**5. Conclusion**

This chapter aimed to address communication vulnerable children's experiences of pain and their need for alternative ways to express their pain so as to receive appropriate pain treatment. The concept of communication vulnerability was explained framed in the context of the adapted social communication model of pain for communication vulnerable children. According to this model, there are many ways in which communication vulnerable children can encode (B) their pain experience (A). The model also emphasises the need for observers (C) to be open to other communication modes that children may use to communicate their pain. The discussion centred on the pain experiences of communication vulnerable children such as children with Down syndrome, with intellectual disabilities, autism or cerebral palsy, as well as of children in intensive care settings who experience temporary communication vulnerability. The chapter concludes with suggestions on how AAC strategies can be used to support communication vulnerable children in communicating their pain.

### **Acknowledgements**

The author would like to thank and acknowledge Prof Stefan Nilsson from Gothenburg University and Prof Juan Bornman from the Centre for AAC, University of Pretoria for their valuable comments to improve the content of this manuscript. The author would further like to thank Ms Olivia Loots for the drawings as portrayed in the three figures in this chapter.

The funding from the National Research Foundation in South Africa to this project is also acknowledged.

## **Conflict of interest**

The author declares no conflict of interest.

*Pain Management - Practices, Novel Therapies and Bioactives*
