Parents and Physiotherapists Recognition of Non-Verbal Communication of Pain in Individuals with Cerebral Palsy

Health Commun. 2018 Dec;33(12):1448-1453. doi: 10.1080/10410236.2017.1358243. Epub 2017 Aug 29.


Pain assessment is difficult in individuals with cerebral palsy (CP). This is of particular relevance in children with communication difficulties, when non-verbal pain behaviors could be essential for appropriate pain recognition. Parents are considered good proxies in the recognition of pain in their children; however, health professionals also need a good understanding of their patients' pain experience. This study aims at analyzing the agreement between parents' and physiotherapists' assessments of verbal and non-verbal pain behaviors in individuals with CP. A written survey about pain characteristics and non-verbal pain expression of 96 persons with CP (45 classified as communicative, and 51 as non-communicative individuals) was performed. Parents and physiotherapists displayed a high agreement in their estimations of the presence of chronic pain, healthcare seeking, pain intensity and pain interference, as well as in non-verbal pain behaviors. Physiotherapists and parents can recognize pain behaviors in individuals with CP regardless of communication disabilities.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cerebral Palsy / complications
  • Cerebral Palsy / psychology*
  • Child
  • Child, Preschool
  • Chronic Pain / complications
  • Chronic Pain / diagnosis*
  • Chronic Pain / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nonverbal Communication / psychology*
  • Pain Measurement / methods
  • Pain Measurement / psychology*
  • Parents / psychology*
  • Physical Therapists / psychology*
  • Professional-Patient Relations
  • Spain
  • Surveys and Questionnaires
  • Young Adult