Los comportamientos de dolor pueden ser confundidos y achacados a sus discapacidades físicas.
Hay comportamientos de dolor de base, que se identifican de forma frecuente en esta población, pero cada niño mostrará un conjunto único y singular de comportamiento ante el dolor, con diferentes vocalizaciones, expresiones faciales, alteraciones del sueño, movimientos, alteración del tono muscular y de la interacción, reacciones atípicas (autolesión, risas, cara inexpresiva, aplausos, contención de la respiración…).
El personal sanitario tiene una enorme dificultad para la evaluación del dolor en estos niños, por lo que es imprescindible recurrir a la familia para interpretar la conducta del niño. Solo las personas que conviven con ellos a diario, padres y educadores, son capaces de detectar estos cambios en su comportamiento habitual, por lo que es importante que observen cuidadosamente sus conductas para identificar la presencia de dolor.
Al igual que en todo lo relativo al TEA, es fundamental la enseñanza y la atención temprana. Es muy importante establecer el objetivo de conseguir, en la medida de lo posible, alguna forma de expresión del dolor.
Se le ha de enseñar con el empleo de apoyos visuales, como pictogramas, historias sociales y programas informáticos, con aplicación en tablets, para que puedan informar acerca de: “Me duele”, “¿Dónde me duele?”.
Una educación inclusiva que abordara en el colegio la enseñanza de la expresión del dolor a todos los niños sería de enorme ayuda, y existe marco legal en la Ley de Educación vigente para hacerlo.
Pero en aquellos niños no verbales o con gran déficit cognitivo es preciso dotar al entorno cercano de herramientas adecuadas para la identificación del dolor.
En la actualidad, en la comunidad de Murcia, se ha establecido un grupo de trabajo para la mejora de la atención del dolor infantil en niños TEA, en el que personal de Educación y Sanidad conjuntamente están testando en estos niños diferentes escalas adaptadas a ellos, para la evaluación del dolor, con la intención de distribuirlas a padres y colegios, para su utilización rutinaria, lo que permitiría una detección precoz de las circunstancias dolorosas, para anticiparnos a los posibles perjuicios conductuales, fruto del no tratamiento.
fuente: elmedicointeractivo.com
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