Occasional review: assessment of pain in non-communicative children

Pain is a common experience in non-communicative children with significant learning disabilities and may be an important cause of challenging, including self-injurious, behaviour. Important causes of pain include gastro-intestinal, dental and orthopaedic problems. It is difficult for these children to self-report pain and research is ongoing into schemes to aid self-report. A number of observational pain assessment tools have been developed over recent years and these may facilitate a more accurate assessment of pain, but again more research is needed. Paediatricians are well placed to provide appropriate investigation and management of conditions causing pain in this vulnerable group of children.