Pain resources Today I decided to collect resources connected to pain, since many people with autism do not react to or express pain in a typical way.  If any of the links are broken, try removing any blank spaces in the address and try again.  If it still doesn't work, let me know and I'll try to fix it. Visual tools: http://www.do2learn.com/picturecards/printcards/social_emoti onshealthpeople.htm - simple visuals for stomach ache, headache, toothache, etc. http://www.speakingofspeech.com/uploads/ill_story_1.pdf - simple visuals for various ailments like sore throat, runny nose. http://www.setbc.org/pictureset/resource.aspx?id=173 - Pain Indicator visual in PDF and Boardmaker formats. http://www.anes.ucla.edu/pain/FacesScale1.jpg - Universal Pain Assessment Tool, with visuals (faces from Wong scale), verbal rating (eg "moderate pain"), visible clues (eg furrowed brow), and activity tolerance scale (ie how the pain interferes with activity, eg "can be ignored" vs. "interferes with concentration" etc).  The activity tolerance scale is translated into several languages. http://www.academiamexicanadepediatria.com.mx/images/wong.jp g - two different pain assessment scale faces.  The Wong scale has cartoon faces, while the Faces Pain Scale-Revised has realistic faces.  Use what works best for your child. http://www.positivelyautism.com/downloads/ouch_card.doc - Ouch card (see separate post below). http://www.oucher.org/history.html - the Oucher Scale with the face of a real child. Checklists: http://www.ppprofile.org.uk/ - Paediatric Pain Profile, for documenting your child's behavior on a good day versus when s/he is experiencing various types of pains. http://www.aboutkidshealth.ca/Shared/PDFs/AKH_Breau_post-op. pdf - Non-communicating children's pain checklist (specificially for post operative use) http://www.aboutkidshealth.ca/Shared/PDFs/AKH_Breau_everyday .pdf - Non-communicating children's pain checklist - revised (for general use) Articles: http://www.aspmn.org/Organization/documents/NonverbalJournal FINAL.pdf - "Pain Assessment in the Nonverbal Patient."  The section on infants and preverbal toddlers also covers developmentally delayed patients. http://www.mycarecommunity.org/Default.aspx?tabid=271 - "Beyond Words:  Nonverbal Signs of Pain" http://www.iasp-pain.org/AM/Template.cfm?Section=Home&Te mplate=/CM/ContentDisplay.cfm&ContentID=2087  - "Pain issues in individuals with limited ability to communicate due to cognitive impairment" -- an outline of what professionals should know. Any other resources? NorwayMom40124.1483564815 This summary was written by Ellen Arcady, R.N. M.P.H   Unfortunately, I could only find it on Google's buffer but here's the address where it was originally posted: http://npi.ucla.edu/mhdd/INFO/modules/pain.htm.   PAIN:  A HIDDEN CAUSE OF SEVERE & CHALLENGING BEHAVIORS Everyone experiences pain (DIS-EASE) in a unique way. However, a person with a develomental disability who has impaired communication skills (or is possibly nonverbal) may at times communicate his pain through dangerous or socially inappropriate behaviors. What Causes Physical Pain? chronic medical conditions recent, nonvisible injuries untreated dental problems emotional and interpersonal problems Who May Be More Prone to Behavioral Expression of Physical Pain? those who have an expressive language disorder individuals with impaired cognitive abilities infants & children people with idiosyncratic behaviors (for example, a person with autism) Clues That Physical Pain is Causing Behavioral & Emotional Problems aggression and self-injurious behaviors (such as head-banging or self-biting) agitation and restlessness, especially at night temper tantrums (caused by frustration due to an inability to verbally communicate) various attention-seeking behaviors feeding and eating problems (for example, general food refusal or refusal of firm-textured foods) holding a body part (such as gripping one’s cheeks) or hitting a body part (such as the stomach) What Approaches Can Be Used to Increase the Person’s Comfort When Experiencing Pain? Seek a thorough health evaluation. Prepare the person adequately before the healthcare visit so that the exam can be completed. Remember, regardless of a person’s level of disability she is a partner in her own healing—allow her that. Ask primary health care provider about appropriateness of prescription or over-the-counter pain-reducing medications ("analgesia") for temporary relief. Show patience and empathy (reassurance that the person can understand). Speak slowly and softly. Softly touch where and when appropriate. (For example, massage feet, legs, back, or shoulders.) "De-stress" the environment by turning on soft music, eliminating loud noise, and decreasing stimuli. Be sensitive to non-verbal communication, such as body posture, facial expression, words, or sounds. Respond in a caring, non-judgmental way. Ya I wonder why that is exactly. Years ago in collage I fell down some stairs in my dorm. They were wet from the snow, I shook it off but landed on my wrist, it hurt definatly. It was not till the next day that I decided I should go to the hospital it was all red and swallon, hard to use especally for driving the car their. I had a nice broken bone in my wrist, one that would put my entire arm even past the elbow in a cast for 6 weeks. Heck ya know you would think if you broke the thing you would know it, I had a small bone in my wrist broke and didnt know till I looked at it the next day, heh. Stuff never really bothered me, I dont like to complain, their is of course quite a difference from a sharp injury pain VS constant regular backpain I used to get, that bothered me, not so much anymore. I went to grad school with a teacher who taught some of her kids who were non-verbal to use an "Ouch Card." It was a card with a picture of a band-aid and the word "ouch." If the kids hurt somewhere, they would pick up the card and put it on the place on their body that hurt (such as on their knee if it was scraped). I believe that she taught the kids to use it when she obviously knew that they hurt, such as a scraped knee or a bumped arm. The kids would then use it to tell about pain that was no so obvious, like a head ache. I made a version of an ouch card, but I honestly haven't used it yet. If any one wants to try it here's the link: http://www.positivelyautism.com/downloads/ouch_card.doc Glad to see a resource collection about this. It's a really important topic! Nicole "We Read from a Real Book" - Teaching Literacy to the Student with Autism http://www.positivelyautism.com/volume3_issue05/ Thanks, Nicole!   Thank you!  I had been looking for information like this for use with my non verbal son. On page 12 you'll find some symbols and the words kids use together with those symbols when they describe gastro or rheumatological pain. On page 9 you'll find an exercise where the child puts symbols on body parts that have gotten injured at one time or another and tells about the experiences.  Could be an interesting exercise to do with kids who are verbal. http://www.ementalhealthsummit.com/documents/4_6_1%20Calam%2 0IMS.pdf I got an e-mail from these people today, wanting feedback on the checklist.  I haven't used it myself.  If anyone has used it and gets the e-mail, by all means give them feedback on how the tool works for children with autism. http://www.ppprofile.org.uk/ - Paediatric Pain Profile, for documenting your child's behavior on a good day versus when s/he is experiencing various types of pains.
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