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Injuries in Children with Autism Spectrum Disorder: Study to Explore Early Development (SEED)

Friday, May 13, 2016: 5:30 PM-7:00 PM
Hall A (Baltimore Convention Center)
C. G. DiGuiseppi1, S. E. Levy2, G. N. Soke3, S. Rosenberg4, K. Sabourin5, L. C. Lee6, E. Moody5 and L. A. Schieve7, (1)University of Colorado Anschutz Medical Campus, Aurora, CO, (2)Children's Hospital of Philadelphia, Philadelphia, PA, (3)Centers for Disease Control and Prevention, Atlanta, GA, (4)University of Colorado Anschutz Medical Campus, Aurroa, CO, (5)University of Colorado Anschutz Medical Campus, Aurora, CO, (6)Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (7)National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Background:  Studies examining injury risk among children with autism spectrum disorder (ASD) have shown conflicting results. 

Objectives:  We examined medically-treated injuries in children with ASD compared to population (POP) controls.

Methods:  The Study to Explore Early Development (SEED) is a multi-site ASD case-control study of children aged 30-68 months. ASD cases (n=693) were determined using established ASD-specific diagnostic instruments. POP controls (n=882) were ascertained from birth certificates. Each child’s primary caregiver reported if the child ever had a medically-treated injury, and described each such injury.  Injuries resulting in an emergency department visit or hospitalization were defined as “serious.” We determined the nature and cause of each child’s first reported injury.  Associations between ASD and having at least one medically-treated injury and at least one serious injury were examined using multivariable logistic regression models adjusted for child sex, age, and IQ; maternal race/ethnicity and education, and family income, with a random intercept for site.

Results:  Among children with ASD, 33% ever had a medically-treated injury and 25% ever had a serious injury; the most commonly specified injuries were laceration (41%), fracture (22%) and abrasion/contusion (12%). Among POP children, 30% had a medically-treated injury and 22% a serious injury; the most commonly specified injuries were laceration (46%), fracture (23%) and dislocation/sprain (12%). In both groups, the cause most often specified was a fall (56%).  ASD cases and POP controls did not differ in their odds of having a medically-treated injury (crude odds ratio [cOR] = 1.1 [95%CI: 0.9, 1.4]; adjusted OR [aOR] = 1.2 [0.9, 1.7]) or a serious injury (cOR = 1.1 [0.9, 1.4]; aOR = 1.2 [0.9, 1.6]). 

Conclusions:  Children with ASD and population control children had similar odds of having a medically-treated injury and having a serious injury.  Sociodemographic and IQ differences did not influence these results.  We plan to further explore and compare specific injury types and causes, and additional injury outcomes, between the two groups.

See more of: Epidemiology
See more of: Epidemiology