Introduction to Nociception
Pain is generally how people know that something isn’t quite right with their body – it seems natural to assume that everyone must perceive pain similarly. There are those with higher pain thresholds and lower pain thresholds, and whilst this might be an indication of differences in nociception, it is quite different to some of the reactions or lack of reactions to pain that have been recorded anecdotally in autism and sensory processing disorder.
Like many of the lesser researched senses, a lot of the information about differences in nociception is anecdotal – either from teachers, family members, or autistic people. As a result, there isn’t a lot of data on the subject. Some parents report that their children receive quite serious injuries – including broken bones or dislocations – and simply do not react to it. Others describe instances where their children have accidentally bumped into a chair, and reacted as if they have broken bones. Some autistic people report similar incidents, car crashes or falls where they have walked away feeling fine only to later discover quite serious injuries.
Light touch can sometimes be interpreted by the brain as pain due to the way that the tactile input is processed; therefore it is not difficult to imagine that perhaps this same misinterpretation by the sensory processing system could result in incidents such as light bumps or taps being interpreted as incredibly painful. Similarly, as we have seen with other senses, it is entirely possible that the opposite could be true and that stimuli that should be interpreted as painful just isn’t picked up.
The sorts of things you might see include:
- No reaction to a fall, trip, or more serious injury.
- Touches very hot objects and does not react in pain.
- May carry out self-injurious behaviour that, from the outside, looks like it should hurt but does not prompt any reaction from the individual.
- Does not shy away from situations where there is risk of injury, may seem unaffected by or unaware of the risk of injury, even after experiencing something that should be painful.
- The lightest touch, bump, or knock can result in a pain response.
- Will be fearful of situations where the above might occur.
- Will seek out treatment for all injuries – including those that others might think the individual should be able to “brush off”.
The consequences of this difference in sensing pain is fairly obvious. Since we tend to use pain as an indicator that something is wrong, if the pain response is absent then it is possible that serious conditions might not be discovered until it is too late. An individual may not react at all to something as excruciatingly painful as appendicitis, and the end result of lack of treatment for a number of these conditions would be death. On the other hand, for someone who experiences almost every touch or knock as painful, life amongst other people would be a very difficult experience.
Disclaimer: The opinions and information provided in this post are my own, and based on personal, educational, and work-based experience. They do not reflect the opinions of any of the authors of the content referenced in this post. I am not affiliated or supported by any organisation, and this is meant to be an educational series of posts. The information posted here is not a substitute for advice and information provided by your own GP, speech and language therapist, occupational therapist or other professional in the field of autism, and should not be taken as such.