When a nonverbal child is in pain, it’s usually the parent who acts as the interpreter. Does the child behave differently, or move in a different way? But being parents, they may be prone to bias. Healthcare professionals have therefore been seeking objective ways to assess pain and discomfort in nonverbal patients — such as intellectually developmentally disabled children with cerebral palsy — using self-reporting devices otherwise known as “augmentative and alternative communications” tools.
How Columbia is Innovating Self-Reporting Devices
To date, self-reporting tools have included computer programs that require the user to manipulate a mouse to move a cursor to check off a small box on a screen — not the easiest task for someone with mobility challenges. Prof. Agrawal and David P. Roye, Jr., MD, Director of Pediatric Orthopaedic Surgery at NYP/Morgan Stanley Children’s and St. Giles Foundation Professor of Pediatric Orthopaedic Surgery at Columbia University College of Physicians and Surgeons, are collaborating with other members of their teams to adapt existing technologies to make it easier for nonverbal patients to report their symptoms objectively.
Examples include computer tablets with large buttons or numbers on the screen corresponding to a pain scale; use of a wireless joystick to move a computer cursor; or entire sentences (such as “my head hurts” or “I have pain in my leg”) which patients could “swipe” on a screen to communicate how they feel. Says Dr. Roye, “We’re not necessarily looking to create new devices, but for ways to use existing devices in new ways.”