Pain and Autism...continuation of John's Ear Infection

I thought I would write briefly as I have received a few emails of concern for John's ear infection. Here's a little info about autism and pain.

For some children on the autism spectrum pain looks a little like this:

Small pain = BIG REACTION (flapping, screaming, retaliation, rolling around, moaning)
Big pain = Social shut down (maybe initial crying, but then withdrawing from environment)

Here's an example. Several years ago John fell on our tile floor and landed on his head. He screamed for about 1 minute, then was unable to discuss his pain. It was a very disturbing concussion...with nausea and a hematoma the size of an egg. Normal reactions might include screaming "Owie!! Mommy!!" But John didn't want hugs or comfort...he wanted to be left alone.

Contrast with this scenario: Two days ago, Ella flicked John with the fly swatter. John's world caved in immediately. He screamed and cried and wanted a hug. He was offended and is still complaining about it. Even when we went to the ER for his ears, he said it was because Ella flicked him with the fly swatter.

So, in a nutshell, Adam and I are trying to find the balance of understanding our son's true pain. For autistic children, pain is much different. Small things might be excruciating. We also are trying to teach John we don't go to the hospital for little things, even if they are nuerologically very painful for him. I hope this helps explains our dilemma a little better.