Pain communication during infancy and early childhood: When cry becomes a speech act

Elizabeth Stanford (Job) has focused her research on understanding and improving assessment of children’s pain, by learning more about how children express pain, and how pain expression changes from infancy to early childhood. In her Master’s research she pursued three major projects that provided insights into the nature of children’s pain experience and how to improve measurement strategies. Two of her studies examined the language children use when experiencing painful events. The first involved the analysis of recordings of children’s spontaneous use of speech during immunization injections. Results from the study improve understanding of the meaning of these experiences for children and the type of language parents and practitioners can expect from children when they are in pain. The second study examined a large database providing transcriptions of children’s use of pain language during a range of structured and unstructured activities. The results provide important information about children’s spontaneous use of pain language, and could help clinicians and researchers better understand and assess pain in young children. Elizabeth’s final study examined young children’s use of self-report pain scales and described the role of developmental factors in predicting use of these scales. Child age was found to be the best predictor of children’s abilities to use the self-report pain scale. The results also highlight the tendency for over-estimation of young children’s abilities to use self-report scales and the need for tools and training tasks to be developed for use with the scales.