title: Pain Assessment of Children with Autism Spectrum Disorders.
abstract: OBJECTIVE
  Pain assessment of individuals with autism spectrum disorder (ASD) is largely unexplored. The core deficits of ASD may interfere with this population's ability to effectively use traditional pain assessment tools. Accurate pain assessment is essential to providing quality care. The objective was to illuminate barriers to pain assessment in children with an ASD, describe novel methods to communicate about their pain experience, and identify vocabularies that hold meaning with respect to pain to better understand pain from their context.
  
  
  METHODS
  Qualitative descriptive study using semistructured interviews including interactive electronic technology to enhance communication. Subjects included children aged 6 to 17 years with ASD experiencing acute pain after a surgical procedure at a large urban tertiary children's hospital.
  
  
  RESULTS
  Based on the analysis of 40 interviews, participants consisted of 34 (85%) male, 29 (72.5%) non-Hispanic white with mean age 11.75 ± 3.36 years (range: 6-17). All subjects were able to describe and locate their pain but required a variety of approaches. Assessment preferences included minimal time spent focusing on pain and simplistic language and actions using terms familiar to each subject. Notably, subjects were able to reliably demonstrate understanding of graded response and seriation. Parent involvement was essential, both in helping interpret the child's needs and providing trusted support.
  
  
  CONCLUSIONS
  Some children with ASD require an alternate interactive approach to pain assessment. Individualized consideration and estimation of pain assessment methods for use in this population may provide more meaningful interactions, ultimately guiding better pain management interventions.
authors.affiliation: *Center for Pediatric Nursing Research & Evidence-Based Practice, The Children's Hospital of Philadelphia, Philadelphia, PA; †Child Life, Education and Creative Arts Therapy, The Children's Hospital of Philadelphia, Philadelphia, PA; ‡Department of Anesthesiology, New York Presbyterian Hospital Weill-Cornell, New York, NY; §Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA; ‖Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ely
authors.forename: Mei Lin
authors.initials: ML
authors.lastname: Chen-Lim
authors.forename: Kate M
authors.initials: KM
authors.lastname: Carpenter
authors.forename: Emily
authors.initials: E
authors.lastname: Wallhauser
authors.forename: Eron
authors.initials: E
authors.lastname: Friedlaender
mesh_terms: D059787:Acute Pain / Q000175:diagnosis*; D000293:Adolescent; D000067877:Autism Spectrum Disorder; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis*