Assessing Cognitive Impairment Pain

How Cognitive Impairment Pain Is Properly Assessed

Younger children who are afflicted with a cognitive impairment disorder may frequently also have some type of underlying medical condition. This medical condition may be severe enough to at some point require surgery, physical therapy, and other potentially painful diagnostic and treatment procedures. One of the facts that tends to compound this problem is that in far too many cases, the pain may go untreated, simply because the child is not capable of being able to express or communicate the presence or even the severity of the pain.

It has not been until recently that there has been any significant research done to assess the pain and treatment for cognitively impaired children. It has long been known that many studies exist which help to identify pain in infants and young children, who are particularly sensitive to pain in these formative years, similar types of research and studies have not been done for cognitively impaired children. The biggest reason for this exclusion is that levels of pain for a child with cognitive impairment disorder has been extremely difficult to determine, simply based on the child’s difficulties in communications, as well as (depending on the level of impairment) the child himself even being able to recognize the pain.

Newer studies and methods are being developed that focus on the ability to measure the existence and level of pain in a child who cannot “self report” pain levels or measures. In one of these studies, it was found that about half of children tested who were diagnosted with borderline cognitive impairment and about one third of children tested who were diagnosed by a child psychologist Orange County licensed professional with mild cognitive impairment were able to correctly a very simple numerical “pain rating scale”. However, that same study showed that a notable proportion of children with mild to moderate impairment had significant difficulty in understanding even the simple concept of the scale.

As the need for further accurate diagnosis become more pronounced, more studies are underway to refine the methods being used to make them more effective for these types of patients. It has been found that children with severe cognitive impairment will tend to “self-injure” themselves, like hitting their head against a wall, biting themselves, or sometimes even worse. It is for this reason that an accurate determination of the degree of impairment be able to be established, so that parents can fully understand the level of supervision that will be required for the child, as well as determining the appropriate measures to take for the child’s education, where the goal is to be able to at least teach the child how to be able to function in the world with minimal to no constant supervision.

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