20:47, there is a condition in which people do not feel pain. Your son's extreme reactions (I've heard broken bones are very painful) make me wonder if there's a chance he has something like this. I don't think a kid could learn from parental example to ignore that much pain!

A quick google search for "congenital analgesia" and "cannot feel pain" shows a few hits. You can probably find better than I did, if you think this might apply.

Some kids are sensitive to touch and can experience unexpected bumps as painful. This can be particularly true when they are in what to them is a stressful situation like school. Certain types of sensory play can help desensitize them - e.g., swimming, ball pits, lots of baths, light and heavy massage, bounce/trampoline work. The opposite is also true - kids who lack sensistivity can be trained by again exposing them in a supported environment to similar things. The brain can rewire itself on this score.

You can also at the same time work on cognition - that is a different area of the brain - and help them cognitively distinguish the difference between a mild bump and a real injury. I find with my child cognition and sensory work taken together usually help things like this.

Also, when you are sick or tired, do the normal bumps aof life hurt a little more. Same thing with kids - when they are hungry, tired or stressed - the bumps of life will hurt more.

My son is the other end of the spectrum, so I will offer counter point, FWIW. He has broken bones and not told us, and ruptured ear drums from ear infections but we didn't know until we saw fluid coming from his ears. We have always been the kind of parents who tell our kids to "walk it off". Now we wonder if we have given them too much of that advice. Somehow, we can all club ourselves over the head about our parenting choices regardless of the outcome!
In our situation I have worked very hard to help DS identify what should likely hurt and what things should not. But, we have made some progress. He does go ballistic if there is blood, even if it is from a papercut, so we are clearly not there yet. And then if he isn't thinking about it then he will still do things like scrape the skin off his face (this past Saturday) or wear rain boots without socks until he gets blisters and is limping (today).

OP here. Thank you. I have two great pieces of advice that will no doubt compliment one another.

I've taken a somewhat different approach than you. I check each injury but unless it warrants treatment I pretty much ignore them. No kisses. No band aids unless there is blood. No ice unless there is a risk of swelling without it. And direct conversation about the fact that it's not a big deal. My sensitive one is now in middle school and he's worlds better than when he was in early elementary school. He's not special needs.

Do you and your husband model for him the attitude that life's ups and downs are to be taken with a grain of salt? How do you and DH act, for example, when cut off in traffic, or running late, or when there is a minor mishap. Try to model as much as you can the idea that "stuff happens" and everyone has to go with the flow.

With that in mind, he may just be a sensitive little guy. Time will tell whether he grows out of it.

My 6 yr old has always been noticably sensitive to pain. As a toddler, if you accidently stepped on his foot, he reacted as if you'd threatened his life. It's improved as he's aged but he still "overreacts." He has no SN diagnosis and largely fits it well. He is intenese in a few other ways (long attention span, very competitive, serious for his age etc). His kindergarden teacher asked about the injury issue because it has happened in class. He reacts to a minor bump in circle time etc. She was concerned that he may not feel safe in her classroom or wondered if it was something I saw at home. I assured her this is a temperment/sensitivity issue not isolated to the classroom.

So now I'm wondering what can be done to manage these reactions? I largely just give out icepacks and kisses and try not to give too big a reaction. While I believe DS does have a real sensitivity. At times I also see him feign injury for some other reason (take a needed break from soccer perhaps? or an emotional release when he's frustrated). These are probably two separate issues. Any words of advice from those that have dealt with this type of behavior?