Mothers with chronic pain: comparing clinic-based and internet recruitment approaches for a longitudinal mechanistic study of child outcomes

Chronic pain is prevalent in children and adolescents. The current chapter outlines an interpersonal perspective on child pain, demonstrating the central role of child and parent pain-related cognitions in the development and maintenance of chronic pain in childhood. Pain takes place within a social context: children’s expressions of pain (e.g. facial pain displays) are observed and decoded by others (parents), eliciting emotional and behavioural responses. Parents’ responses may impact child outcomes in two ways, directly by imposing activity limitations/encouraging activity engagement or indirectly through observational learning. Although personality and temperamental factors may predispose children and parents to perceive pain as more or less threatening to deal with, the model presented in this chapter focuses on proximal pain-related cognitive processes and associated behaviours that contribute to pain-related disability in children. Recent evidence suggests that perceptions of pain as highly threatening (i.e. catastrophizing) may lead to fearful reactions to pain, activity avoidant behaviours, and more disability. In parents, catastrophizing thoughts about child pain are associated with higher levels of child disability, with recent evidence implicating parent protective behaviours as a mediating mechanism.

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A GROUP FOR PARENTS OF YOUTH WITH CHRONIC PAIN: RATIONALE, STRUCTURE, CONTENT, AND PRELIMINARY OUTCOME DATA

Paediatrics & Child Health ◽

10.1093/pch/pxy054.004 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e2-e2

Author(s):

Kim Edwards ◽

C Meghan McMurtry ◽

Soeun Lee ◽

Elena Jackson

Keyword(s):

Chronic Pain ◽

School Attendance ◽

Pain Catastrophizing ◽

Child Outcomes ◽

Parent Satisfaction ◽

Outcome Data ◽

Feedback Form ◽

School Partnerships ◽

High Satisfaction ◽

Pain Symptoms

Abstract BACKGROUND Parenting a youth with chronic pain can be challenging and have a significant impact relationally, emotionally and financially on caregivers (Palermo, 2000; Lewandowski et al., 2010). There is a growing literature indicating that parent emotions (e.g., anxiety, depression), cognitions (e.g., coping, pain catastrophizing), and behaviours (e.g., attending to pain symptoms) can moderate a child’s adjustment to chronic pain (Logan & Scharff, 2005; Palermo et al., 2014; Palermo & Eccleston, 2008). Therefore, intervening with parents of youth with chronic pain is believed to foster better outcomes regarding children’s functioning (e.g., school attendance; Coakley & Wihak, 2017). OBJECTIVES No study has evaluated a stand-alone intervention targeted at parents of youth with chronic pain. Consequently, this poster presents a five week parenting group that we developed and ran on four occasions. Preliminary results pertaining to group feasability, satisfaction, and effectiveness will also be presented. DESIGN/METHODS The group is designed to augment the treatment of youth in our program and includes the following topics: chronic pain 101 (psychoeducation), impact of pain on the family, self-care, tools for managing a child’s pain, identifying and overcoming barriers, school partnerships, and celebrating successes. Each session involves homework review, a mindfulness activity, new material (inclusive of a didactic activity), goal-setting, and assigned readings. To date, 41 parents of youth with chronic pain have participated in the four group cycles. Outcomes were measured using the Adult Responses to Children’s Symptoms (ARCS) Questionnaire (Noel et al., 2015; Van Slyke & Walker, 2006) which parents completed at the start and end of the group. Feedback and parent satisfaction were also obtained on a feedback form designed by authors and given on the last session of group. RESULTS Overall, the group demonstrated adequate feasibility, was well-received by parents, and high satisfaction was reported. Preliminary data suggest that the group was helpful in reducing some parental responses associated with maladaptive child outcomes. More specifically, statistically significant decreases in protectiveness, monitoring, and minimizing (subscales of the ARCS) were found after the 5 week intervention. CONCLUSION “Anecdotally, many parents expressed uncertainty about how to respond when adolescents complained of pain and refused to go to school, and parents appeared eager for…strategies to help them negotiate the situation” (Logan & Simons, 2010, p. 833). Our results are consistent with previous literature (Logan & Simons, 2010; Saunders et al., 1994) and suggest that intervening with parents may help improve outcomes for youth with chronic pain.

