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）的儿童通常无法报告他们的疼痛 在口头上，父母经常充当代理记者，解释和描述他们孩子的痛苦。虽然 是大量的证据表明，在生物，心理和社会因素之间的相互作用，在这两个层面上， 儿童和父母影响儿童的行为疼痛表达和父母对疼痛的解释 行为在一般人群中，几乎没有工作调查的影响， 亲子关系对碘缺乏病儿童疼痛评估的影响该项目的长期目标是 提高对影响父母如何评价和应对的动态和相互过程的理解 由于IDD而难以用语言表达自己的儿童的疼痛， 特异质疼痛体征。为了实现这一目标，本项目的短期目标是确定特定的父代 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。为了达到这个目的，本计划将在 这些儿童年龄在1.5至5岁之间，并被诊断为全球性 发育迟缓（GDD）。将在临床指征采血期间对二人组进行视频记录，以评价 疼痛表达、父母的疼痛强度评级和疼痛事件期间的父母行为。信息 亦会收集家长对子女疼痛敏感程度的整体判断。我们将收集以下信息： 儿童的适应行为，沟通能力和粗大运动功能，以及一些 标准化评级量表，对父母的一般负面影响和疼痛相关信念进行分类， 认知完成拟议的项目将导致更好地了解如何亲子因素 交互影响父母对不能自我报告的儿童疼痛的判断。

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.