Chronic Pain in Children With Developmental Disabilities

A large national survey study published in JAMA Pediatrics has found that children with developmental disabilities experience a significantly higher prevalence of chronic pain compared to those without such disabilities.

The research indicates that the prevalence of parent-reported chronic pain in children with developmental disabilities is 13.2%, compared to 5.5% in children without these disabilities. This represents a risk that is more than twofold higher for children with developmental disabilities.

Study Scope and Methodology

The study utilized data from the 2016-2023 National Survey of Children’s Health (NSCH), involving 263,168 children and adolescents aged 3 to 17 years. The weighted sample analyzed in the study included 224,467,664 children, of whom 51.1% were male, with a mean age of 10.2 years.

Approximately 18.7% of the children in the sample reported having at least one disability. Researchers analyzed the data between June 2025 and August 2025, using logistic regression models to examine the association between various categories of developmental disabilities and pain, as well as potential health disparities.

Key Findings and Risk Factors

The study found that the increased risk of chronic pain was especially pronounced in children with specific conditions, such as cerebral palsy or seizures.

Beyond the presence of developmental disabilities, the researchers identified several socioeconomic and environmental factors that further increased the likelihood of chronic pain in this population:

• Lower parental education levels
• Lower household income
• Adverse childhood experiences

These findings highlight a critical need for targeted screening and interventions for children with developmental disabilities, as pediatric pain can impede healthy development throughout adulthood.

Challenges in Pain Assessment

Assessing pain in children with intellectual and developmental disabilities presents unique clinical challenges. Because these children may have limited communication skills, their pain can be more difficult to manage and assess than that of typically developing peers.

Clinical complexities often include the presence of multiple complex pain problems and maladaptive behaviors. While self-reporting is an option for a small number of higher-functioning children, observational measures currently have the most consistent evidence to support their use.

For children and youth 18 years of age or younger, the Non-communicating Children’s Pain Checklist – Postoperative Version is recommended as a tool for assessment, though other measures may be consulted depending on the specific application.

Clinical Context of Developmental Disabilities

Developmental disabilities are characterized as a range of chronic disorders. These may manifest as impairments in motor function, cognitive abilities, language, behavioral patterns, or physical development.

The disparity in pain prevalence suggests that children with these disabilities are a particularly vulnerable population. The intersection of physical disabilities, such as cerebral palsy, and socioeconomic stressors further compounds the risk of chronic pain, necessitating a multidisciplinary approach to screening and care.