Elephants Dancing in My Head: A Developmental Approach to Children's Concepts of Specific Pains

Abstract

The present study produced an empirically derived, developmental continuum of children's understanding of specific pains. Subjects of 5 age groups: preschool (ages 3-4), first grade (ages 6-7), third grade (ages 8-10), sixth grade (ages 11-12) and college freshmen (ages 18-23) were interviewed with open-ended questions. The subjects were questioned extensively about 3 specific types of pain: an injury (skinned knee), a medical intervention (injection), and an illness (headache). Subjects were asked to describe each pain, tell why the pain hurt, and state the value of the pain. Their answers were then categorized and the categories ordered developmentally by experts in pediatric pain who were unaware of the children's ages. Then children's specific answers were given developmental scores. Multivariate analyses revealed that older children had more complex and precise understandings of pain, and this pattern differed by type of pain and by aspect of pain being considered. The subjects were also asked to report the frequency of their own pains and their parents' pain; parental and self-reported pains were closely related.

Pediatric procedural pain

“…Only older adolescents are able to understand and describe such complex concepts as the value of pain. 42,43 Sex. Adult studies have found that women report more recurrent pains and more severe pain to a given stimulus than men.…”

Children's Understanding of Psychogenic Bodily Reactions

“…Thus, children's understanding of pain provides at least some insight into their reasoning about mind-body links. Some evidence suggests that younger children are less likely than older children to link the sensation of pain with physical bodily states, such as increased pressure in blood vessels (Harbeck & Peterson, 1992). This finding would seem to suggest that children have some difficulty linking external bodily conditions with internal, subjective states.…”

Preliminary psychometric evaluation of the Child Health Ratings Inventory (CHRIs) and Disease-Specific Impairment Inventory-Hematopoietic Stem Cell Transplantation (DSII-HSCT) in parents and children

“…Historically, it was thought that children's developing emotional maturity and cognitive capacity rendered them incapable of providing consistent and accurate information about their level of functioning or state of well-being [9][10][11]. The design of developmentally appropriate (and age-specific) measures that are accessible to children across a wide age range represents one of the most important innovations in this area and serves as a model for the work reported herein [7,[12][13][14].…”