The Concept of Pain

Introducing the concept of pain or hurt to a young child is a difficult one. I can’t help wondering how many babies and children have something as simple as a headache or a sore throat and are unable to tell us. And we wonder why they’re crying. Having a child with a developmental delay compounds things a bit more. Two-way communication with the child takes much longer than for a typically developing child. Whereas a typical child can tell you what they’re doing or feeling or what they see when they’re two, a child with a delay can sometimes take twice as long, if not more. And to make matters worse, our kids with Down syndrome often have a higher tolerance for pain, which always worries me. Will she be able to recognize something crucial as important to tell mommy and daddy? To what extend do our children have a higher tolerance? While we don’t want our children to feel pain, we do want to know when there’s a potential problem so we can fix it.

This was all driven home for me several weeks back, after Samantha’s accident. I think I had mentioned already how we had a bit of a giggle (along with some frustration) when the doctors and nurses kept asking Samantha what hurts. I just kept picturing her jumping up, pointing to her elbow and saying, “Well, doc, I have this big bruise here, and my arthritis is acting up, and, well, it hurts when I inhale…” I’ve been talking to her more about her boo boos and about how they hurt, and I think she now gets it. She’s very sensitive about boo boos and will cry if she has a Band Aid (just knowing there’s a boo boo under it upsets her). When the Band Aid comes off, she says, “All done Band Aid” and is very relieved to be done with the whole mess, real or imagined. The other day while she was lying with her head on my chest while we watched cartoons, my stomach grumbled (rather loudly, I might add). She sat up, touched my stomach, and said, “tummy hurt!” She did that again, every time it made noise. Also, we’ve been trying to get her constipation under control (it’s gotten particularly bad after her visit to the hospital that day—we think she may have been particularly constipated because of all the drama and fear surrounding that day, but then she may have just become afraid to go as a result), and gave her some extra Miralax and some prune juice yesterday. I think it may have caused some cramping, because a couple of times she said “tummy hurt,” but not in reference to my rather boisterous hunger pangs this time. When I asked her, “Does your tummy hurt?” she responded yes. She then proceeded to make full use of our plumbing facilities, if you know what I mean (Sorry, I was determined not to have a poo post here).

This idea that she can tell us when something hurts is quite exciting to me. Not that I want anything to hurt, but at least I can know how best to help her when she needs it. As it is absolutely not a certainty that she truly understands this, I’d love to hear how some of you have taught your children how to identify and communicate their discomfort. By the way, one of these days I'll learn how to write shorter, more to-the-point posts, rather than rambling on and on like this. I guess that's what I get when I post less than once a week.