» Trauma and Pain in the Child: Reporting of the Parent and the Child
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Trauma and Pain in the Child: Reporting of the Parent and the Child

Sue Weber BSc, DC, MSc

BACKGROUND: There is a paucity of information in how best to gather information regarding how children experience pain and if there is a correlation between how children and parents report the child’s pain.

OBJECTIVES: To establish if there were differences: between how children and parents report whether the child has pain and how often the child suffers from pain; whether the child had suffered trauma to the head or neck; and how intense the child reports their pain.

DESIGN: A cross-sectional observational study among pre-adolescent students in Sweden.

METHODS: Students from a Swedish municipal school (n=131) aged 10-13 years were given a consent form to take home to be signed by their parents. The consent form included questions about the child and investigated whether: the child had experienced an injury to the head or neck; if the child had neck pain and/or headache; and how often the child had neck pain and/or headache. All students completed their own questionnaire in the classroom.

RESULTS: Of the 131 children, 40%(n=52) complained of neck pain/headache.  The parents were asked if their child complained of neck pain/ headache; 6.1 % (n=  8) answered often; 20.6 %(n=27) answered sometimes; 27.5 %(n=36) answered seldom.  Thirty-one percent (n=41) of students reported neck pain and/or headache often. Seven students reported daily, 8 claimed 3-5 times a week, 26 answered 1-2 times a week, 9 checked once a month and 7 checked once every three months. The parents were asked if their child had experienced trauma to the neck or head and 21.3 % (n=28) responded yes.  Sixty-one percent (n=80) of the children reported trauma to the head/neck. Students reported having fairly high levels of pain and having pain often. For usual pain intensity during episodes, on a VAS scale, 6 was the most common answer; for the worst episodes, 7 was the most common answer. Girls reported lower average pain intensity (3/10) when compared to boys (6/10). Of the children who complained of neck pain/ headache, 17 % (n=9) sought some kind of help.

The degree of disability children experienced with neck pain/ headache was investigated by asking how it affected their activity level.  Children could choose more than one answer.  Nearly 30 %(n=16) said that it didn’t bother them; 18.7%(n=10) said they could feel it all the time, but did what they usually do; 12.5 %(n=7) felt pain when they thought about it; 7.8%(n=4) had difficulty concentrating; 7.8 %(n=4) could only participate in activities at half speed; 10.9 %(n=6) reported they couldn’t participate in activities; 12.5%(n=7) wrote that they had to lie down; and 7.8 %(n=4) missed school.

CONCLUSIONS: Findings from the study showed that there was discrepancy between parental report and the child’s self-report of trauma history and neck pain and/or headache. The results from the VAS scale and the degree of disability reported are not congruent. Children reported frequent, high levels of pain, unreported by parents.


References:

Recurrent Neck Pain and Headaches in Preadolescents Associated with Mechanical Dysfunction of the Cervical Spine: A Cross-Sectional Observational Study with 131 Students. JMPT; 2009. Weber Hellstenius S.

Camarda R, Monastero R, Santangelo G, Raimondo D, Puma D, Pipia C, Camarda L, Camarda C, Raieli V. (2002). Migraine headaches in adolescents: a five-year follow-up study. Headache;42;1000-5.

El-Metwally A, Salminen J, Auvinen A, Kautiainen H, Mikkelsson M. (2004). Prognosis of non-specific musculoskeletal pain in preadolescents: A prospective 4-year follow-up study till adolescence. Pain;110:550-9.

Gallelli L, Iannacchero R, Peltrone F, Colosismo M, De Sarro G, DeCarro E. (2005). A questionnaire-based study on prevalence and treatment of headache in young children. J headache pain;6:277-80.

Hakala P, Rimpelä A, Salminen J, Virtanen, S Rimpelä. (2002). Back, neck and shoulder pain in Finnish adolescents: national cross sectional surveys. BMJ;325:743-5.

Laimi K, Vahlberg T, Salminen J, Metsähonkala L, Mikkelsson M, Anttila P, Aromaa M. (2007). Characteristics of neck pain associated with adolescent headache? Cephalalgia;27:1244-54.

Laurell K, Larsson B, Eeg-Olofsson O. (2005). Headache in schoolchildren: Association with other pain, family history and psychosocial factors. Pain;119:150-158.

Lundqvist C, Clench-Aas J, Hofoss D, Bartonova A. (2006). Self-reported headache in schoolchildren: Parents underestimate their children’s headaches. Acta Paediatrica;95:940-6.

Raieli V, Eliseo M, Pandolfi E, La Vecchia M, La Franca G, Puma D, Ragusa D. (2005). Recurrent and chronic headaches in children below 6 years of age. J Headache Pain;6:135-42.

Sillanpää M, Anttila P. (1996). Increasing prevalence of headache in 7-year old schoolchildren. Headache;36:466-70.

Van de Brink M, Bandell-Hoelstra E, Huijer Abu-Saad H. (2004). The occurrence of recall bias in pediatric headache: A comparison of questionnaire and diary data. Headache;41:11-20.

Wöber-Bingöl C, Wöber C, Karwautz A, Auterith A, Serim M., Zebenholzer K, Aydinkoc K, Kienbacher C, Wanner C, Wessely P. (2004). Clinical features of migraine: A cross-sectional study in patients aged three to sixty-nine. Cephalgia;24:12-17.

Sue A. Weber BSc, DC, MSc Chiropractic Paediatrics