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Parent Responses to Their Child's Pain: Systematic Review and Meta-Analysis of Measures

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsaa005 ◽

2020 ◽

Vol 45 (3) ◽

pp. 281-298 ◽

Cited By ~ 2

Author(s):

Lauren E Harrison ◽

Inge Timmers ◽

Lauren C Heathcote ◽

Emma Fisher ◽

Vivek Tanna ◽

...

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Pain Intensity ◽

Functional Disability ◽

Meta Analysis ◽

Child Outcomes ◽

Temporal Stability ◽

Study Characteristics ◽

Meta Analyses ◽

Mixed Pain

Abstract Objective Parent responses can have a major impact on their child’s pain. The purpose of this systematic review is to (a) identify and describe measures assessing pain-related cognitive, affective, and behavioral responses in parents of children with chronic pain and (b) meta-analyze reported correlations between parent constructs and child outcomes (i.e., pain intensity, functional disability, and school functioning). Prospero protocol registration ID: CRD42019125496. Methods We conducted a systematic search of studies including a measure of parent/caregiver responses to their child’s chronic pain. Study characteristics and correlations between parent measures and child outcomes were extracted. Data were summarized and meta-analyzed. Results Seventy-nine met inclusion criteria using 18 different measures of cognitive/affective (n = 3), behavioral (n = 5), and multidimensional responses (n = 10). Measures were used a median of three times (range 1–48), predominantly completed by mothers (88%), and primarily in mixed pain samples. Psychometrics of measures were generally adequate. Meta-analyses were based on 42 papers across five measures. Results showed that each of the cognitive, affective, and behavioral parent constructs we examined was significantly associated with pain-related functional disability. A small number of measures assessing parent cognitions and affective functioning were associated with higher child pain intensity; however, the majority were not. Conclusion Findings demonstrate that there is a wealth of measures available, with adequate reliability overall but a lack of psychometrics on temporal stability. Synthesizing data across studies revealed small effects between parent responses and child functioning, and even smaller and/or absent effects on child pain intensity.

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Engagement in Multidisciplinary Interventions for Pediatric Chronic Pain: Parental Expectations, Barriers, and Child Outcomes

Clinical Journal of Pain ◽

10.1097/ajp.0b013e3181cf59fb ◽

2010 ◽

Vol 26 (4) ◽

pp. 291-299 ◽

Cited By ~ 74

Author(s):

Laura E. Simons ◽

Deirdre E. Logan ◽

Laura Chastain ◽

Madelin Cerullo

Keyword(s):

Chronic Pain ◽

Child Outcomes ◽

Parental Expectations ◽

Pediatric Chronic Pain

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Applying Generalizability Theory to Optimize Analysis of Spontaneous Teacher Talk in Elementary Classrooms

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00118 ◽

2020 ◽

Vol 63 (6) ◽

pp. 1947-1957

Author(s):

Alexandra Hollo ◽

Johanna L. Staubitz ◽

Jason C. Chow

Keyword(s):

Special Education Teachers ◽

Generalizability Theory ◽

Child Outcomes ◽

Elementary Classrooms ◽

Teacher Talk ◽

Group Instruction ◽

Data Set ◽

School Year ◽

Minimum Number ◽

Representative Samples

Purpose Although sampling teachers' child-directed speech in school settings is needed to understand the influence of linguistic input on child outcomes, empirical guidance for measurement procedures needed to obtain representative samples is lacking. To optimize resources needed to transcribe, code, and analyze classroom samples, this exploratory study assessed the minimum number and duration of samples needed for a reliable analysis of conventional and researcher-developed measures of teacher talk in elementary classrooms. Method This study applied fully crossed, Person (teacher) × Session (samples obtained on 3 separate occasions) generalizability studies to analyze an extant data set of three 10-min language samples provided by 28 general and special education teachers recorded during large-group instruction across the school year. Subsequently, a series of decision studies estimated of the number and duration of sessions needed to obtain the criterion g coefficient ( g > .70). Results The most stable variables were total number of words and mazes, requiring only a single 10-min sample, two 6-min samples, or three 3-min samples to reach criterion. No measured variables related to content or complexity were adequately stable regardless of number and duration of samples. Conclusions Generalizability studies confirmed that a large proportion of variance was attributable to individuals rather than the sampling occasion when analyzing the amount and fluency of spontaneous teacher talk. In general, conventionally reported outcomes were more stable than researcher-developed codes, which suggests some categories of teacher talk are more context dependent than others and thus require more intensive data collection to measure reliably.

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