A model for pain behavior in individuals with intellectual and developmental disabilities.
The NCAPC gives you a two-factor pain map for nonverbal adults with IDD.
01Research in Context
What this study did
Lotan and team built a pain-behavior checklist for adults who can't say 'it hurts.'
They tested the 18-item NCAPC on the adults with intellectual or developmental disabilities.
Statistical modeling split the items into two clear groups: body signals and social signals.
What they found
Two factors fit the data perfectly: basic (grimace, sweat, fast heart) and advanced (vocal, emotional, facial).
The model explains how pain shows up when words can't.
How this fits with other research
Smith et al. (2010) showed 1 in the adults with severe ID also have autism—pain signs may be missed if we blame 'autism behaviors.'
Li et al. (2015) found kids with lower IQ and more behavior problems refuse dental exams; Lotan's model gives dentists a way to spot pain even when cooperation is low.
Mahdi et al. (2018) listed 110 ways autism affects daily life; adding the NCAPC fills the pain-sized gap in that picture.
Why it matters
You now have an 18-item lens that turns 'something's wrong' guesses into data. Use it during medical visits, post-surgery checks, or after suspected injuries. Score both factors: a high basic score says 'look for medical cause,' a high advanced score says 'comfort and calm first.' Share the profile with doctors so treatment starts faster and restraint use drops.
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02At a glance
03Original abstract
The dearth of information on the pain experience of individuals with intellectual and developmental disabilities (IDD) calls for a more comprehensive understanding of pain in this population. The Non-Communicating Adults Pain Checklist (NCAPC) is an 18-item behavioral scale that was recently found to be reliable, valid, sensitive and clinically feasible to assess pain levels in adults with IDD. The aim of the present article is to propose and examine a pain model for adults with IDD. The procedure involved videotaping 228 participants (mean age: 38.7 years) before and during an influenza vaccination. The pain model was constructed using previously collected data, by means of confirmatory factor analysis of the sum scores, using the half split procedure. The model was tested on a randomized group of participants (N=89) for generalization. The constructed model seems to reflect two categories of pain responses: a basic response consisting of physiological measures and body reaction, and an advanced response consisting of vocal and emotional reactions, as well as facial and protective expressions. The model presented excellent Goodness of Fit Index (0.99) and an acceptable RMSEA value (0.061). We conclude that the current article presents a first-of-its-kind model of pain behavior in adults with IDD.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.05.028