Accuracy of Children′s and Parents′ Memory for a Novel Painful Experience

Abstract

BACKGROUND: Despite recent progress in understanding memory of pain in adults, the validity of the assumption that these findings extend to children has not been established. Because treatment often is evaluated on the basis of pain recall, it is crucial that the accuracy of pain memories in children be established.OBJECTIVES: To examine children's ability to recall pain intensity and contextual details associated with a novel painful experience. Furthermore, children's memories were compared with those of their parents.SUBJECTS AND METHODS: Twenty-three parent-child dyads were recruited from a sample participating in an earlier study investigating children's responses to the cold pressor test and parents' characterization of the children's responses. Children (age five to 12 years) and parents independently had rated the child's pain using a seven-point Faces Pain Scale. Approximately one year later, they were asked to recall the experience and rate the pain again. Memory for contextual details associated with the event also was assessed through a series of open-ended questions.RESULTS: A 2 (rater) × 2 (time period) repeated measures ANOVA examined the reliability of ratings and differences between parent and child ratings of pain, both recorded at the time of the cold pressor and recalled one year later. There were no significant differences in ratings over time or between parent and child.CONCLUSIONS: The findings indicate that children's memories of a novel painful experience can be consistent over a long interval. Moreover, parents' ratings also reflect good recall and can be in agreement with those of their children.

Children's memory for pain: overview and implications for practice

“…3,43,44,69 This research indicates that children can accurately recall previously experienced pain over a period of months or even years. For example, Badali et al 3 examined 5-to 12-year-old children's memory of reported pain intensity for pain from a cold pressor task, which requires children to immerse their hand in cold water for as long as they can.…”

“…What is the consequence of recalling painful experiences on management of subsequent medical experiences in childhood and adulthood? With respect to children, much of what we know concerns recall of stressful experiences, rather than recall of the experience of pain itself (with a few exceptions 3,43,69 ). A body of evidence shows that stressful invasive procedures are recalled quite accurately over delays of between 6 weeks and many years.…”

Remembering pain after surgery

“…Previous memory research has used time frames ranging from one week to one year [2; 9]. Parents and children completed the memory interviews out of earshot of each other so as to not bias their recall.…”

“…Parents and children completed the memory interviews out of earshot of each other so as to not bias their recall. The memory assessment followed a similar protocol to that used with children and adolescents examining children’s memory for venipuncture [25] and cold pressor pain [2; 22; 23]. Prior to answering the four memory questions, children and parents were asked to first recall when they/their child were at home in the first few weeks following surgery.…”

Guidelines for the cold pressor task as an experimental pain stimulus for use with children

“…Some researchers have adapted various kinds of tanks (eg, insulated picnic chests, Figs 1 and 2) with 2 compartments separated by a plastic or metal filter. 3,9,16,25,33,34,42,47 In an apparatus of this type, one compartment holds ice and water, and the other, the immersion tank, holds water alone so that the child's hand never comes into direct contact with ice. A pump causes water to flow (continuously or as needed) between the 2 compartments, a process that helps to keep the water near the target temperature and prevents the development of a microenvironment of warm water around the child's hand.…”