title: Brief report: behaviors identified by caregivers to detect pain in noncommunicating children.
abstract: OBJECTIVE
  To develop an observational measure, based on caregiver reports, to assess chronic pain in children with significant cognitive impairment who are unable to communicate verbally. The issue of whether these children share a core set of cues to express pain was investigated.
  
  
  METHODS
  Specific pain cues were elicited during detailed interviews with 29 female caregivers of noncommunicating children. Pain cues were categorized by a two-stage Delphi process and cues indicating severe and definite pain identified.
  
  
  RESULTS
  Six cues from five different categories were used by 90% of caregivers to identify definite or severe pain in their child.
  
  
  CONCLUSIONS
  Although the specific expression of pain may be very individual, there is a shared set of core pain cues. The relationship between these cues and evidence of pain and distress is discussed.
authors.affiliation: Department Child & Family Psychiatry, Royal United Hospital, Bath, England. paul.stallard@awp.nhs.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Stallard
authors.forename: Lindsey
authors.initials: L
authors.lastname: Williams
authors.forename: Richard
authors.initials: R
authors.lastname: Velleman
authors.forename: Simon
authors.initials: S
authors.lastname: Lenton
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017028:Caregivers; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003147:Communication Disorders / Q000523:psychology*; D003463:Cues; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis*; D010465:Perception