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Are Individuals with ASD Hyper or Hyposensitive to Pain?


Autism spectrum disorder, or ASD, is a disorder that affects social, communicative, and sensory abilities. Nonetheless, one of the hallmarks of ASD is sensory processing difficulties, which heightens reactions to sensory stimuli, including sound, taste, sight, and pain. Although numerous previous studies have focused on social and emotional deficits in ASD, not many studies are done on pain reception. It is highly important to study how pain is processed in ASD because pain can be overlooked if not studied extensively. This is especially true for children who already have difficulties with communicating. Moreover, most studies that attempted to study pain perception base pain on self-report instead of objective measurements, leading to difficulties in replicating data.

In previous studies, there have been reports of both under and oversensitivity to pain in individuals with ASD. One person can exhibit both hypo and hypersensitivities to different stimuli, and what causes sensitivity differs person by person. Individuals who show hyposensitivity to pain may also exhibit self-injurious behaviors, such as head banging and scratching. Moreover, in some cases, individuals would engage in specific behaviors when they are in pain, instead of verbal signs, suggesting that the self-reports that have been used might be inadequate in gaging pain. Thus, this lessened sensitivity might not be due to an inability to feel pain, but an altered response to pain.

On the other hand, there have been more reports of hypersensitivity to pain in individuals with ASD. When asked to choose a moderate level of pain, individuals with ASD chose lower levels of stimulation than individuals without ASD. Further, a higher level of neural stimulation in a brain region that accounts for pain, negative emotion, and response anticipation was shown for the individual with ASD for both the pain itself and the anticipation of pain. Several brain regions can be responsible for the altered pain sensation, but more research is needed to understand perception in ASD. Moreover, an individual with ASD can show increased sensitivity to pain, but not towards the pain of others due to the impaired social cognitive ability. ASD is a complex disorder that affects more than one ability of an individual, and more researches are necessary to find the best intervention plan for individuals with ASD.

References:

Allely C. S. (2013). Pain sensitivity and observer perception of pain in individuals with autistic spectrum disorder. TheScientificWorldJournal, 2013, 916178. https://doi.org/10.1155/2013/916178

Gu, X., Zhou, T.J., Anagnostou, E., Soorya, L., Kolevzon, A., Hof, P.R. and Fan, J. (2018), Heightened brain response to pain anticipation in high-functioning adults with autism spectrum disorder. Eur J Neurosci, 47: 592-601. https://doi.org/10.1111/ejn.13598


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