Chronic Pain Assessment in Middle Childhood: Findings from a Community-Based Study

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Health, Growth, Injury

Abstract

Objective: Understanding the scope of chronic pain in childhood is a daunting task given the difficulties of assessment and entanglement with other diagnoses. However, it is crucial to understand chronic pain in childhood and adolescence as it is not only correlated with poor outcomes in the immediate future, but is also associated with a lifelong trajectory of poor physical, psychosocial, and vocational outcomes (Groenewald et al., 2019; Hoftun et al., 2011; Huguet & Miró, 2008; Murray et al., 2020; Walker et al., 2012). The current study describes the process of assessing diagnosable chronic pain conditions among children in community research settings. We examined the prevalence of six chronic pain conditions among a community-based sample of children in middle childhood.

Methods: Participants included 795 twin children (51.2% female; 59.8% non-Hispanic Caucasian, 28.0% Hispanic) and their caregivers (399 families) from an ongoing, longitudinal twin study. When the twins were approximately nine years of age (M=9.71, SD=0.93) families were contacted to participate in an intensive assessment focused on child pain. Primary caregivers completed a screening questionnaire on recurring pain for each child. If recurring pain was endorsed, caregivers then completed a battery of clinical pain questions for the child. Clinical pain assessment measures included modified questionnaires developed for the Orofacial Pain: Prospective Evaluation and Risk Assessment Study (Dionne et al., 2008; Dworkin & LeResche, 1992; Headache Classification Subcommittee of the International Headache Society, 2004; Hyams et al., 2016; Slade et al., 2011; Wolfe et al., 2010).

Results: Overall, 365 children did not have a clinical pain assessment completed for them either due to not meeting criteria from the screening form or the caregiver did not complete the assessment at all. Therefore, 430 children met screening criteria for at least one of the clinical pain conditions. Out of those assessed, 166 children met criteria for at least one chronic pain condition (20.9% of total sample). Specifically, 22 children met criteria for migraines with another 17 reporting a migraine diagnosis, 125 met criteria for tension-type headaches (90 infrequent type, 93 frequent type, and 2 chronic), 3 met criteria for chronic temporomandibular pain, 21 met criteria for chronic abdominal pain, 11 met low-back pain criteria, and 1 child met criteria for widespread pain.

Conclusions: Findings indicate that over 20% of children met diagnostic criteria for at least one chronic pain condition, with the majority of these meeting criteria for a headache condition. This study demonstrates the feasibility of assessing diagnostic levels of chronic pain for multiple conditions among children in community-based research settings. Further, given the prevalence rate, this study underscores a need for early pain interventions, especially targeting risk factors for headache pain, as pain in childhood is associated with lifelong pain trajectories and poor mental and physical health outcomes.

Authors

• Samantha Miadich, University of Massachusetts Lowell
  Presenting Author

• Mary Davis, Arizona State University
  Non-Presenting Author

• Kathryn Lemery-Chalfant, Arizona State University
  Non-Presenting Author