The chair will present a brief overview to set the scene for a lively discussion of the unique nature of pain in autistic children and youth and novel approaches that are needed to advance pain management in this pediatric population. Autism Spectrum Disorder is neurodevelopmental disorder that encompasses disordered social communication, and repetitive or restricted behavioral routines, with a prevalence of 2% in children aged 1 to 17 years. Austistic children and youth have more accidents and co-occurring conditions that require treatment leaving them at increased risk for insufficient pain assessment (e.g., mismatch between pain scores and behaviours) and management. ASD is associated with altered processing of sensory information, whereby, clothing might feel rough and uncomfort­able, and rain touching the skin might feel like sandpaper. Such hypersensitivity leads some individuals to experience sensory overload leading to a paradoxical ‘shut down’ response or withdrawal. This hypo­sensitive response may leave some individuals less aware of potentially salient environmental cues making them susceptible to ongoing harm,  pain and undertreatment. Compounding this are frequent placebo responses frequently observed in research and clinical contexts, often constraining our ability to distinguish treatment effects from contextual factors that also play a role in pain assessment and treatment. To advance our understanding and management of pain in autistic children, we will bring together 5 international experts in pain, ASD and placebos in this panel to engage in an audience-interactive conversation that will serve as a springboard for a novel conversation about the unique lived experience of pain in ASD, the cognitive, social, emotional, sex/gender dimensions and placebo responses that appear to characterize the acute and chronic pain experiences in autistic children and youth.