Whether it’s a sore arm or a fear of injections, how a child is treated when they present with pain could significantly affect how they respond to and manage pain later in life.
In a new study from the University of South Australia, researchers say that parents and doctors should be mindful of how they talk to and treat children experiencing pain – no matter how big or small the injury – knowing that these foundational experiences can be carried forward into adulthood.
Drawing from diverse research across developmental psychology, child mental health, and pain sciences, researchers say that it may be important to validate children’s pain by demonstrating that their pain-related experiences, emotions, or behaviours are acceptable, understood, and legitimate.
By validating a child’s pain, the child feels heard and believed, which reinforces their trust and connection with their parent, or with a treating doctor.
UniSA researcher Dr Sarah Wallwork says social relationships play a critical role in shaping how health is experienced throughout the lifespan.
“When a parent or doctor validates a child’s experiences in a way that matches their expressed vulnerability, it helps the child to feel accepted, builds connection and trust, and may help the child to develop critical skills in regulating their emotions,” Dr Wallwork says.
“For example, when a doctor is attentive, and responds to a child’s emotional and behavioural cues, particularly about seeking help, the clinician is telling the child their pain is real and concurrently reinforcing helpful pain management behaviours, such as attending the clinic.
“However, if these cues are missed, or the doctor questions the validity of their pain, this can have negative consequences for the child. Not only can it affect the clinician-patient relationship and trust but it can also impact future attendance at appointments and adherence to a pain management plan.
“Pain and emotion are inextricably linked, with emotion dysregulation commonly co-occurring with chronic pain.
“By validating children’s experiences of pain, they are likely to hold fewer negatively biased memories of pain and be in better position to seek help in the future, when then need it.”
In Australia, as many as one in four children experience chronic pain. The economic burden of chronic pain in Australia is more than $139 billion, mostly through reduced quality of life and productivity losses.
Dr Wallwork says that setting children up for success should cover all aspects of life, including pain management.
“Our research highlights an underemphasised element of child and youth pain treatment, especially for children in minoritised groups, who are systematically undertreated for pain,” Dr Wallwork says.
“People with chronic pain often report that their pain-related experiences are met with disbelief or dismissal. This can have significant consequences, including poor mental health and reduced quality of life.
“Given the significant burden of chronic pain, and the clear intersection with the rising child mental health crisis, it’s important that we better manage pain earlier on, rather than waiting until it is too late.”
Dr Wallwork says this review provides a building block for future empirical research.
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Media contacts: Annabel Mansfield M: +61 479 182 489 E: Annabel.Mansfield@unisa.edu.au
Jack Trehearne E: Jack.Trehearne@unisa.edu.au
Researcher: Dr Sarah Wallwork E: Sarah.Wallwork@unisa.edu.au
Journal
Pain
Method of Research
Content analysis
Subject of Research
Not applicable
Article Title
“I hear you”. Validation in the context of children's pain as an untapped opportunity to prevent chronic pain
Article Publication Date
30-Jul-2024
COI Statement
G.L.M. has received support from Reality Health, ConnectHealth UK, Institutes of Health California, AIA Australia, Workers' Compensation Boards, and professional sporting organisations in Australia, Europe, South America, and North America. Professional and scientific bodies have reimbursed him for travel costs related to presentation of research on pain and pain education at scientific conferences/symposia. He has received speaker fees for lectures on pain, pain education, and rehabilitation. He receives royalties for books on pain and pain education. He is non-paid CEO of the nonprofit Pain Revolution and an unpaid director of the nonprofit Painaustralia. C.S. has received reimbursement for travel related to training on validating and invalidating behaviours. C.M.M. has received support from the Public Health Agency of Canada, Genome Canada, the Canadian Institutes of Health Research, and the Canadian Foundation for Innovation. She has received honoraria for lectures on pain. She holds nonpaid leadership and service roles within the pain field (Pain in Child Health training program), provincially (College of Psychologist of Ontario, Jurisprudence and Ethics Exam), nationally (Canadian Psychological Association, Ethics Committee), and locally within her institution. A.M.H. has been financially supported to attend meetings and is a Medical Education Advisor for Crescent Kids Sickle Cell Charity, UK. A.E.O. has received funding from the National Institute of Child Health and Human Development.