Prevalence and impact of bumps, bruises, and other painful incidents among children while handling and riding horses

Horseback riding and related activities bring risks for serious injury. Extant literature focuses largely on moderate to severe horse-related injuries resulting in a need for medical care. Yet incidents deemed as less severe are also important, with potential to impact subsequent safety precautions and behaviors of parents and children. The study objectives were to gather preliminary information about: (1) the prevalence of a range of horse-related painful incidents experienced by children, (2) children\u27s helmet use and supervision, and (3) the subsequent impact of horse-related painful incidents. The methodological approach was based on a questionnaire. One hundred and twenty four child (120 Female; Mage: 11.82 years; rangeage: 8–18; SDage: 2.26) and parent (103 mothers; 16 fathers; 5 other legal guardians) dyads completed a brief 5 minute researcher-generated questionnaire. The results show, that painful incidents are common for children when handling and riding horses, with the majority of children having experienced these incidents more than once. Helmet use and supervision (typically by parents and coaches) were reported to occur consistently during riding, but less commonly during handling (e.g., grooming). Despite the high prevalence of painful incidents, these incidents largely do not impact children\u27s ability to participate in other activities, result in access to specialized medical attention, or alter children\u27s perceptions or behavior around horses. Findings may have implications for safety and education initiatives. Management implications: Findings from this work suggest several implications. First, in acknowledging the range and frequency of incidents that occur during horse-related activities, educational initiatives should target a broad range of incident types when teaching about horse safety and injury prevention. Second, in recognizing primary caregivers and riding coaches as the most common supervisors of horse-related activities, they should also be targeted in educational initiatives (e.g., horse and safety knowledge, first aid, supervision guidelines). Finally, in developing and implementing targeted safety and injury prevention initiatives, reported benefits of the sport (e.g., improved problem-solving skills) could be used and supported in safety programming

Caring for children with intellectual disabilities part 1: Experience with the population, pain-related beliefs, and care decisions

Some children with intellectual disabilities (ID): experience pain more frequently than children without ID, express their pain differently, and are incapable of providing self-reports. No research has examined disability and pain-related beliefs of respite workers (RW) and their relations to pain assessment and management decisions for children with ID. Objectives (1) compare disability and pain-related beliefs between RW and a sample with little experience in ID; (2) determine whether individuals’ beliefs and personal characteristics are related to pain assessment and management decisions. Participants Fifty-six RW (aged: 18–67 years, Mage = 33.37, 46 female) and 141 emerging adults (aged: 18–31 years, Mage = 19.67, 137 female). Procedure/measures In an online survey, participants responded to six vignettes depicting pain in children with ID, and completed measures of pain and disability-related beliefs. Results/discussion Compared to those without experience, RW held more positive disability-related beliefs, t(192) = 4.23, p \u3c 0.001. Participants’ pain-related beliefs (e.g., sensitivity to pain) differed depending on severity of the child\u27s ID and participant group. Participants’ pain-related beliefs predicted care decisions. Results provide initial insight into RW pain-related beliefs about children with ID, and a basic understanding of the relations among pain beliefs, personal characteristics and pain-related decisions

Observer perceptions of pain in children with cognitive impairments: vignette development and validation

AIM: Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses

Caring for children with intellectual disabilities part 2: Detailed analyses of factors involved in respite workers’ reported assessment and care decisions

Respite workers (RW) commonly care for children with intellectual disabilities (ID), and pain is common for these children. Little is known about factors which inform RW pain assessment and management-related decisions. Objectives To describe/determine the following in response to a series of pain-related scenarios (e.g., headache, falling): (1) factors considered important by RW when assessing children with ID\u27s pain; (2) whether children\u27s verbal ability impacts pain assessment factors considered; (3) RW assessment and management approach. Participants Fifty-six RW (18–67 years, Mage = 33.37, 46 female). Procedure/measures In an online survey, participants read and responded to six vignettes manipulating child verbal ability (verbal, nonverbal) and pain source. Results The factors most frequently considered when assessing pain were child behavior (range: 20–57.4%), and history (e.g., pain, general; 3.7–38.9%). Factors did not vary by child\u27s verbal ability. RW indicated varied assessment and management-related actions (range: 1–11) for each scenario. Discussion Findings suggest: a) factors informing pain assessment did not depend on whether or not the child was verbal and b) a degree of flexibility in RW response to pain across situations. While these findings are encouraging, ensuring RW have adequate pain assessment and management knowledge specific to children with ID is critical

Facilitating respite, communication, and care for children with intellectual and developmental disabilities: Preliminary evaluation of the Caregiver Pain Information Guide.

