The development of a self-report measure to assess the location and intensity of pain in people with intellectual disabilities.

Bromley et al. (1998) built a simple pain scale for adults with intellectual disability. The tool pairs a body outline with color squares. Clients point to where it hurts and pick a color that matches how much it hurts.

The team compared adults with ID to adults without ID. They checked if answers stayed the same when the same person was asked again later.

Both groups pointed to the right body part. Answers stayed stable over time. Yet adults with ID rated mild pain as stronger than the control group did.

Only two-thirds of the intensity choices followed a clear bigger-smaller pattern. The tool works, but clinicians must watch for over-rating of light pain.

Storch et al. (2012) extends this idea. They watched for pain signals during self-injury. Their data show pain cues vary minute-to-minute. Together the two papers say: ask the client first, then watch for extra clues.

Giesbers et al. (2020) and Prigge et al. (2013) used the same build-and-test steps for other ID tools. These studies prove the method is sound across topics.

There is no clash. J et al. look at what the person says. A et al. look at what the body shows. Both are needed for a full picture.

You now have a quick pain screen that takes two minutes and needs no reading. Use it at intake, after new injuries, or before dental visits. If the client points to red or dark colors for mild bumps, pair the scale with caregiver reports and direct observation. This guards against missed pain and keeps you from over-treating small hurts.