Research has documented that pain and physical discomfort commonly occur in persons with intellectual and developmental disabilities (IDD). However, many individuals are unable to communicate their distress and achieve symptom relief. The present study was a descriptive and qualitative evaluation of care providers to identify how they detected pain in the adults they supported at a human services organization including the type of pain indicators and influence of communication ability on reliably reporting pain. The study combined quantitative and qualitative ratings within a cross-validation descriptive methodology that also elicited care provider recommendations for improving pain assessment. We report findings, summarize common themes, and suggest future directions for clinical practice and research.