Measurement properties of the Non-Communicating Adult Pain Checklist (NCAPC): a pain scale for adults with Intellectual and Developmental Disabilities, scored in a clinical setting.
The NCAPC checklist lets you spot pain in nonverbal adults with IDD during routine visits—no video needed.
01Research in Context
What this study did
Doctors watched 59 adults with intellectual and developmental disabilities during real clinic visits.
They scored the 18-item Non-Communicating Adult Pain Checklist (NCAPC) live, right in the room.
The team compared scores before, during, and after medical steps that usually hurt a little or a lot.
What they found
The checklist numbers jumped when patients were in clear pain and stayed low when they were not.
NCAPC could tell the difference between low-pain and high-pain procedures on the spot.
You do not need to film and re-watch; scoring live works just as well.
How this fits with other research
Weissman-Fogel et al. (2015) later asked caregivers to fill out the same NCAPC in group homes. Their proxy scores also spotted chronic pain, so both doctors and direct-care staff can use the tool.
McKeown et al. (2022) argue that hidden pain often fuels problem behavior in kids with developmental disabilities. The NCAPC gives behavior analysts an adult version to borrow that idea: check for pain first, then treat behavior.
Kraijer et al. (2005) built a quick autism screen for people with mental retardation. Like NCAPC, it is short, free, and made for the IDD population—showing brief checklists can be both valid and practical.
Why it matters
If your client cannot say "it hurts," you need a fast way to know. Keep a copy of NCAPC in every medical binder. Score it while the client waits, during dental cleanings, blood draws, or physical therapy. Spotting pain early keeps procedures short, reduces problem behavior, and protects your reinforcement history with the client.
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02At a glance
03Original abstract
The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have been evaluated and found satisfactory, using scores based on video-uptakes. The aim of the article therefore was to examine the instrument's discriminative ability and sensitivity to pain of adults at different levels of IDD when scored within a clinical situation as well as through video-uptakes. Participants were 59 adults at different levels of IDD who were observed for pain behavior, before and during dental hygiene treatment (scored directly) and influenza injection (scored from video-uptakes), using the NCAPC. The results suggest that the NCAPC differentiated between pain and non-pain situations, as well as between pain reaction during two different medical procedures expected to cause more or less pain, and it was found sensitive to pain at all levels of IDD. We conclude that the present findings add to previous findings of measurement properties of the NCAPC, and support that it can be scored directly in a clinical setting.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2009.10.008