Pain Perception and Responding: Understanding Variability Within and Between Stages of Childhood

This interdisciplinary session will present new results from three pediatric pain leaders (2 Full Professors, 1 Assistant Professor) focused on interrogating distinct stages of childhood – stages specifically known for steep developmental changes. Geared to the behavioural scientist, the biological scientist, and the clinician, speakers will facilitate interdisciplinary discussion. Audiences will be engaged through both formal questions posed to the audience and informal questions from the audience to the panel.
Fabrizi will begin the symposium with the stage of development marked by the starkest changes – the neonatal stage. In a recent paper (Jones et al., 2025, Pain), Fabrizi’s team examined how brain networks for pain perception develop in infants using MRI data from the developing Human Connectome Project. He will be presenting data on the development of the infrastructure that allows for pain perception in 372 neonates (26–42 weeks postmenstrual age). Their work suggests the network responsible for encoding the sensory aspect of pain develops before the affective and cognitive, suggesting neonates might feel pain before they can fully understand or emotionally respond.
Pillai Riddell will challenge audiences with new analyses from her team exploring the second year of life (Jasim et al., 2025, Scientific Reports). The second year of life is a critical stage in pain regulation as toddlers are shifting from total dependence on parents for comfort to self-regulation. Using cardiac and behavioural data on over 200 toddlers during their 12-, 18-, and 24-month vaccination, a key developmental shift was detected marking a more mature acute pain response around 18-months. However, discordant development suggesting physiology lagged behavioural responses providing fascinating insights on the beginnings of independent pain regulation.
Nahman-Averbuch will finish the formal presentation of the symposium by moving to puberty, another highly pivotal stage of development involving extensive biopsychosocial changes that can impact pain. She will present data on pubertal and hormonal effects on pain showing that in 45 adolescents, sex hormone levels do not correlate with pain sensitivity to experimental stimuli (Banerjee et al., 2025, Pain). In addition, after 1 year of follow-up, the changes in sex hormone levels during puberty were not related to the changes in experimental pain sensitivity (unpublished data) suggesting that other biopsychosocial factors have a greater impact on experimental pain sensitivity.

Each of the speakers have experience engaging large audiences, with two of the speakers having been invited plenary speakers at both IASP and/or ISPP (Child Pain SIG meeting). Dr. Pillai Riddell (Canada; Behavioural-Scientist and Clinical Psychologist) pioneered the study of biopsychosocial responses of pain in infants, having created one of the largest datasets in the world following parents and their young through acutely painful procedures over the first years of life. Dr. Fabrizi (UK; Basic Scientist- Bioengineering) uses advanced brain imaging techniques combined with physiology and behaviour to investigate the maturation of somatosensory and pain in preterm neonates. Dr. Nahman-Averbuch (US; Translational Scientist- Neuroscientist) is an emerging leader in neuroendocrinology and uses quantitative sensory testing, neuroimaging, and hormonal assays to examine the interactions between hormones and pain.