Dyadic parent-child influences on pain expression and proxy ratings in children with IDD

因为患有智力和发育障碍(IDD)的儿童经常无法报告他们的疼痛 口头上，父母经常充当代理记者，解读和描述孩子的痛苦。尽管在那里 大量证据表明，生物、心理和社会因素之间在两者水平上的相互作用 儿童和父母影响儿童的行为疼痛表达和父母对疼痛的理解 在一般人群的行为中，几乎没有研究二元性影响的工作 亲子关系对缺碘儿童疼痛评估的影响这个项目的长期目标是 加深对影响父母评价和回应的动态和互惠过程的理解 因缺碘导致言语表达困难的儿童和可能表现出 特殊的疼痛征兆。为了实现这一目标，这个项目的短期目标是确定具体的父母 与IDD儿童疼痛表达相关的儿童因素以及父母疼痛的差异 强度等级。该项目将通过招募大样本的亲子二人组来实现这一目标 这些儿童年龄在1.5岁到5岁之间，并已被诊断为全球 发育迟缓(GDD)。在临床指征的抽血过程中将对二元体进行录像以评估 疼痛表达，父母的疼痛强度评级，以及父母在疼痛事件中的行为。有关的信息 家长对孩子疼痛敏感性的总体判断也将被收集起来。我们将收集有关信息 儿童的适应行为、沟通能力和大运动功能，以及几个 标准化评价表，用于对父母的一般负面情绪和与疼痛相关的信念进行分类 认知。拟议项目的完成将有助于更好地了解亲子因素如何 互动，以影响父母对不能自我报告的儿童的痛苦判断。

Because children with intellectual and developmental disabilities (IDD) are frequently unable to report their pain verbally, parents often serve as proxy reporters in interpreting and describing their child's pain. Although there is substantial evidence that interactions among biological, psychological, and social factors at the level of both the child and the parent influence children's behavioral pain expression and parents' interpretation of pain behavior in the general population, there has been almost no work investigating the influence of dyadic parent-child relationships on pain assessment among children with IDD. The long-term goal of this project is to improve the understanding of dynamic and reciprocal processes influencing how parents rate and respond to pain in children who have difficulty expressing themselves verbally due to IDD and who may exhibit idiosyncratic pain signs. To achieve this end, the short-term goal of this project is to identify the specific parent and child factors associated with pain expression among children with IDD and differences in parental pain intensity ratings. The project will achieve this objective by recruiting a large sample of parent-child dyads in which the children are between the ages of 1.5 and 5 years and have been diagnosed with global developmental delay (GDD). Dyads will be video recorded during a clinically-indicated blood draw to evaluate pain expression, parents' pain intensity ratings, and parental behaviors during the pain event. Information on parents' overall judgments of their children's pain sensitivity will also be collected. We will collect information on the children's adaptive behavior, communication abilities, and gross motor function, as well as several standardized rating scales to categorize parents' general negative affect and pain-related beliefs and cognitions. Completion of the proposed project will lead to improved understanding of how parent-child factors interact to influence parents' judgments of pain among children who cannot self-report.