Revue systématique de la représentation des personnes autistes dans la littérature sur les traitements de la douleur chronique pédiatrique

Titre original en anglais : Systematic review of autistic representation in the treatment literature for pediatric chronic pain

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Boerner, K. E., Pawliuk, C., Heran, A., Donaghy, B., Moore, D., Leong, K., Devan, H., & Oberlander, T. F. (2025). Systematic review of autistic representation in the treatment literature for pediatric chronic pain. The Journal of Pain, 37, 105390. https://doi.org/10.1016/j.jpain.2025.105390

Date de publication: 12/04/2025 Ajout dans AutiHub: 05/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
8
Auteur·ices de la publication identifié·es comme autistes
1 / 8 (12,5 %)
  1. Katelynn E. Boerner
  2. Colleen Pawliuk
  3. Aishwarya Heran
  4. Bethany Donaghy *
  1. David Moore
  2. Kai Leong
  3. Hemakumar Devan
  4. Tim F. Oberlander

Résumé

La douleur chronique touche de manière disproportionnée les enfants et les jeunes autistes, mais ils sont sous-représentés dans la recherche sur la douleur. Les recherches sur les thérapies psychologiques, physiques et pharmacologiques pour d'autres affections suggèrent que des modifications sont nécessaires pour garantir l'accessibilité et l'efficacité des traitements pour les personnes autistes. Cependant, aucune base de données probantes de ce type n'a été synthétisée dans le domaine de la douleur pédiatrique. L'objectif de cette revue était de (1) examiner la littérature existante sur les traitements « de référence » de la douleur chronique pédiatrique afin de déterminer la représentation des participants autistes, et (2) examiner la littérature sur le traitement de la douleur chronique spécifiquement chez les enfants et les jeunes autistes afin de décrire l'état actuel des données probantes et d'identifier les prochaines orientations de la recherche. Parmi les essais contrôlés randomisés inclus dans les revues Cochrane portant sur les interventions pour la douleur chronique pédiatrique, 16,7 % (12/72) excluaient explicitement les jeunes présentant un retard de développement ou un handicap, dont seulement 8,3 % mentionnaient spécifiquement l'autisme. Cependant, 52,8 % des essais inclus dans les revues Cochrane comportaient des critères ou des protocoles susceptibles d'avoir eu un impact disproportionné sur les participants autistes, tels que l'exclusion de la déficience intellectuelle, de troubles psychiatriques, d'affections médicales, et/ou l'obligation pour les participants de communiquer verbalement. Vingt-neuf études sur le traitement de la douleur chronique chez les enfants et les jeunes autistes ont été identifiées, dont la majorité étaient des rapports de cas (k = 27, 93 %), avec une grande variation quant à l'affection douloureuse, à l'intervention appliquée et aux résultats mesurés. Compte tenu de la prévalence élevée de la douleur chronique chez les enfants et les jeunes autistes, il existe un impératif éthique à garantir leur représentation dans les essais d'intervention, à co-développer des interventions répondant aux besoins spécifiques des personnes autistes vivant avec une douleur chronique pédiatrique, et à accroître plus largement l'accessibilité de la recherche sur la douleur chronique. ENREGISTREMENT : PROSPERO : https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=491423 enregistré le 19 mars 2024. Open Science Framework : https://osf.io/8na64/ enregistré le 18 décembre 2023 PERSPECTIVE : Les enfants et les jeunes autistes (CYP) ne sont pas représentés dans les revues sur les traitements de la douleur chronique, et la littérature sur le traitement de la douleur chronique spécifiquement dans cette population est si variable qu'aucune conclusion claire ne peut être tirée. Des efforts sont nécessaires pour accroître l'accessibilité des interventions et de la recherche sur la douleur chronique pour les CYP autistes.

Chronic pain disproportionately affects autistic children and young people, yet they are underrepresented in pain research. Research on psychological, physical, and pharmacological therapies for other conditions suggests modifications are required to ensure treatment accessibility and efficacy for autistic individuals. However, no such evidence base has been synthesized in pediatric pain. The aim of this review was to (1) review existing "gold-standard" treatment literature for pediatric chronic pain to determine the representation of autistic participants, and (2) review literature on treatment of chronic pain specifically in autistic children and young people to describe the current evidence landscape and identify next directions for research. 16.7% (12/72) of randomized controlled trials included in Cochrane reviews of interventions for pediatric chronic pain explicitly excluded youth with a developmental delay/disability, of which only 8.3% specifically named autism. However, 52.8% of Cochrane-included trials had criteria or protocols which may have disproportionately impacted autistic participants, such as excluding intellectual disability, psychiatric conditions, medical conditions, and/or requiring participants to communicate verbally. Twenty-nine studies of treating chronic pain in autistic children and young people were identified, of which the majority were case reports (k = 27, 93%) with large variation in pain condition, intervention applied, and outcomes measured. Given the high prevalence of chronic pain in autistic children and young people, there is an ethical imperative to ensure their representation in intervention trials, co-develop interventions that address the specific needs of autistic individuals who live with pediatric chronic pain, and to increase accessibility in chronic pain research more broadly. REGISTRATION: PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=491423 registered March 19 2024. Open Science Framework: https://osf.io/8na64/ registered December 18, 2023 PERSPECTIVE: Autistic children and young people (CYP) are not represented in reviews of chronic pain treatments, and the literature on treating chronic pain specifically in this population is so variable no clear conclusions can be drawn. Efforts to increase accessibility of chronic pain interventions and research for autistic CYP is needed.

Bibliographie citée par cette référence

Les références citées sont importées depuis des sources externes de métadonnées lorsqu’elles sont disponibles. La liste peut être partielle.

Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:30.

Références citées
167
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
5 / 167 (3,0 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
7 / 1051 (0,7 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 7 / 92 (7,6 %). Auteurices cité·es distinct·es identifié·es comme autistes : 6 / 913 (0,7 %).
Occurrences citées rattachées à la base AutiHub
92 / 1051 (8,8 %)
Auteurices cité·es distinct·es rattaché·es : 79 / 913 (8,7 %)
Occurrences rattachées, non identifiées comme autistes
85 / 92 (92,4 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 85 / 1051 (8,1 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 73 / 79 (92,4 %).
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