Autistic Children and Their Abnormal Reaction to Pain and Discomfort

As parents of kids with high-functioning autism, we may be familiar with the mystery of their unequal reaction to pain and discomfort. A stubbed toe or paper cut may set off a disproportionate pain response (e.g., hysterical crying or screaming). 
But, a burst ear drum or broken arm may go seemingly unnoticed. As moms and dads of kids on the spectrum, we may be baffled by this unequal response to pain stimuli. Anecdotal evidence from parents worldwide is full of reports on this topic.

Some of the perplexing behaviors that such children exhibit include: 
  • Crashing into walls and/or people
  • Having an unusually high or low pain threshold
  • Putting inedible things (e.g., rocks, paint) into their mouth
  • Screaming if their face gets wet
  • Throwing tantrums when parents try to get them dressed

These and other abnormal behaviors may reflect sensory processing problems in which the high-functioning autistic child is overwhelmed because of difficulty integrating information from the senses. Sensory processing issues are considered a symptom of the disorder because the majority of kids on the spectrum also have significant sensory problems.

One response to being overwhelmed is to flee. For example, if a high-functioning autistic youngster dashes across the street (oblivious to the danger), it should be a “red flag” that he may be heading away from something distressing (which may not be apparent to the mother or father), or toward an environment or sensation that will calm his system. Many kids on the spectrum gravitate toward the sensations and environments they find calming or stimulating. However, their self-regulation is lacking, so safety takes a back seat to their need to get a calming experience (e.g., jumping in a pond, sometimes resulting in drowning).

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

This fight-or-flight response is why a child with sensory problems will shut down, escape the situation quickly, or become aggressive when in sensory overload. The child is having a neurological panic response to everyday sensations that “typical” kids take for granted.

So, what is behind this perplexing dilemma? The answer has to do with dopamine levels.

“Typical” (i.e., non-autistic) people are physiologically equipped to limit the amount of stimuli entering their brain, thus preventing the brain from becoming overloaded. However, people with autism have a hyper- or hypo-sensitivity to stimuli (i.e., they are either under-stimulated or over-stimulated).

The enzyme “dopamine beta hydroxylase” (DBH) is released from nerve endings during “stimulation” via the five senses (i.e., touch, sight, taste, smell, sound). DBH is essential for cell communication and regulating neurons in the central and peripheral nervous systems. An increase in stimulation results in an increase in the level of this enzyme. Scientific research has shown that people with autism have much higher levels of DBH in their system than found in “ordinary” people. The presence of this enzyme is also linked to certain behaviors (e.g., repetition, agitation, aggression, etc.).

Repetitious activity (e.g., rocking, flapping, pacing, etc.) results in the release of endorphins through the system. Endorphins reduce the sensation of pain and have the ability to block pain. Through the use of repetitious activity, kids on the spectrum have the ability to purposely (but unknowingly) overload their sensory system in order to shut it down completely.

Blocking out all sensation by the production of endorphins may seem like an easy way to cope with sensory over-stimulation; however, in caring for autistic kids, parents need to realize that reaction to ALL sensation becomes limited. Such children may not recognize hunger, tiredness, body temperature (which carries with it the risk of overheating), a full bladder or bowel, pain, etc.

They display agitation through use of repetitious behaviors (e.g., rocking, flapping, pacing, head-banging, staring, screaming, spinning, chanting, humming, etc.). The parents’ job is to recognize these signals of agitation. These repetitive behaviors are used to block out over-stimulation from the environment, certain emotions, and responses to pain. The behaviors also may serve to calm the youngster (if their use is monitored rather than unlimited).

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

For high-functioning autistic kids, the build-up of these endorphins throughout the day also needs to be taken into consideration. This is why those children who have accidents may not show pain or appear to feel it.

All physical exercise causes the release of natural endorphins into the system that can help to protect the youngster without switching off the sensory response. Thus, exercise (e.g., walking, running, swimming, etc.) is extremely beneficial in the youngster's daily routine as a preventative measure. Exercise may be used during periods of agitation to help calm the youngster. In this way, it is used to develop an appropriate social responses (e.g., it is more acceptable to jump on a trampoline rather than on the furniture).

Parents should monitor their youngster's production of endorphins, because the presence of excess endorphins causes him or her to lose the ability to respond to any stimulation. This means that the child will miss much of what he or she is supposed to be learning from the environment. Also, parents need to realize that these repetitive behaviors have social consequences for kids with high-functioning autism. 
They are a visual reminder that these young people are different from their “typical” peers. Parents should take into account the youngster's socializing skills and ability when monitoring and setting limits on the use of repetitive behaviors (e.g., tell him or her the times and places when repetitive behaviors are acceptable, for controlled periods of time).

Parents do not need to eliminate sensory stimulation in order to protect their youngster. Without stimulation, the world will become meaningless to the child. Instead, parents should attempt to provide their child with a safe sensory environment (e.g., dim lights, softer noises and voices, reduced odors, etc.), thus giving him or her the opportunity to learn and respond appropriately to the environment.

More resources for parents of children and teens on the autism spectrum:

No comments:

Raising Kids with Autism Spectrum Disorder: Parents' Grief and Guilt

Some parents grieve for the loss of the youngster they   imagined  they had. Moms and dads have their own particular way of dealing with the...