Do Children With Autism Feel Pain?

I would like to have this made into billboards across the world.  I have had such a problem convincing some of the parents of children I teach that this is true.

One of the first things we are taught to do as board certified behavior analysts (BCBA) is to rule out any medical issues before beginning any type of behavior modification program.

It is easy to fall into the trap of assuming that if a child throws himself down on the floor screaming and kicking that it is behavioral.  Especially if that does happen on occasion as the method of choice to vent.

I've had many parents or teachers tell me that a child is just manipulating the adults.  If a child isn't able to communicate effectively and he is in pain he may definitely use some inappropriate tactics to indicate he is in pain.  Ethically we must rule out any possibility of pain even though a child may have autism and behavioral issues.  We must err on the side of caution and assume the child is experiencing pain if he is showing standard signs of pain.  To assume that the child is simply demonstrating behavioral problems and ignore the possibility of a problem that is actually causing pain is both dangerous and a form of profiling.  Children with autism experience pain just as typically developing children do.  They may show many of the same signs or they may demonstrate a completely opposite response to the pain as their neuro-typical peer.

If you look at the situation from the eyes of a child with autism and put yourself in their shoes you will find that you approach the problem more as a detective trying to discover the problem from the clues rather than as a policeman who is ready to punish bad behavior.

Children with autism feel pain.  Just because they cannot speak doesn't mean they don't have anything to say.  Just because they can't point to what hurts or even answer yes or no to your question of "Where does it hurt?"----in no way proves the child is not experiencing pain.

I would venture a guess that if any of us were in pain and unable to get anyone to notice, as the pain got worse and our patience grew thinner, we might resort to some pretty "behavioral" strategies, too.  Print this little sign out and put it where you'll see it every day if you work with children or adults on the autism spectrum.  Err on the side of caution and assume if a child is demonstrating the signs of pain....he probably is in pain.  That's what you'd want someone to do if it were you, right?