Phantom limb sensations in adolescents: a case study to illustrate the utility of sensation and pain logs in pediatric clinical practice.

Although the nature of pain following amputations has been well documented for adults, little research has been conducted to determine the incidence, prevalence, and nature of phantom limb sensations and pains in children and adolescents. This case study documents the nature of phantom limb sensation (intensity, quality, location, duration, and frequency) for a 15-yr-old adolescent after leg amputation. She completed a brief sensation/pain log, consisting of quantitative and qualitative scales, for 28 days after surgery. She experienced phantom limb sensations, which spread from her toes to encompass her entire leg by day 10 after surgery. The pattern of spread was not consistent throughout this period. The quality of sensations remained relatively constant and was described as itching and tingling. The phantom sensations were not experienced consistently throughout the day, but were experienced as discreet episodes. Both the duration and frequency of these episodes decreased throughout the 28 days. Similarly, the intensity of her phantom sensations decreased gradually throughout this period. This case study illustrates how it is possible to integrate research with health care delivery in a practical manner, to obtain prospective information about the nature of childhood sensory experiences.

The enigma of pain in children: an overview.

During the last 2 decades, a vast amount of information has been obtained about the sensory system responsible for pain perception, with the result that there have been dramatic changes in the understanding of how pain is experienced and how pain can be modified. However, recent advances in the management of pain have been confined almost exclusively to adults. Consequently, our understanding about pain perception in infants, children and adolescents, our knowledge about the prevalence of different pain problems for children and data about the effectiveness of various pharmacological and nonpharmacological pain control methods are limited. This article explores the issue of the undertreatment of acute, recurrent, chronic and cancer pain in infants and children.

Age and gender differences in school-age children's appraisals of injury risk.

OBJECTIVE: To examine age and gender differences in children's perception of injury risk and to evaluate cognitive factors that relate to their appraisal of risk. METHODS: The participants were 120 children (6 to 10 years of age), who used a series of photographs, which depicted play activities that varied from no to high risk, to appraise injury risk. RESULTS: Children were able to distinguish varying degrees of injury risk. Boys rated risk as lower than girls, and 6-year-old children identified fewer risk factors and did so more slowly than 10-year-old children. For girls, perceived vulnerability to injury was the best predictor of injury risk ratings, whereas for boys it was judged severity of potential injury. CONCLUSIONS: Children's appraisal of risk and age and gender differences in related factors highlight important components for injury prevention programs.