Developmental influences on the meanings of pain in children

Abstract

What does pain mean to a child? As a child develops, so does their meaning of pain. In this chapter, developmental influences on a child's meaning of pain are explored. It is argued that a child learns the meaning of pain when they can understand the word "pain, " or its equivalent in another language, and if a child is a sufficiently fluent participant in the practice of using "pain. " Cognitive, affective, social, and experiential factors influence a child's personal meaning of pain in unique ways. Pain science education, where learning is focused on the "what, " "why, " and "how" of pain, is considered foundational to education about pain treatment strategies. A child's meaning of pain is theoretically impacted upon by pain science education, an approach based on conceptual change theory. Individual conceptual changes over time are a key consideration. Next, the meaning of pain in disadvantaged or vulnerable children is discussed. More research is needed, particularly in terms of clinical assessments. Then, the effects of linguistic competence on the assessment of pain in children are evaluated. Here, vocabulary development, novel assessment approaches, and specific assessment tools are explored. Finally, emerging research gaps are considered, and clinical implications are offered in light of the identified developmental influences. Terminology, age appropriateness, and targeted pain science education are unpacked in this section. Complex concepts develop in children as they develop, and so pediatric pain science education should gradually increase in complexity, building on a child's previous conceptual developments.