Cognitive functioning in children and adolescent chronic pain patients

Abstract

Many pediatric pain patients report difficulties in concentration and school performance. Eccleston's and Crombez's (1999) functional model of pain and attention suggest disruption of attention can be adaptive when pain is acute and caused by a specific stimulus. However, when pain is chronic, interruption of attention can become debilitating as it interferes with work, school, or home activities. Attention and memory deficits have been demonstrated in adults with chronic pain and via experimental studies. However, only one study has examined cognitive functioning in children with chronic pain. Ho and colleagues (2009) found in 57 chronic pain patients, ages 8 to18 years old, overall cognitive and achievement scores were mostly in the average range and working memory was a relative weakness. Given the scarcity of research on this issue, a retrospective chart review was conducted to examine cognitive functioning of pediatric pain patients. 111 children and adolescents, 11-18 years old (M = 15, SD = 1.85) who attended the Mayo Clinic Pediatric Pain Rehabilitation Program from 2008 to 2010 were examined. 85 (76.6%) were female. 21.6% of these patients demonstrated difficulties with attention and concentration, 11.7% were behind grade level in at least one subject, 7.2% showed a significant split between verbal and performance skills on the WAIS, and 7.2% met criteria for specific learning disorder. 19.8% were receiving school accommodations for these issues or due to their pain prior to our program. 32.4% received additional recommendations for academic planning in accordance with their screening results. Thus, pediatric pain patients can benefit from receiving psychoeducational assessment as part of their multidisciplinary treatment. Such services can be useful in academic planning which is important given many of these patients enter treatment on homebound instruction but leave with the goal of returning to school. (Iezzi et al., International J Beh Med, 2004)