Pain assessment tools

For pain assessment in people who can communicate well, see Assessing a patient with pain. Additional considerations when assessing pain in people with impaired cognition, are discussed here.

Several tools are available to assess pain and distress in people with moderate to severe communication difficulties, for example:

• Wong Baker FACES pain rating scale—requires the person to choose an option
• Abbey pain scale—requires observation of the person.

Observable features (eg as outlined in the Abbey pain scale) may not capture atypical responses to pain (eg laughing) that can occur in some people with developmental disability. In people with developmental disability who have difficulty expressing themselves, pain may manifest as behavioural change or challenging behaviour.

It may be useful to give pain assessment tools to parents and carers, to help them identify distress or pain in a person with communication difficulties.