Challenges in assessing the pain of children with special needs are created by the differing abilities of these students to self-report pain presence and intensity. This article reports the results of a literature review examining methods of pain assessment for children with special needs. The authors note the need to foster partnerships with parents and educators when assessing pain in difficult-to-assess students, and identify research priorities, including: obtaining perspectives of school nurses and parents on child perception of pain and challenges encountered during the assessment process, including educators in research, identifying current assessment practices used by school-based caregivers, and including a broader population of children with special needs in pain assessment research.