Pain affects people’s quality of life and is an important issue for equal health. How professions within social work deal with other people’s pain is therefore a central question. Previous studies on pain among groups unable to self-report have mainly focused on the role of the nurse (Hemsley, Balandin & Worrall, 2012; Martin, Connor-Fenelon & Lyons, 2012). A few studies have focused on housing, but knowledge of the Swedish context is lacking. This literature review presents the findings of previous research on professionals working closely with people with disabilities who, due to their disabilities, have difficulties communicating pain. Such disabilities may include intellectual disabilities, autism spectrum disorder, and severe and persistent intellectual disability following brain injury in adulthood or mental disability not due to normal ageing.

The aim of this scoping review is to summarize and communicate the state of the art and the results of earlier studies. It will also identify gaps in the existing research on – in this case, the application of – pain detection methods in people with disabilities who have communication difficulties in user-centred work. The report is based on a scoping review (Arksey & O'Malley, 2005). Four databases were searched: PsycInfo, Cinahl, Swepub and Sociological abstracts, between the years 2010-2023. Only peer-reviewed articles were included. The results of the included studies are presented under themes corresponding to the research questions of the report:

• Pain occurrence and expression

• Pain recognition - experiences and practitioners

• Tested or validated pain assessment tools

• Challenges and recommendations in clinic and practice and

• Future technical solutions.

The scoping review shows that there is no validated tool that covers multiple disabilities/ diagnoses. It also shows that several of the tools used require medical training and are time and resource consuming. Further, the results show that there is a lack of training and knowledge about pain among staff and that they often rely primarily on verbal and explicit communication of pain, even when users have limited communication skills. Increased knowledge of pain physiology is therefore essential for those working to support and care for people with disabilities that result in reduced communication skills. Studies on different types of disabilities are missing as most studies focus on intellectual disabilities. Also, studies from a Swedish context are few.