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Pain communication of children with cerebral palsy in South African school settings: AAC implications

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Many children with cerebral palsy (CP) and complex communication needs experience pain on a daily basis and this may affect their attention and schoolwork. Owing to their communication difficulties they communicate less than their peers with typical development. Professionals in schools should therefore be aware of when and how these children express their pain and also acknowledge that proxy assessments cannot replace children's self-reports. Self-report of pain experiences are essential to ensure appropriate pain treatment.

AIM. The aim of the current study is to explore how professionals in South African school settings assess pain in children with CP; how they interpret children’s pain communication, and what pain-related vocabulary could be considered when selecting vocabulary for augmentative and alternative communication systems of multi-lingual children with CP.

METHOD. Thirty-eight school professionals participated in five focus groups. Their statements were categorised using qualitative content analysis.

RESULTS. The presentation will focus on a discussion of the results such as professionals’ observations and how professionals interpret children’s pain communication. The use of alternative communication strategies by children with CP in South African school settings during pain communication as well as their use of pain-related vocabulary in the multi-lingual context will also be addressed.

CONCLUSION. The importance of offering children with CP means to self-report and express their pain experiences. The use of alternative communication strategies, to enable children with CP and complex communication needs to communicate pain is advocated. The necessity of considering pain-related vocabulary in multilingual contexts during vocabulary selection is highlighted.


Ensa Johnson    
Centre for AAC, University of Pretoria
South Africa

Stefan Nilsson    
Institute of Health and Care Sciences, University of Gothenburg

Margareta Adolfsson    
School of Education and Communication, Jönköping Universityf


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