024-23 – Co-creating a Psychophysical Protocol for Studying Pain in Autistic Children

Autistic children experience pain more frequently than non-autistic children, yet understanding of these experiences remains limited [1; 2; 5]. This study furthers objective understanding of the latter using psychophysical methods to establish differences and similarities in pain perceptions and responses between autistic, and non-autistic children. Autistic and non-autistic children aged 11-16 will attend LJMU with their parent and first complete a demographic questionnaire. Then whilst behavioural and facial expressions are recorded, data will be collected upon: Mechanical Pain Threshold (average of 5 measures from 7 weighted pinpricks [3]), Pressure Pain Threshold (average of 3 measures from an algometer [4]), and both Cold Pain Threshold and Tolerance (single measure from a Cold Pressor Task (CPT) (Dancer Design)). After each measure children rate their pain intensity out of 10.
Ensuring autistic voices were heard a Public and Patient Involvement Panel (PPI) of autistic people and an autistic child’s parent were involved in study design and reviewed all materials and protocols. The PPI panel were satisfied with the study deeming all measures as appropriate. Adaptations were suggested for explaining psychophysical sensory experiences through comparison to familiar sensations. For example, comparing CPT pain to cold pain when holding an iced drink. Pain intensity rating scales were modified to include visual elements such as colour. For example, ratings of 0 coloured green, and 10 coloured dark red. Additional explanations of how these pain rating scores would affect the child in their daily life were also provided.
“Nothing About Us Without Us” should be synonymous with all research like the established work with pain patient partners. Here we highlight the value of continuing to apply this statement within the field of pain in autism to produce protocols rooted in good quality science whilst considering inclusive adaptations for who the research aims to help.