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Why Children with Autism Sustain More Injuries

Attention problems may be a leading reason for higher rates of injury among children with autism.

November 28, 2017

Past research has indicated that children with autism spectrum disorders are at greater risk for injury. A new study, however, concludes that autism itself is not a predictive factor for a child’s rate of injury. Rather, attention problems — which often, but not always, present alongside autism symptoms — may be more likely to result in incidents that require medical attention.

The study, conducted on more than 2,200 children between the ages of two and five, used data from the CDC’s Study to Explore Early Development. Of the 693 children with autism who were included in the study, 32.3 percent had previously sustained injuries that had required medical attention, compared to 30.2 percent of the control subjects.

The difference was small, and researchers concluded that it was not statistically significant. However, when they controlled for comorbid attention problems, they found that the difference in injury risk between the two groups all but disappeared, indicating to the researchers that attention problems, in children with or without autism, may be the real factor behind the increased injury risk seen in previous studies.

“Attention problems do appear to contribute to injury risk,” says study author Carolyn DiGuiseppi, from the Colorado School of Public Health. “That existing relationship may explain why some [past] studies have found a higher risk of injury in children with autism.” If confirmed, the association between attention problems and injuries may allow doctors to give specific attention-related safety advice to parents of affected children, she said.

One autism expert did note, however, that parents of children with autism may be more reluctant than other parents to bring their children to doctors’ offices or hospitals following an injury — which may result in an artificially lowered injury rate for children with autism.

“Hospitals and [emergency rooms] are chaotic and loud, and there are long waits and not a lot of people who are that well trained in neurodevelopmental disorders,” said Luther Kalb, from the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, who was not involved in the study. “I think there is a question of whether parents are a little more apprehensive to use those services.”

Still, Kalb praised the study for its “attention to detail” and its focus on potentially confounding factors, he said. The next phase of research, according to DiGuiseppi, is to identify other specific autism symptoms that may be most related to a child’s rate of injury.

The study1 was published in October in the Journal of Autism and Developmental Disorders.

1 DiGuiseppi, Carolyn, et al. “Injuries in Children with Autism Spectrum Disorder: Study to Explore Early Development (SEED).” Journal of Autism and Developmental Disorders, Nov. 2017, doi:10.1007/s10803-017-3337-4.

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