Pain is as difficult as personal experience. Therefore, pain patients need good care and sensitivity. However, in the case of children with chronic pain, it can be difficult for them to convey this because children do not have all the words it might take to express what they are feeling except crying. This is one of the reasons why modern medicine and psychology did not pay attention to chronic pain in children in the 20th century.
The fact is that even before the 1950s, doctors believed that children were not as sensitive to pain as adults. This indisputable belief has had serious consequences. In many hospitals, doctors perform surgical procedures on children under 2 years of age with very little or no anesthetic.
Although they cannot express it, children and babies feel pain just like adults.
Instruments for measuring chronic pain in children
Today modern medicine and psychology realized that chronic pain in children has the same characteristics as chronic pain in adults. Thus, today both groups of patients are treated equally. Children are considered to have chronic pain if they experience it for 6 months or longer, regardless of psychological reasons.
However, the problem is that there are no previous protocols or tools for diagnosing chronic pain in children. The instruments used were generally designed for adults and adapted for children. Fortunately, the situation is changing today, and clinical psychology is playing an important role in this change.
Chronic pain in children today has been more noticed, studied and treated using everything from projective methods to recognition techniques and emotional expression. Pain is no longer considered a simple complaint in children. Doctors give it the meaning it has and don’t think it’s a way for children to try to get their parents’ attention.
Drawings, facial expressions and colors, rather than terminology used by adults, are the most useful and common tools to help children pay attention, express and control your chronic pain.
Pain description methods
When it comes to babies and toddlers younger than 3-4 years old who are not yet sufficiently developed linguistically or cognitively to express their pain with words or pictures, the most reliable diagnostic methods are reports of behavior and physiological changes. Older children and adolescents can use other ways to express their pain. Among the most common:
- Pain thermometer: usually on a scale of 0 to 10, where 0 means no pain , and 10 means “the most severe pain imaginable.” A child can show how much pain he is feeling by coloring the corresponding area by a degree nick.
- Åland Color Tool (ECT): a color scale in which the child can select one of eight colors corresponding to different pain intensities, from “no pain” to “worse than you can imagine.”
- Face Pain Scale: Used for children over 5 years of age. It has nine faces. Four of them represent varying degrees of positive facial expressions, four represent different negative facial expressions, and four have neutral expressions. The child can choose a face that displays the pain they are experiencing at the moment.
- Pain Questionnaire: Used for older children and adolescents. It consists of 8 questions about the child’s pain.
- Pain Diary: This is a diary that the child keeps for himself and in which the child reports his pain. The book has a scale of pain from 0 – “no pain” to 5 – “very severe pain.” The doctor assesses the pain twice a day in the postoperative period.
Psychological treatment of children with chronic pain
When discussing the treatment of children with chronic pain, a person is faced with painful reality. Most pain medications are not suitable for children. Therefore, special attention is paid to the multidisciplinary treatment of children.
In this case, clinical psychology contributes to a number of procedures that are considered effective and work for children 7 years and older. These treatments have also shown very promising results when it comes to chronic pain, even in young children. Typically, treatment depends on the type of pain and how you analyze it. Some of the most commonly used techniques are:
- Biofeedback: The method is most often used for various types of headaches. It consists of checking the physiological parameters of the voltage as well as the temperature within the measured parameters.
- Relaxation techniques: deep breathing or muscle relaxation. It is very effective for children due to the fact that the methods eliminate the causes of active pain.
- Mindfulness: Several studies available show statistically significant improvements in variables such as intensity and frequency during periods of pain.
- Visualization: uses mental images or internal representations to reduce the experience of pain and thereby create an analgesic effect.
- Distraction: It has been proven that when you focus your attention on something that causes pain, it intensifies the sensation of pain, and vice versa.
- Preparedness: You perform a functional analysis of the patient with the aim of facilitating the reorganization of the environment a for altered behavior in relation to painful cases and to avoid reinforcing or rewarding uncontrolled behavior.
Us more research needed
Despite these advances, and although they have proven effective and successful, access to psychological treatment for children with chronic pain is still still limited. Therefore, we need interdisciplinary progress and more research in this area so that we can learn how best to deal with chronic pain in children.