Assessing pain in children is such a challenge. Besides the obvious reasons of challenges with communication with non-verbal children as well as difficulty expressing pain in young children, there are more issues that can be encountered. Its difficult to grade pain in some children who have behavioral issues, e.g. overactive, autistic, etc. Some children have overprotective parents who tend to exaggerate even the smallest of issues. It then becomes hard to recognize those instances where the pain is actually significant. Some children want to manipulate their parents by expressing signs of much pain even in the absence of this. What I have found is that when faced with a difficult child or parent, one needs to explore why they are behaving the way they are and address that first. Over protective parents could be doing this because of lack of insight and tremendous fear of the unknown, and with better understanding of their child’s condition this may improve. One needs a lot of patience and understanding when managing children with pain.
