Although talking about pain is not always the most comfortable thing in the world (in fact, even thinking about pain can be painful for some), it is an important topic that is often misunderstood. With summer right around the corner, the opportunity for a child with autism spectrum disorder (ASD) having something potentially painful happen is high – sunburn, walking barefoot outside on hot pavement or rocks or sand, stepping on sharp objects, even falling while running or riding a bike. Common childhood experiences resulting in common childhood injuries happen to all children, including those with ASD. But often the reaction of the child and the response of adults can be different than what we see when the child is “neurotypical.”
Let’s examine the “pain cycle” in some detail:
We’ll take an external situation as an example – you are barefoot walking through grass and then you step onto a very hot sidewalk. The heat impacts the sensory nerves on the soles of your feet. Those nerves send a signal to your brain which interprets that signal and triggers a response. For many of us, the interpretation is one of discomfort or pain and we then react by jumping up, getting back onto the grass, letting out a yelp or in some other way expressing our feeling of pain.
When you look at the pain cycle at that level of detail, it becomes clear that there are many areas that can interrupt what most of us consider “normal.” First, there might be some interruption in the nerves that receive the heat sensation or transmit that sensation to the brain. Then, there might be something the impacts the brain’s interpretation of the signal. Our response to the signal is part automatic and part learned, and we don’t all learn to respond to pain in the same way. Additionally, a large part of our response to pain is social communication, so our abilities in this area also impact how we respond to things that may be painful.
An assumption of many is that people with ASD often have less sensitivity to what most of us consider painful but are overly sensitive to things that most of consider to be not painful. But if the way we respond to pain is based on our ability to communicate, there’s a good chance that a person with ASD will not communicate that they are in pain the way we “expect” them to. There hasn’t been a lot of well-designed research in this area. But what little there is seems to indicate that people with ASD actually do experience pain but simply are unable to communicate it to others in a way that is understood.
What is the practical take-a-way of all this? There are a few: places to buy viagra online
- Don’t assume a person with ASD is not experiencing pain because of a lack of expected reaction;
- If you know something would be painful to most people, and you can do something to limit that pain, you should probably do it – even if the person with ASD has not shown pain before; kamagra viagra differenze
- The self-injurious behaviors we worry about might not be showing a lack of sensitivity to pain, but could actually be the person’s way of communicating pain!
Russell Bonanno, M.Ed.
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