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Background: There is growing evidence confirming that youths with physical disabilities are at risk for chronic pain. Although many scales for assessing pain intensity exist, it is unclear whether they are all equally suitable for youths. The aim of this study was to address this knowledge gap by comparing the validity of the Numerical Rating Scale (NRS-11), the Wong Baker FACES Pain Rating Scale (FACES), and a 6-point categorical Verbal Rating Scale (VRS-6) for assessing pain intensity among youths (aged 8–20) with physical disabilities. Methods: One hundred and thirteen youths (mean age = 14.19 years; SD = 2.9) were interviewed and asked to rate their current pain intensity and recalled (in the past week) worst, least, and average pain with the NRS-11 and the FACES. Participants were also asked to rate their average pain intensity during the past 4 weeks using a VRS-6, and were administered measures assessing pain interference, disability and psychological functioning. Results: Analyses showed that all of the pain intensity measures were associated positively with each other. Nevertheless, the NRS-11 appeared to out-perform both the VRS-6 and in particular the FACES scale with respect to: (1) the associations with the validity criterion (i.e. pain interference, disability and psychological functioning) and (2) a lack of any moderating effect of age on the association between the measure and the criterion variables. Conclusions: The findings support the validity of the NRS-11 for assessing pain intensity in youths with physical disabilities between the ages of 8 and 20 years.

The role of the occupational therapist in pediatric pain management is emerging. Whatever intervention methods are used, effective management of pain and associated symptoms depends upon accurate assessment. The use of the Sensory Integration and Praxis Tests (SIPT) for identifying vestibular-proprioceptive abilities in children experiencing recurrent migraine or mixed headaches was investigated. Most of the subjects showed significantly high postrotary nystagmus scores and strengths in the areas of sensory processing and praxis. These data suggest the SIPT may be helpful in determining cortical versus brain-stem processing dysfunction in children with recurrent headaches to assist with treatment intervention.

Pain is a primary reason for seeking health care. The effect of a cognitive-behavioral treatment program on complaints of chronic, recurrent, non-malignant pain was evaluated. The treatment procedure consisted of a combination of a psychoeducational approach, and relaxation and attention diversion techniques, positive coping self-statements and homework assignments. Decreased pain complaints and improved mood were reported after completion of the program. These data support the use of the cognitive-behavioral frame of reference to alleviate adult pain complaints and suffering.

SYNOPSIS The long-term effects of relaxation training for pediatric headache disorders was determined for 17 of 20 original participants from a prospective control-group experimental design study with random assignment to antogenic relaxation, progressive relaxation, autogenic plus progressive relaxation, or waiting list control groups. Long-term follow-up data were obtained at an average of 51 months post-treatment. All participants reported some increases in headache activity. Participants in the three relaxation treatment groups, however, had significantly more headache-free days and less severe headache compared to the control group. There were no significant effects of treatment for headache duration, medication intake and rest time due to headache. Twelve of the 13 treated participants indicated relaxation training was effective in relieving headaches, with 7 reporting they practiced relaxation exercises within the past month. The results generally support the long-term benefits of relaxation in reducing headaches originating in childhood.