When it comes to pain assessment, children with special needs require extra consideration on the part of the healthcare professional. Alison Twycross, Catherine Mayfield and June Savory provide guidance which ill help to improve practice

‘By any reasonable code, freedom from pain should be a basic human right limited only by our knowledge to achieve it’ (Leibeskind and Melzack 1988). McCaffery (1972) defined pain as, ‘whatever the experiencing person says it is, existing wherever they say it does’. This definition infers that patients will be able to verbalise their pain, but not all patients are able to do so. In this paper we discuss pain management in children with special needs who may have difficulty communicating their pain or may communicate it differently compared to other children. The lack of research and literature in this area will be identified and case studies are used to provide anecdotal evidence that pain is managed inconsistently and inappropriately in children with special needs. Finally, some recommendations for practice are provided.