Parental assessment of pain coping in individuals with intellectual and developmental disabilities.
Mental age predicts pain-coping style in IDD—match your support to the child’s level.
01Research in Context
What this study did
The team asked 331 parents to fill out a pain-coping survey about their sons and daughters with intellectual or developmental disabilities.
Kids’ mental ages ranged from toddler to teen. Parents ticked how their child acts when hurt.
What they found
Children with a mental age of four or younger mostly cry, scream, or seek hugs.
Kids at a 12-year mental level use distraction, self-talk, and problem solving.
More catastrophizing by the parent meant more pain behaviors seen.
How this fits with other research
Estes et al. (2011) also used parent checklists, but they warn the same pain signs do not work for every age group. Their work says to adjust your watch list as clients grow.
Pichardo et al. (2026) show parents can track feeding-treatment effects as well as trained staff. Together these papers say: train parents, then trust their data.
Chou et al. (2007) built DisDAT to capture any distress cue. Their tool is broad; the coping survey is pain-only. Use both if you want the full picture.
Why it matters
You now have a quick way to guess how a client will cope with shots, braces, or bumps. Ask parents a few questions. If mental age is low, plan for basic soothing. If higher, teach distraction or deep breathing. Watch for parents who catastrophize—coach them to stay calm so their reaction does not amplify pain behaviors.
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02At a glance
03Original abstract
Pain coping is thought to be the most significant behavioural contribution to the adjustment to pain. Little is known about how those with intellectual and developmental disabilities (IDD) cope with pain. We describe parental reported coping styles and how coping relates to individual factors. Seventy-seven caregivers of children and adults with IDD reported on coping styles using the Pediatric Pain Coping Inventory (PPCI), pain behaviour using the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R), illness-related interactions using the Illness Behaviour Encouragement Scale (IBES) and past pain experience using the Structured Pain Questionnaire. Scores were compared across mental ages and interactions between pain coping and the other factors were explored. A Multivariate Analysis of Variance (MANOVA) by mental age group ('≤4 years', '5-11 years' and '≥12 years') revealed that those in the '5-11 years' mental age group used more coping styles than those in the '≤4 years' mental age group, and those in the '≥12 years' group used more cognitively demanding coping styles than the other two groups (F(10,130)=2.68, p=.005). Seeking Social Support (r=.39, p=.001) and Catastrophizing/Helplessness (r=.33, p<.01) coping styles were significantly related to a greater display of pain behaviour. Those with younger mental ages, who Seek Social Support or Catastrophize, also displayed more pain behaviour, which may be an attempt to seek external resources when pain is beyond their ability to deal with independently.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.01.050