ABSTRACT
This chapter reviews the thinking and highlights some of the pitfalls in the assessment of pain in the preverbal child. To optimize the usefulness and specificity of physiological variables in the assessment of pain, proper clinical assessment of the child is essential to exclude other causes of stress. The evidence suggests that body movement in response to a painful stimulus can be used to assess pain in the pre-verbal child. Very little research has been done in trying to develop a pain assessment tool for the mentally handicapped child; this remains one of the most difficult areas of paediatric pain assessment. When using a pain assessment tool it is important to record the pain score obtained on a flow chart designed specifically for the purpose. It is agreed that small children, including neonates, are capable of experiencing pain. The evidence for this is based on both anatomical and physiological data.
