Creating new tools: Researcher finds ways to assess and treat pain in patients with intellectual disabilities
Dr. Lynn Breau knows that children can’t always tell adults they’re in pain. Young kids don’t know the words to describe how, and how much, they hurt. It’s even harder for children with intellectual disabilities to express their pain. Many of these children suffer more pain than typical kids, more often, and some lack not just vocabulary but the ability to speak.
That’s why Lynn has developed and validated checklists for health professionals to use as tools to help them assess pain in children who can’t communicate. “If you know what to look for, you can determine if a child is in mild, moderate or severe pain within five minutes,” says Lynn, a clinical psychologist and key member of the IWK Centre for Pediatric Pain Research. “We look at facial expressions, like a furrowed brow, and behaviours, which can range from agitation to withdrawal when a child is in pain.”
Lynn’s pain-assessment tool has been adapted for use in many countries and translated into French, Italian, German, Swedish, Norwegian and Russian.
She is extending this work into the realm of postoperative pain, as co-leader of a multi-centre project involving both Canada and France. This project is examining the effectiveness of a tool that Lynn developed to assess pain after surgery in children and adults with intellectual disabilities. A new adult version of the tool has also just been validated, so that pain assessment can be improved in youth over age 18.
In addition to developing better ways of assessing pain in people with intellectual disabilities, Lynn is working hard to develop and test better ways of treating pain in these patients. She is testing five psychological pain treatments, which she adapted for children with intellectual disabilities. These treatments include breathing techniques, progressive muscle relaxation, biofeedback, and guided imagery, which tells a story about the pain being gone.
“Often these kids are on multiple medications and adding more for chronic pain may not be desirable,” she says. “These non-drug methods work through the sympathetic nervous system to reduce tension, which reduces pain. Our goal is to develop the methods that work best and put training manuals online for professionals and parents to access for free.”
A Canadian Institutes of Health Research (CIHR) New Investigator, Lynn is also a site investigator with the Canadian Arthritis Network, a CIHR Network of Centres of Excellence.
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