Behavioral-Based Educational Intervention Can Promote Pain Communication for People with Autism and Intellectual Disability

June 13, 2022

Participants in New Study Learned How to Report Pain Location, Pain Levels, and Ask for Relief

Self-reporting of pain for individuals with co-morbid autism spectrum disorder and intellectual disability (ASD-ID) is an area of research that has historically lacked thorough investigation. Due to communication deficits for those with ASD-ID, the presence of pain can result in troubling nonverbal conduct such as self-injurious behavior, aggression, irritability, and reduced activity. Communication deficits and problematic behaviors are just a few reasons why a team of researchers set out to determine whether a behavioral-based educational intervention could improve pain-related communication among children with ASD-ID who frequently experience pain. The team’s research had three goals. First, they wanted to determine if children with ASD-ID could label the location of their pain. Second, the team set out to establish if the subjects could quantify their pain severity. Last, the team wanted to ascertain if the children could request pain relief. The researchers used three children with ASD-ID and frequent pain to conduct this work. The intervention used in the study consisted of educational materials and behavioral reinforcements. The subject’s caregivers assessed their child’s pain using the Non-Communicating Children’s Pain Checklist–Postoperative (NCCPC-PV). The subjects used the Wong Baker FACES Pain (WBFPS) Scale to try to express their pain levels. Challenging behaviors were recorded by the team based on frequency.  The study’s results ultimately showed that in-situ training (the direct practice of the skill with instruction and feedback) and prerequisite skills to identify and label pain severity were necessary to develop pain-related communication. The study also highlighted that the children required more than a visual prompt (i.e., WBFPS) to report pain or request pain relief at first. However, after proper in-situ training, all three participants could independently respond to a question about how they felt by vocalizing the location of pain or indicating their pain level using the WBFPS. The subjects were also able to request pain relief by the end of the study.

Original Study

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