The child's language of pain
A series of experiments was conducted with children, aged between five and eleven years, which sought to determine the utility of using their verbal, and non-verbal, communications to measure the quality or intensity of the pain they are experiencing. Experiments which investigated children's ability to use language to communicate pain suggested that children are aged seven years, and older, before they discriminate between pain and non-pain words, or can show that these words share a similar meaning with an adult comparison group. When children aged between seven and ten years completed verbal pain questionnaires, the results showed that the seven year olds demonstrated only rudimentary discrimination between five acute painful situations. Discrimination improved with age, but the ten year olds were not as discriminating as an adult comparison group. Children aged five to ten years were asked to recall, and describe, all of their past painful experiences. Results show significant developmental trends in the following; the number of painful experiences that children can recall, the figurative use of language to describe the recalled pain, and the number of pain descriptions that children generate. An experiment investigated the reliability of non-verbal rating scales when completed by children aged between five and ten years. Results indicate that children below the age of seven failed to show satisfactory levels of reliability, and that the response strategies that they use may overestimate the degree of reliability they do show. Older children do show reliable responses using these scales. The final experiment looked for changes in children’s behaviour when they received either a drug or placebo, whilst undergoing a painful medical procedure. Results are not conclusive, but do suggest that the frequency and intensity of facial expressions, and vocalisations, decrease when an analgesic was administered. Overall, these studies show that children are, on average, seven years of age before we can use their own pain communications as reliable indicators of the quality and severity of the pain they experience.