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Pain Research and Management
Volume 14, Issue 2, Pages 116-120

Assessing Pain in Children with Intellectual Disabilities

Lynn M Breau1 and Chantel Burkitt2

1School of Nursing and Departments of Psychology and Pediatrics, Dalhousie University, and Pediatric Complex Pain Team and Division of Child Neurology, IWK Health Centre, Halifax, Nova Scotia, Canada
2Department of Psychology, St Mary’s University, Halifax, Nova Scotia, Canada

Copyright © 2009 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Children with intellectual and developmental disabilities suffer more often from pain than their typically developing peers. Their pain can be difficult to manage, and assessment is often complicated by their limited communication skills, multiple complex pain problems and the presence of maladaptive behaviours. However, current research does provide some guidance for assessing their pain. Although self-report is an alternative for a small number of higher-functioning children, observational measures have the most consistent evidence to support their use at this time. For this reason, the Non-communicating Children’s Pain Checklist – Postoperative Version is recommended for children and youth 18 years of age or younger. However, other measures should be consulted for specific applications. Changes in function and maladaptive behaviour should also be considered as possible reflections of pain. In addition, children’s coping skills should be considered because improving these may reduce the negative impact of pain.