The relation between children's pain behaviour and developmental characteristics: a cross-sectional study.
OBJECTIVE
To determine whether children with developmental disabilities show responses to pain that vary according to developmental level.


METHODS
Factor analytical methods were used to explore whether pain behaviour is independent of developmental characteristics. As part of a longitudinal study, caregivers of 123 children (67 males, 56 females; age range 40 mo-21 y 6 mo) completed the Non-communicating Children's Pain Checklist-Revised (NCCPC-R), the Vineland Adaptive Behavior Scales, Second Edition (VABS-II), and the Pediatric Evaluation of Disability Inventory (PEDI). Deviation intelligence quotients (DIQs) were also generated. Two varimax rotated principal components analyses (PCAs) included the NCCPC-R subscales, DIQs, and age. One also included VABS-II subdomain scores and the other, PEDI scores, to allow examination of whether pain and developmental scores produced distinct components to evaluate the independence of pain behaviour from developmental factors.


RESULTS
Children's mean age equivalents on the VABS-II were: Communication (36.4 mo, SD 34.8), Daily Living Skills (31.8 mo, SD 35.9), Socialization (43.2 mo, SD 49.9), and Motor Skills (21.6 mo, SD 20.3). Pain behaviour was distinct from developmental characteristics. The PCA including the VABS-II accounted for 78.4% of variance, with four components: Developmental Level, Pain Behaviour, Motor Development, and Chronological Age. The PCA that included the PEDI accounted for 69.4% of variance, with three corresponding components: Pain Behaviour, Developmental Level, and Chronological Age.


CONCLUSIONS
Pain behaviour was distinct from developmental factors in two separate analyses using two functional measures. Clinicians can be confident that pain assessment with the NCCPC-R is not affected by children's developmental level.
School of Nursing and Departments of Paediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada. lbreau@dal.ca
Lynn M
LM
Breau
Carol S
CS
Camfield
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D009633:Nonverbal Communication; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D025341:Principal Component Analysis; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D055815:Young Adult