Children with cognitive impairment: Parent report of pain and coping

Information about pain in children with cognitive impairment is lacking. To gather pain-relevant information in this population, parents of 145 childr en with borderline to profound cognitive impairment were interviewed regard ing their children's pain expression, experience, treatment, and coping beh avior. Descriptions of pain expression and coping behavior were associated with the level of cognitive impairment. Children with mild to moderate cogn itive impairment were more likely to be described as directly communicating their pain and exhibiting procedural coping strategies similar to those ob served in children without cognitive impairments. More than half of the par ents reported that their children experienced pain differently than did chi ldren without cognitive impairment, with the majority perceiving decreased pain sensitivity and greater pain tolerance. Finally, one third of parents felt that their children's pain was treated differently than that of other children. Half of these parents believed that health care providers had dif ficulties assessing and treating their children's pain. Results contribute to the developing foundation of information about pain in this special pedi atric population.