Orlova N., Bazian A., Arzumanova I. 

DIAGNOSIS OF CHRONIC PAIN IN CHILDREN WITH PARALYTIC 

SYNDROMES ON THE NCCPC-R SCALE AND CLINICAL SIGNS 

Kharkiv National Medical University 

Department of Pediatrics No.1 and Neonatology 

Kharkiv, Ukraine 

Supervisor: Riga O. 

 

Introduction. According to experts in the field of chronic pain in children, 

it occurs in 12 % of all pediatric patients, which negatively affects the quality of 

life of children and their families. Especially often chronic pain is associated 

with disability. 

Aim. Determination of clinical signs diagnosing chronic pain in children 

with paralytic syndromes using the NCCPC-R scale. 

Materials and Methods. 92 children were involved in the study. The age of 

the children ranged from 1 to 7 years. Study group included 64 children (40 

boys, 24 girls) with paralytic syndromes, among them 38 children (24 boys, 14 

girls) with chronic pain and 26 children (15 boys, 11 girls) without pain. 

Control group included 28 healthy children (17 boys, 11 girls). 

Результати. The Non-communicating Children’s Pain Checkist - Revised 

scale (NCCPC-R) is recommended by the developer for use in children from 3 

years of age. When evaluating the NCCPC-R scale for children older than 3 

years with paralytic syndromes and chronic pain in the voice, the most common 

clinical sign was "Moaning or whining" (83.3 %). Every second child shows 

clinical signs of "Moderate or loud crying" (50.0 %). The child calms down 

during physical intimacy with the mother (search for comfort). In the domain 

"Social skills" - the search for comfort was most often registered in children 

older than 3 years with chronic pain and paralytic syndromes. We believe that 

the clinician when assessing chronic pain in children with paralytic syndromes 



should also pay attention to such clinical signs as "Communication" (61.1 %) 

and "Interaction with others" (50.0 %). When analyzing 5 clinical signs of the 

domain "Face" of the NCCPC-R scale, such a clinical symptom as "Change of 

gaze and squinting" is most often observed. In the analysis of 2 clinical signs of 

the domain "Body and limbs" of the NCCPC-R scale, 77.7 % had a decrease in 

motor activity, and 22.2 % had an increase in motor activity. Also, in children 

with paralytic syndromes that reduced motor activity, chronic pain affected the 

child's display of clinical signs such as "Body movement to show pain" (44.4 

%) and "Body rotation or body movement" (44.4 %). When analyzing 6 clinical 

signs of the NCCPC-R Physiological Signs domain, children with paralytic 

syndromes are more likely to respond to chronic pain with clinical signs such as 

"Tears" (55.5 %) and changes in the respiratory system: "Sharp breath and 

shortness of breath" (50.0 %). "Skin discoloration, pallor" and "Trembling" 

were observed with the same frequency of 44.0 %. Also analyzed 3 clinical 

signs of the domain "Eating/sleeping" on the NCCPC-R scale can not be 

isolated as a separate sign of eating or sleeping disorders in children with 

pralitic syndromes and chronic pain. Hypersomnia and hyposomnia, which 

together account for 66.5 %, were equally common. 

Conclusions. We believe that in children with paralytic syndromes older 

than 3 years, the most common clinical signs diagnosing chronic pain are: 

moaning/whining, less active, seeking comfort, change of gaze, squinting, tears, 

shortness of breath, shortness of breath.