Parent-Reported Chronic Pain in Children With and Without Developmental Disabilities

Importance: Although pediatric pain can impede healthy development throughout adulthood, the prevalence of chronic pain among US children with developmental disabilities remains unclear. Objective: To evaluate parent-reported chronic pain prevalence and the association between developmental disabilities and chronic pain in US children and adolescents (hereinafter, children). Design, Setting, and Participants: This national survey study included 263 168 children aged 3 to 17 years who participated in the 2016-2023 National Survey of Children's Health (NSCH). Data were analyzed from June 2025 to August 2025. Exposures: Reporting any of the 10 developmental disabilities included in the NSCH: seizure, cerebral palsy, autism, attention-deficit/hyperactivity disorder, vision, hearing, and/or speech delay, intellectual and/or learning disability, and developmental delay. Main Outcomes and Measures: The weighted prevalence of parent-reported chronic pain in children with or without any of these 10 disabilities was calculated across the study period and by year. Logistic regression models were applied to examine the association between various categories of developmental disabilities and pain among US children as well as potential health disparities. Results: This study included a weighted sample of 224 467 664 children; of them, 135 848 (51.1%) were male with a mean (SD) age of 10.2 (4.5) years. Approximately 18.7% of children reported having at least 1 disability. The weighted prevalence of parent-reported chronic pain was higher in children with at least 1 developmental disability compared to peers without a disability (13.2% vs 5.5%) over the study period. Adjusted analyses revealed significant associations between any of the disabilities and parent-reported chronic pain, with an odds ratio of 2.31 (95% CI, 2.14-2.49). Similar positive associations were also observed for all disability categories, particularly seizure and cerebral palsy. Moreover, higher odds of parent-reported chronic pain were associated with lower levels of parental education and family income, or more adverse childhood experiences. Conclusion and Relevance: The findings in this study indicate that children with diverse developmental disabilities were more likely to have parent-reported chronic pain, and this likelihood was associated with several socioeconomic factors. These findings provide important insights into targeted screening and interventions for pain in pediatric populations with developmental disabilities.