Pain in individuals with an intellectual disability: Scope of the problem and assessment challenges

Definition and prevalence of Intellectual Disability
Intellectual disability (ID) is characterized by significant limitations both in intellectual functioning (e.g. reasoning, learning, problem solving) and in adaptive behavior in a range of everyday social and practical skills. This disability originates before the age of 18 years. Etiologies of ID include, but are not restricted to: cerebral palsy, Autism Spectrum Disorders (ASDs), Down syndrome, Fragile-X syndrome, Fetal Alcohol Spectrum Disorder (FASD), neurofibromatosis, and Prader–Willi syndrome. The prevalence rate of ID is around 1% and higher rates occur in low and middle-income countries.
The problem of pain in ID
It is recognized in the IASP definition of pain that the inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. However, because pain is a subjective experience, it may be expressed in atypical or unfamiliar ways in those with significant cognitive and communicative difficulties. In some conditions, such as Down syndrome, pain may actually be experienced differently. Consequently, pain may not be easily recognized and may go untreated. Some reports suggest that individuals with ID are prescribed with significantly less analgesic medications compared to their cognitively intact peers. There are also reports of increased, unnecessary death rates that could have been prevented if pain could be adequately monitored and treated on time. (author introduction) #P4HEwebinarJuly2024