Stories for Reporting Pain
As with the discussion of toileting, it will be helpful to partner with your child to gain an understanding of what and how much pain she experiences as it relates to signals received from the brain to the body. Again, becoming literate and articulate about body parts and how the body functions, paired with gentle exercise, may enhance your child's ability to respond to pain in a timely way.
Entering these discussions using visuals — diagrams, charts, pictures, videos — will aid your child in retaining the information but won't tell her what to do about it. This is where instructional stories come into play. What follows are examples that you may use to adapt and make specific in reflection of your child's needs. If you feel there is too much information for your child to take in at one time, break it down into manageable bits. Your child will feel personally invested if you print little portions of the story on separate pages so that she may illustrate it. This has been very successful with a number of children with Asperger's, and you may be surprised at what you learn, such as seeing the imagery your child associates with her pain (for example, a prickly monster).
My body is my own. My body is beautiful. I will try to take good care of my body so I can enjoy good health all my life.
My body is made up of many different parts inside and out.
Inside parts are like my heart and stomach.
Outside parts are like my arms and legs.
Sometimes my body is hurt. When my body is hurt, I may be in pain or I may feel discomfort, like an ache or a pinching feeling.
The part of my body that hurts could be an inside or an outside part.
I know when my body is hurt because my body will give me a signal.
A signal is a sign that something is wrong with a part of my body or that a part of my body is hurt.
This is normal.
Another word for signal is symptom.
Everybody's body gives them symptoms or signals when a part of their body is hurt or they are feeling pain or discomfort.
If I don't report the pain, it could get worse.
If I don't report the pain, it is difficult for others to help me feel better.
A symptom or signal that my stomach is hurting may be that I am unable to eat, or I feel a burning in my stomach, or I throw up.
A symptom or signal for my throat hurting may be scratchiness or burning and difficulty swallowing or eating.
A symptom or signal that my head is hurting may be pain in my forehead.
A symptom or signal that my acid reflux is causing me pain or discomfort may be when I have burning in both my throat and stomach.
It is important for me to report when my body gives me signals that it hurts or is in pain.
I can report when my body is giving me a signal and I am in pain or have discomfort.
One way I can report this pain or discomfort is by pointing to the spot that is hurting on a picture of my body. Another way is to point to the place on my own body where I feel pain or discomfort. Another way is to write on paper where I am feeling pain or discomfort.
When I report this pain, others will know how to help me get relief from the pain. This may be by getting extra rest. It may be by taking a warm bath or shower. It may be by taking medicine to make the pain go away. It may be other ways, too.
Sometimes, I might have to go to the doctor so he can give me a different kind of medicine to help the pain go away. The doctor will know best of all how to help me feel better.
You may also script similar stories to address precisely what your child can do to gain relief from a variety of ailments. Review the stories with your child once or twice a week, allowing her to read to you and explain any pictures she has created to illustrate them. As this is a new process, your child may initially require reminders or your prompting to begin to self-report pain and discomfort. Once your child “gets” the concept, you may phase out use of the stories.
One caveat of which to be aware is that your child may seize the opportunity to demonstrate this newly learned concept by reporting every tiny nick, scrape, or minor ache. After all, this is what's been taught, although others may perceive it as a nuisance. The challenge here is to coach your child about the degree and intensity of pain. This is where another visual will be useful, such as a linear scale of smiley faces with expressions in varying states of deterioration due to pain. Use faces that correlate with numbers of intensity, from one to five. (If smiley faces are not concrete enough, work with your child to take similar photos of her own expressions.) Number one on the scale is no pain and number five on the scale is the most pain. You and your child may then practice communicating the intensity of the pain in the appropriate moment and discuss reporting the pain if it gets above a “two” or a “three” on the intensity scale, meaning it cannot be personally managed. Err on the side of caution so that your child does not feel inhibited about reporting pain. Living in a way that is virtually pain free can dramatically alter the lives of many children with Asperger's in positive ways (the same as it would for anyone), while concurrently quelling some anxieties and so-called “behaviors.”
