicek, A., & Zeltzer, L. (2008). Core outcome domains and mearures for pediatric acute and chronic/recuurrent pain clinical trials: PedIMMPACT recommendations. Journal of Pain, 9, 771–783.
Merkel, S. I., Voepel-Lewis, T., Shayevitz, J. R., & Malviya, S. (1997). The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatric Nursing, 23, 293–297.
Metsähonkala, L., Sillanpää, M., & Tuominen, J. (1997). Headache diary in diagnosis of childhood migraine. Headache, 37, 240–244.
Miró, J., Huguet, A., & Nieto, R. (2007). Predictive factors of chronic pediatric pain and disability: A Delphi poll. Journal of Pain, 8, 774–792.
Nader, R., Oberlander, T. F., Chambers, C. T., & Craig, K. D. (2004). Expression of pain in children with autism. The Clinical Journal of Pain, 20, 88–97.
Paclawskyj, T. R., Matson, J. L., Rush, K. S., Smalls, Y., & Vollmer, T. R. (2000). Questions about Behavioral Function (QABF): A behavioral checklist for functional assessment of aberrant behavior. Research in Developmental Disabilities, 21, 223–229.
Palermo, T. M., Valenzuela, D., & Stork, P. P. (2004). A randomized trial of electronic versus paper pain diaries in children: Impact on compliance, accuracy, and acceptability. Pain, 107, 213–219.
Penzien, D. B., Andrasik, F., Freidenberg, B. M., Houle, T. T., Lake, A. E., 3rd, Lipchik, G. L., Holroyd, K. A., Lipton, R. B., McCrory, D. C., Nash, J. M., Nicholson, R. A., Powers, S. W., Rains, J. C., & Wittrock, D. A. (2005). Guidelines for trials of behavioral treatments for recurrent headache, first edition: American Headache Society Behavioral Clinical Trials Workgroup. Headache, 45, S110–S132.
Perquin, C. W., Hazebroek-Kampschreur, A. A., Hunfeld, J. A., van Suijlekom-Smit, L. W., Passchier, J., & van der Wouden, J. C. (2000). Chronic pain among children and adolescents: Physician consultation and medication use. Clinical Journal of Pain, 16, 229–235.
Prkachin, K. M. (2005). The consistency of facial expressions in pain. In P. Ekman & E. L. Rosenberg (Eds.), What the face reveals: Basic and applied studies of spontaneous expression using the Facial Action Coding System (FACS) (2nd ed., pp. 181–197). New York: Oxford University Press.
Richardson, G. M., McGrath, P. J., Cunningham, S. J., & Humphreys, P. (1983). Validity of the headache diary for children. Headache, 23, 184–187.
Scott, P., Ansell, B., & Huskisson, E. (1977). Measurement of pain in juvenile chronic polyarthritis. Annals of the Rheumatic Diseases, 36, 186–187.
Sleed, M., Eccleston, C., Beecham, J., Knapp, M., & Jordan, A. (2005). The economic impact of chronic pain in adolescence: Methodological considerations and a preliminary costs-of-illness study. Pain, 119, 183–190.
Stallard, P., Williams, L., Lenton, S., & Velleman, R. (2001). Pain in cognitively impaired, non-communicating children. Archives of Disease in Childhood, 85, 460–462.
Stallard, P., Williams, L., Velleman, R., Lenton, S., & McGrath, P. J. (2002). Brief report: Behaviors identified by caregivers to detect pain in noncommunicating children. Journal of Pediatric Psychology, 27, 209–214.
Stallard, P., Williams, L., Velleman, R., Lenton, S., McGrath, P. J., & Taylor, G. (2002). The development and evaluation of the pain indicator for communicatively impaired children (PICIC). Pain, 98, 145–149.
Stanford, E. A., Chambers, C. T., & Craig, K. D. (2006). The role of developmental factors in predicting young children's use of a self-report scale for pain. Pain, 120, 16–23.
Stinson, J. N., Kavanagh T., Yamada, J., Gill, N., & Stevens, B. (2006). Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain, 125, 143–157.
Terstegen, C., Koot, H. M., de Boer, J. B., & Tibboel, D. (2003). Measuring pain in children with cognitive impairment: Pain response to surgical procedures. Pain, 103, 187–198.
Tsao, J. C. I., Meldrum, M., Kim, S. C., & Zeltzer, L. K. (2007). Anxiety sensitivity and health-related qualify of life in children with chronic pain. The Journal of Pain, 8, 814–823.
Turk, D., & Flor, H. (1999) Chronic pain: A biobehavioral perspective. R. J. Gatchel & D. C. Turk (Eds.), Psychosocial factors in pain. New York: Guilford Press.
Turk, D., et al. (2003). Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain, 106, 337–345.
Verhaak, P. F. M., Kerssens, J. J., Dekker, J., Sorbi, M. J., & Bensing, J. M. (1998). Prevalence of chronic benign pain disorder among adults: A review of the literature. Pain, 77, 231–239.
von Baeyer, C. L., & Spagrud, L. J. (2007). Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 Years. Pain, 127, 140–150.
Williams, A. C., Davies, H. T., & Chadury, Y. (2000). Simple pain rating scales hide complex idiosyncratic meanings. Pain, 85, 457–463.
Wong, D., & Baker, C. (1988). Pain in children: Comparison of assessment scales. Pedi-atric Nursing, 14, 9–17.
Woolf, C. J., & Salter, M. W. (2000). Neuronal plasticity: Increasing the gain in pain. Science, 288, 1765–1769.
Zwakhalen, S. M. G., van Dongen, K. A. J., Hamers, J. P. H., & Abu-Saad, H. H. (2004). Pain assessment in intellectually disabled people: Non-verbal indicators. Journal of Advanced Nursing, 45, 236–245.
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Andrasik, F., Rime, C. (2009). Pain Assessment. In: Matson, J.L., Andrasik, F., Matson, M.L. (eds) Assessing Childhood Psychopathology and Developmental Disabilities. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09528-8_15
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