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

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.