TABLE 2

Behaviors That May Be Markers of Abdominal Pain or Discomfort in Individuals With ASDs

Vocal BehaviorsMotor BehaviorsaChanges in Overall State
Frequent clearing of throat, swallowing, tics, etcFacial grimacingSleep disturbances: difficulty getting to sleep, difficulty staying asleep
ScreamingGritting teethIncreased irritability (exaggerated responses to stimulation)
Sobbing “for no reason at all”WincingNoncompliance with demands that typically elicit an appropriate response (oppositional behavior)
Sighing, whiningConstant eating/drinking/swallowing (“grazing” behavior)
Moaning, groaningMouthing behaviors: chewing on clothes (shirt sleeve cuff, neck of shirt, etc), pica
Delayed echolalia that includes reference to pain or stomach (eg, child says, “Does your tummy hurt?” echoing what mother may have said to child in the past)Application of pressure to abdomen: leaning abdomen against or over furniture or kitchen sink, pressing hands into abdomen, rubbing abdomen
Direct verbalizations (eg, child says “tummy hurts” or says “ouch,” “ow,” “hurts,” or “bad” while pointing to abdomen)Tapping behavior: finger tapping on throat
Any unusual posturing, which may appear as individual postures or in various combinations: jaw thrust, neck torsion, arching of back, odd arm positioning, rotational distortions of torso/trunk, sensitivity to being touched in abdominal area/flinching
Agitation: pacing, jumping up and down
Unexplained increase in repetitive behaviors
Self-injurious behaviors: biting, hits/slaps face, head-banging, unexplained increase in self-injury
Aggression: onset of, or increase in, aggressive behavior
  • A functional behavioral assessment would be useful in interpreting these behaviors.

  • a Motor behaviors also may be markers of pain or discomfort arising in other parts of the body.