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Development and validation of the Pain Awareness Scale (PAS) for autistic adults: A mixed-methods study
Merry Kalingel Levi1, Yelena Granovsky2, Irit Weissman-Fogel3
1Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
The Journal of Pain
|July 11, 2025
Summary
Researchers developed the Pain Awareness Scale (PAS) to measure pain awareness in autistic adults. The PAS is a reliable tool that identified significant differences in pain awareness between autistic and neurotypical individuals.
Area of Science:
- Neuroscience
- Psychology
- Autism Research
Background:
- Autistic adults often experience differences in sensory processing, including pain.
- A validated tool is needed to assess pain awareness in this population.
Purpose of the Study:
- To develop and validate the Pain Awareness Scale (PAS) for autistic adults.
- To assess differences in pain awareness between autistic and neurotypical adults.
Main Methods:
- Mixed-methods approach including literature review, expert consultation, and cognitive interviews.
- Administered the PAS to 59 autistic and 73 neurotypical adults.
- Used Principal Axis Factoring for scale development and validation.
Main Results:
- The PAS demonstrated good internal consistency (Cronbach's α=0.71-0.92) and strong construct validity.
- Autistic adults scored significantly higher than neurotypical adults on the PAS total score and three subscales (p < 0.001).
- Convergent validity was supported by correlations with the Toronto Alexithymia Scale-20 (TAS-20).
Conclusions:
- The Pain Awareness Scale (PAS) is a reliable and valid measure for assessing pain awareness in autistic adults.
- The PAS can aid clinical assessment and research into pain processing differences in autism.
