Injuries Among Children With Autism Spectrum Disorder |
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| Affiliation: | 1. Lewin Group, Falls Church, Va;2. OptumInsight Life Sciences, Eden Prairie, Minn;3. Drexel University School of Public Health, Philadelphia, Pa;4. OptumHealth Behavioral Solutions, San Francisco, Calif;1. Department of Pediatrics, Division of Inpatient Medicine, Primary Children''s Hospital, University of Utah, Salt Lake City, Utah;2. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill;3. Division of Pediatric Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill;4. Ann and Robert H. Lurie Children''s Hospital of Chicago, Chicago, Ill;5. Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, New Haven, Conn;6. Department of Pediatrics, NYU School of Medicine/Bellevue Hospital, New York, NY;7. Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kan;8. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa;9. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md;1. Division of General Pediatrics, Center for Child and Adolescent Health Research and Policy, Boston, Mass;2. MassGeneral Hospital for Children, Boston, Mass;1. Johns Hopkins University School of Medicine, Baltimore, Md;2. Bronx-Lebanon Hospital Center, Bronx, NY;3. Drexel University Medical School, Philadelphia, Pa;4. Indiana University School of Medicine, Indianapolis, Ind;1. Sport Psychology Department, Faculty of Physical Education & Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, Iran;2. Sport Physiology Department, Faculty of Physical Education & Sport Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran;1. Psychology, School of Social Science and Human Services, Ramapo College of New Jersey, Mahwah, NJ 07430, USA;2. Department of Psychology, New York University, New York, NY 10003, USA |
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| Abstract: | ![]()
ObjectiveWe compared risk of injury among children with autism spectrum disorder (ASD) to those without ASD, adjusting for demographic and clinical characteristics.MethodsWe used claims data from 2001 to 2009 from a commercial health plan in the United States. A validated ASD case identification algorithm identified 33,565 children (ages 0–20 years) with ASD and 138,876 children without. Counting process models tested the association between ASD status and injury episodes with separate regressions run for children during different age periods.ResultsUnadjusted results demonstrated that children with ASD had a 12% greater injury risk than children without ASD (hazard ratio [HR] = 1.119; P < .001). After including demographic variables, the HR was 1.03 (P < .05); after controlling for co-occurring conditions, such as seizures, depression, etc, HR decreased to 0.889 (P < .001). For the age period analysis, HR values were as follows: for 0 to 2 years, HR 1.141; 3 to 5 years, HR 1.282; 6 to 10 years, HR not significant; and 11 to 20 years, HR 0.634 (P < .05 for all significant results).ConclusionsChildren with ASD have more injuries than children without ASD. After controlling for demographic factors and co-occurring conditions, children with ASD are at lower risk of injury, suggesting that co-occurring conditions or the ways these conditions interact with ASD is related to injuries. Clinicians should understand that injury risk in children with ASD may be driven by co-occurring conditions. Treating these conditions could thus decrease injury risk as well as have other benefits. Injury prevention interventions are especially warranted for younger children with ASD and those with seizures, depression, visual impairment, or attention-deficit disorders. |
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| Keywords: | administrative claims autism spectrum disorder child injury commercial insurance |
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