Pain and irritability of unknown origin (PIUO)
About the Project
Children born with severe brain-based developmental disabilities frequently experience persistent unexplained periods of pain and irritability, often compounded by a limited capacity to communicate their distress. We call this phenomenon Pain and Irritability of Unknown Origin (PIUO). Informed by our clinical and research experience, we have designed a systematic approach, called the PIUO Pathway, to address the management of these children’s pain and irritability with the goals of reducing pain symptoms, improving the day-to-day lives of the child and family, and simplifying treatment options for clinicians.
In this study we evaluate the effectiveness of an integrated clinical pathway (i.e. a sequential order of standardized evaluation steps) for managing unexplained pain and irritability in children with complex conditions and limited communication. We are also testing how to best move our program from a research environment into community clinics and studying the uptake of the PIUO Pathway by pediatricians who see children with PIUO in a primary care setting.
If the PIUO Pathway proves to be useful in addressing PIUO in children with SNI and if the Pathway can be successfully implemented into a community setting, it will be the first-ever systematized practice guideline to treating pain in this population based on a solid evidence base. Such guidelines will streamline pain management for some of the most vulnerable children seen in clinics.
Lead Investigator
Dr. Hal Siden
Co-Investigators and Collaborators
Dr. Stephanie Glegg, Dr. Tim Oberlander, Dr. Caroline Sanders, Laesa Kim, Gail Andrews, Dr. Sharon Hou