Prevalence of chronic pain among U.S. children with neurodevelopmental disorders

Neurodevelopmental disorders (NDDs) affect up to 15% of children in the United States and are associated with co-occurring health challenges such as chronic pain, which can negatively affect development and quality of life. Increased risk of chronic pain in children with NDDs remains poorly understood; this study aimed to estimate chronic pain prevalence among children with NDDs and explore whether this association differs by sex.

We conducted a cross-sectional analysis of children participating in the 2022 to 2023 National Survey of Children's Health (age 3-17 years, n = 84,117). Neurodevelopmental disorders included attention deficit and hyperactivity disorder, autism, intellectual disability, speech disorder, Tourette syndrome, learning disability, and developmental delay. Chronic pain was defined as frequent or persistent pain in the past 12 months. Weighted multivariable logistic regression estimated associations between NDDs and chronic pain, adjusting for sociodemographic and health covariates.

Overall, 18.7% (95% confidence interval: 18.2%-19.2%) of children had an NDD. Chronic pain prevalence was higher among children with NDDs than among those without (10.3% vs 5.2%, P < 0.001). After adjustment, children with any NDD (aOR 1.9 [1.7-2.2]) had increased odds of chronic pain. Tourette syndrome showed the greatest odds (aOR = 3.2 [1.7-6.2]). Sex did not alter the association between NDDs and chronic pain (P = 0.79).

Neurodevelopmental disorders affect 1 in 6 U.S. children and are associated with almost double the odds of chronic pain. This increased odds emphasizes the need for improved chronic pain recognition and management among children with NDDs. Future research should examine chronic pain in youth with NDDs, to improve assessment, management, and understanding of pain mechanisms.