Exploring children's preferences for graphic symbols to represent pain-related words.

Children who are hospitalized may sometimes not be able to communicate verbally to self-report their pain or other symptoms due to medical conditions, medical interventions, or communication difficulties. As such, these children may need other means, such as augmentative and alternative communication (AAC) strategies, in this case, graphic symbols, to express their pain-related experiences and receive applicable treatment. Choosing suitable graphic symbols to represent pain-related words contributes to the effective use and implementation of visual support. This study explored the preferences of 6.0-9.11-year-old (years; months) children with typical development regarding graphic symbols to represent pain-related words. These symbols were selected from two commonly used and widespread symbol resources: Picture Communication Symbols (PCS®) and Aragonese Portal of Augmentative and Alternative Communication (ARASAAC) symbols. A descriptive, quantitative study design was employed, including a total of 30 typically developed South African children. Data were collected by means of an electronic questionnaire and analyzed using descriptive and inferential statistics. Probability values were determined and predictions, as well as inferences, were implemented. The results showed that the children preferred ARASAAC symbols to represent most pain-related words (p < 0.001). It is important to consider stakeholders' (in this case, children's) input on their preferences in designing communication support to enable participation during the clinical decision-making process.