National prevalence of pain among children and adolescents with autism spectrum disorders
Open accessAbstract
Pain is a leading contributor to the global morbidity and disability burden. 1 Pediatric pain is especially problematic, as it may impede healthful development into and throughout adulthood.2 For children with autism spectrum disorders (ASD), pain is a highly understudied area, perhaps owing to the misguided historical impression that children with ASD have lower pain sensitivity.3 However, recent evidence has contradicted this perspective 4 and indicates that pain may be implicated in pathogenesis of poor health outcomes in children with ASD. 5 Therefore, this study sought to provide recent national estimates of the prevalence of pain among children and adolescents with ASD.a The median (interquartile range) age is 11.0 (8.0-14.0)years.b The median (interquartile range) age is 11.5 (8.7-13.7)years.c The median (interquartile range) age is 10.6 (7.8-14.0)years.d Comorbidities include presence of cerebral palsy, epilepsy or seizure disorder, or intellectual disability.jamapediatrics.
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Two major reasons for difficulty diagnosing GI problems in ASD are that children with ASD often have limited verbal ability and, even if verbal ability is intact, sensory perception is often abnormal, making it difficult to localize and/or describe sources of discomfort.
“Two of the major reasons that this occurs is because children with ASD often have limited verbal ability and, even if their verbal ability is intact, sensory perception is often abnormal, making it difficult for these individuals to localize and/or describe sources of their discomfort 72.”
From Gastrointestinal Issues and Autism Spectrum Disorder (2020) · cites this paper as [72]
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Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., Charlson, F., Davis, A., Degenhardt, L., Dicker, D., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60692-4 · Cited by 6,414 · see citing works
Chronic pain in adolescence and internalizing mental health disorders
Noel, M. E., Groenewald, C. B., Beals‐Erickson, S. E., Gebert, J. T., & Palermo, T. M. (2016) · Pain · doi:10.1097/j.pain.0000000000000522 · Cited by 217 · see citing works
Pain Sensitivity and Observer Perception of Pain in Individuals with Autistic Spectrum Disorder
Allely, C. S. (2013) · The Scientific World Journal · doi:10.1155/2013/916178 · Cited by 135 · see citing works
Sensory cognitive abnormalities of pain in autism spectrum disorder: a case–control study
Yasuda, Y., Hashimoto, R., Nakae, A., Kang, H., Ohi, K., Yamamori, H., Fujimoto, M., Hagihira, S., & Takeda, M. (2016) · Annals of General Psychiatry · doi:10.1186/s12991-016-0095-1 · Cited by 74 · see citing works
Pain as a predictor of sleep problems in youth with autism spectrum disorders
Tudor, M. E., Walsh, C. E., Mulder, E., & Lerner, M. D. (2014) · Autism · doi:10.1177/1362361313518994 · Cited by 40 · see citing works
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Gastrointestinal Issues and Autism Spectrum Disorder
Madra, M., Ringel, R., & Margolis, K. G. (2020) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2020.02.005 · Cited by 159 · see citing works
Editorial: Comorbidity and Autism Spectrum Disorder
Casanova, M. F., Frye, R. E., Gillberg, C., & Casanova, E. L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.617395 · Cited by 110 · see citing works
Baeza-Velasco, C., Vergne, J., Poli, M., Kalisch, L., & Calati, R. (2025) · Autism · doi:10.1177/13623613251328059 · Cited by 10 · see citing works
- Authors
- Whitney, D. G., & Shapiro, D. N.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Whitney, Daniel G.
- ORCID
- Whitney, Daniel G.
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2019-12-01
- Volume
- 173
- Issue
- 12
- Pages
- 1203
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- PMC
- PMC6820065
- OpenAlex
- W2982155474
- Cited by
- 65
- References
- 5
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 9 · 2023: 8 · 2022: 11 · 2021: 11 · 2020: 5 · 2019: 1
- FWCI
- 7.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, pediatric pain, pain prevalence, children and adolescents, pain sensitivity, comorbidities, cerebral palsy, epilepsy, intellectual disability
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Pain, Population Surveillance, Retrospective Studies, United States, Prevalence
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