Pain expression in children with an intellectual disability

Abstract

Background: Children with an intellectual disability (ID) are sometimes unable to verbalize and describe their painful experience; therefore family members and health carers can assess the intensity of the pain only from the behaviour exhibited by the children.

Aim and method: The purpose of this descriptive and exploratory study was to examine the behavioural pain expression in 30 children with ID aged from 5 to 18 years in a surgical context. Children were matched with 30 typically developing children of the same chronological age and 30 typically developing children of the same developmental age.

Results: The results showed the influence of the level of expressive communication on the pain expression. Children who were able to verbalize their pain exhibited a normative pain expression with behavioural traits similar to those of typically developing children of the same developmental age. Children who were unable to verbalize their pain produced particular pain expressions with behavioural traits that were atypical and without a communicative goal.

Conclusion: Pain expression modalities are extremely different between children able to verbalize their pain and those unable to do so. This study confirmed the necessity to take into account the particularities of each child with ID in order to individualize the pain management and avoid misdiagnosis and the under treating of pain in non verbal children.