The development and evaluation of the pain indicator for communicatively impaired children (PICIC).

A previous study found that parents of communicatively impaired children with severe cognitive impairments identified six core cues as indicating definite or severe pain in their child (J. Pediatr. Psychol. 27 (2002) 209). The frequency of each cue was assessed by 67 caregivers of communicatively impaired children, twice per day over a 1 week period. On each occasion the caregivers also rated whether they considered their child to be in pain and the severity of any pain. There was a statistically significant relationship between five of the cues and the presence and severity of pain. The single cue of screwed up or distressed looking face was the strongest predictor and on its own correctly classified 87% of pain and non-pain episodes. The study highlights the potential clinical utility of a short carer completed assessment to assess pain in this vulnerable group of children.