Background: Pain is common in children with intellectual and developmental disabilities (I/DD) and yet is an understudied issue. Respite workers commonly care for children with I/DD but are lacking in resources to assist in pain assessment and management for this population. Without adequate knowledge in this domain, children with I/DD are at risk of their pain being underrecognized and undermanaged. A resource for caregivers was developed to address this issue, facilitating communication between parents and respite workers and better addressing the complex pain-related needs of children with I/DD. The objective of this study was to solicit initial feedback on the content, feasibility, and usability of the resource. Method/Procedure: Semistructured individual interviews and questionnaires were completed with 7 parents of children with I/DD and 6 respite workers. Results: All participants viewed the resource as important and potentially useful. Content analyses indicated that participants appreciated the comprehensiveness and format of the resource, whereas the modifiability was identified as an area for improvement. Participants believed that the resource would be useful across settings with a variety of caregivers. Three categories of considerations were identified as potential facilitators and barriers for implementation: consideration of how the resource is being completed, who is completing it, and organization-based procedures. Discussion/Conclusions: Results from this study suggest that the Caregiver Pain Information Guide is a promising resource for helping respite workers better understand pain in children with I/DD. Future work is needed on implementation and impact of this resource in community settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Implications for Impact Statement—Children with intellectual and developmental disabilities experience pain frequently and are at risk of having their pain missed by caregivers. Parents would like to share pain-related knowledge and skills specific to their children with intellectual and developmental disabilities with those who support their child in other settings. The Caregiver Pain Information Guide was created to facilitate communication between parents and caregivers of these children. The current article discusses initial feedback from parents and respite workers regarding this new tool. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Pain in children with intellectual disabilities: a randomized controlled trial evaluating caregiver knowledge measures

Inadequate knowledge has contributed to inaccurate pain assessment and treatment for children with intellectual disabilities

Massage therapy for symptom reduction and improved quality of life in children with cancer in palliative care: A pilot study

Background: For children with cancer in palliative care, pain and worry are common and frequently under-managed, which negatively impacts quality of life (QOL). Massage therapy (MT) can lead to reduced pain in children with chronic illnesses. Children with cancer have experienced lower anxiety after MT. No studies have examined the effects of MT in pediatric oncology patients receiving palliative care. Objective: Conduct a MT intervention to determine intervention acceptability and initial effects on ratings of pain, worry reduction, and quality of life. Design: Pre-post single group pilot study. Setting/Subjects: Eight children with cancer (age 10–17) and one of their parents were recruited from a palliative care service. Procedure/Measurements: Baseline (one week prior to intervention): demographics, MT expectations, QOL, and pain measures. Intervention (one month): MT was provided once per week, with children\u27s pain and worry ratings occurring immediately before and after each MT session. Follow Up (4–6 weeks after baseline): QOL, pain, and MT/study acceptability questionnaires. Results: Participants reported significant decreases in pain following two MT sessions, and worry following one session. No significant changes in pain symptoms and QOL were found between baseline and follow up. Participants positively endorsed the study and the MT intervention, and there were no adverse effects reported. Conclusions: MT may lead to immediate decreases in pain and worry in children with cancer who are receiving palliative care, however the effects may not be sustained long term. Difficulties regarding protocol feasibility including recruitment and study compliance remain important considerations for future work

Pain in Children with Developmental Disabilities: Development and Preliminary Effectiveness of a Pain Training Workshop for Respite Workers

Introduction: Pain in children with intellectual disabilities (ID) is common and complex, yet there is no standard pain training for their secondary caregivers (ie, respite staff). Objectives: Determine perceived pain training needs/preferences of children\u27s respite staff (phase 1) and, use this information combined with extant research and guidelines to develop and pilot a training (phase 2). Methods: In phase 1, 22 participants responded to questionnaires and engaged in individual interviews/focus groups about their experiences with pain in children with ID, and perceived training needs/preferences. In phase 2, 50 participants completed knowledge measures and rated the feasibility of, and their own confidence and skill in, pain assessment and management for children with ID immediately before and after completing a pain training. They also completed a training evaluation. Results: Participants viewed pain training as beneficial. Their ideal training involved a half-day, multifaceted in-person program with a relatively small group of trainees incorporating a variety of learning activities, and an emphasis on active learning. Phase 2 results suggested that completion of the 3 to 3.5-hour pain training significantly increased respite workers\u27 pain-related knowledge (effect sizes: r=0.81 to 0.88), as well as their ratings of the feasibility of, and their own confidence and skill in, pain assessment and management in children with ID (effect sizes: r= 0.41 to 0.70). The training was rated favorably. Discussion: Training can positively impact respite workers\u27 knowledge and perceptions about pain assessment and management. As such, they may be better equipped to care for children with ID in this area

Historical analysis in pediatric psychology: The influence of societal and professional conditions on two early pediatric psychology articles and the field\u27s subsequent development

The field of pediatric psychology arose in the 1960s in response to a variety of societal and professional needs. 2 seminal articles written during this time, by Jerome Kagan (1965) and Logan Wright (1967), played key roles in the field\u27s development. However, their efficacy in galvanizing a response from medical professionals and psychologists had much to do with broad-ranging developments in pediatric public health, intraprofessional changes among medical specialties, and a growing preoccupation with \u27\u27psychosocial\u27\u27 and parenting issues. The purpose of this paper is to situate Kagan\u27s (1965) and Wright\u27s (1967) contributions within their social and historical contexts, and thereby to elicit reflection on the field\u27s subsequent and continued development