Chronic Physical Pain in Children With and Without Autism Spectrum Disorder in the United States: Findings from the 2016 - 2021 National Survey of Children's Health.
Autistic kids are 76 % more likely to live with chronic pain—so screen for headaches and body pain at every visit.
01Research in Context
What this study did
Qianyi et al. (2025) looked at six years of national parent survey data. They compared kids with autism to same-age peers without autism.
Parents answered yes or no to questions about chronic pain and headaches. The team used statistics to see if autism raised the odds of pain.
What they found
Kids with autism were 76 % more likely to have long-lasting pain anywhere in the body. They were also 78 % more likely to have frequent headaches.
The gap stayed even after the researchers controlled for income, race, and other health issues.
How this fits with other research
Paone et al. (2026) used the same survey years and found sleep problems shift with age in autism. Together the two papers show pain and sleep issues both peak in school-age kids with autism.
Spanoudis et al. (2011) found parents of kids with lower mental age report more pain behaviors. Qianyi’s numbers now prove those behaviors likely reflect real pain, not just caregiver stress.
Shawler et al. (2021) showed two-thirds of parents can’t find dentists for autistic children. Add Qianyi’s pain data and you see a double gap: kids hurt more yet get less dental and medical care.
Why it matters
Start every assessment by asking, “Where does it hurt?” Use pictures or a 1-10 scale even with non-speakers. Track pain before and after sessions; sudden drops in cooperation may signal a headache or toothache. Share the Qianyi numbers with medical teams to speed referrals and justify insurance for pain clinics or dental work.
Get CEUs on This Topic — Free
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Add one pain question to your session check-in: point to a body map and ask, “Any hurt today?”
02At a glance
03Original abstract
Individuals with autism spectrum disorder (ASD) have long been reported to exhibit atypical pain experiences. Chronic physical pain is a significant comorbidity in ASD, leading to substantial burdens on daily functioning and quality of life. This study aims to examine the potential associations between ASD and chronic physical pain, including its specific types. The study used data on chronic physical pain and headaches from the 2016 - 2021 National Survey of Children's Health. Participants were children aged 3 to 17 years old. Generalized linear models were used to estimate the associations between ASD and pain-related indicators (e.g., chronic physical pain, headaches, and other back or body pain). The study included 177,539 children, of whom 5311 had a current ASD diagnosis. Among children with current ASD, 14.41% experienced chronic physical pain, with 4.86% reporting headaches and 9.56% reporting other back or body pain. Compared to those without, children with current ASD had higher odds of chronic physical pain [odds ratio (OR) = 1.76, 95% confidence interval (CI): 1.40 - 2.21]. Notably, the odds of headaches (OR = 1.78, 95% CI: 1.33 - 2.38) were higher than the odds of other back or body pain (OR = 1.62, 95% CI: 1.20 - 2.19). Children with current ASD were more likely to experience chronic physical pain than those without. This trend is more pronounced in headaches compared to other back or body pain. Our findings highlight the importance of prioritizing pain management in children with ASD through thorough physical assessments.
Journal of autism and developmental disorders, 2025 · doi:10.1007/s10803-025-06846-4