Assessing children’s pain: A guide for clinicians caring for children with profound cognitive impairment and complex health care needs

Children with profound cognitive impairment are often unable to verbally communicate their pain, or purposefully communicate it in other ways. As a result, they rely on other people to interpret a wide range of behavioural indicators, signals which are often atypical and idiosyncratic.

These children are a diverse group who also often have complex health care needs. Even very skilled clinicians say that assessing pain in children whose responses are atypical can be tricky and complex. It can place them ‘outside their comfort zone’, making them feel less secure about their pain assessment knowledge and skills.

This guide has been developed from research with clinicians and parents to highlight some of the key things to consider.