Barney, C. C., Andersen, R. D., Defrin, R., Genik, L. M., McGuire, B. E., & Symons, F. J. (2020). Challenges in pain assessment and management among individuals with intellectual and developmental disabilities. Pain reports, 5(4), e821. https://doi.org/10.1097/PR9.0000000000000822

Cedarville University

In populations of individuals with intellectual disability, pain scales may be adapted. A visual adaptation such as pictures like faces or pyramid scales may be used or physical items like blocks.

Adapted Pain Scales

Challenges in pain assessment and management among individuals with intellectual and developmental disabilities


These scales have limited validity in those with  mild or moderate intellectual disabilities and may not be applicable to those with severe intellectual developmental disabilities due to language or cognitive deficits.

Limitations of Using Adapted Pain Scales in IDD Populations

There has yet to be an overall agreement on which scale is best. Scales have been created without the reference of relevant research. Their evidence is questionable as their measures have not been proven to be pain specific. 


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