 Many interventions used to treat physical disabilities are associated with acute pain. In an example of scoliosis surgery, it has been found that children and adolescents with severe intellectual disability receive significantly fewer analgesics after surgery compared to typical cases. This example is one case that shows how pain may go untreated in populations of those with severe intellectual disability. 

Interventions and Untreated Associated Pain in Individuals with Severe IDD

- More likely to have restricted movements and play
- Increased health needs
- Increased need for health-related services
 - Particularly vulnerable to health disparities

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This includes 3-4% of individuals with intellectual disabilities. Individuals in the Severe IDD level have minimal communication skills, although can typically learn some self-help skills. Individuals with severe IDD can take minimal care of themselves, though they require complete supervision. 

Severe Intellectual Developmental Disability (IDD)

Raskoff, S. Z., Thurm, A., Miguel, H. O., Kim, S. Y. H., & Quezado, Z. M. N. (2023). Pain research and children and adolescents with severe intellectual disability: ethical challenges and imperatives. The Lancet. Child & adolescent health, 7(4), 288–296. https://doi.org/10.1016/S2352-4642(22)00346-7

Pain research and children and adolescents with severe intellectual disability: ethical challenges and imperatives

- Higher adaptive skills 
  - Associated with an improved QOL
- Increased age
  - Associated with a lower QOL
- Parent health and psychological functioning

Factors Related to Quality of Life of Children with Severe Developmental Disabilities (SDD)

How Children with Severe Intellectual Disability are Disadvantaged

We do not have a thorough understanding of how children with severe intellectual disability experience pain. Children with severe IDD may be unable to self report or communicate their level of pain. They may have a higher pain tolerance because several developmental disabilities may be associated with atypical pain sensitivity. Another posibility is that they may experience typical pain levels but express it atypically.

Pain Sensitivity in Children with Severe Intellectual Disability

Alternative research methods may need to be used because children and adolescents are unable to give their assent and may have an indistinguishable dissent.

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