Johnson Ensa, van Zijl Karen, Kuyler Ariné
Department of Inclusive Education, College of Education University of South Africa Pretoria South Africa.
School of the Arts: Visual Arts University of South Africa Pretoria South Africa.
Paediatr Neonatal Pain. 2023 Oct 13;5(4):127-141. doi: 10.1002/pne2.12115. eCollection 2023 Dec.
Children with autism spectrum disorder (ASD) experience social interaction and communication challenges and often display repetitive, restricted patterns of behavior, activities, and interests. The concept of pain is regarded as one of the most complex human stressors due to its subjective and personal nature and the influences of multiple internal and external factors. Due to the complexity of this disorder, it remains concerning how children with ASD communicate their pain and how observers (i.e., parents, carers, and health care practitioners) respond to these children's pain communication. This scoping review aimed to identify how children with ASD communicate or express their pain. Ten studies met the inclusion criteria for further data extraction. Through reflexive thematic analysis, two main themes were identified: verbal and nonverbal responses used by children with ASD to communicate their pain that could influence pain assessment and management strategies. This review highlighted that children with ASD utilized various verbal and nonverbal methods to communicate their pain experiences and that these methods differed compared to children without disabilities. Furthermore, this review emphasizes the importance of holistic pain assessment strategies as well as additional pictorial support for children with ASD. This review recommends that future research should focus on understanding how the inclusion of different stakeholders in pain assessment for children with ASD, can contribute to holistic pain assessment.
患有自闭症谱系障碍(ASD)的儿童在社交互动和沟通方面存在困难,并且常常表现出重复、受限的行为、活动和兴趣模式。由于疼痛具有主观性和个人性,以及受到多种内部和外部因素的影响,因此疼痛的概念被视为人类最复杂的应激源之一。由于这种疾病的复杂性,患有ASD的儿童如何传达他们的疼痛,以及观察者(即父母、照顾者和医护人员)如何回应这些儿童的疼痛传达,仍然令人担忧。本范围综述旨在确定患有ASD的儿童如何传达或表达他们的疼痛。十项研究符合进一步数据提取的纳入标准。通过反思性主题分析,确定了两个主要主题:患有ASD的儿童用于传达疼痛的言语和非言语反应,这可能会影响疼痛评估和管理策略。本综述强调,患有ASD的儿童利用各种言语和非言语方法来传达他们的疼痛经历,并且与无残疾儿童相比,这些方法有所不同。此外,本综述强调了整体疼痛评估策略以及为患有ASD的儿童提供额外图片支持的重要性。本综述建议,未来的研究应侧重于了解在患有ASD的儿童的疼痛评估中纳入不同利益相关者如何有助于进行整体疼痛评估。