Carolyn DiGuiseppi1, Katherine R Sabourin1, Susan E Levy2, Gnakub N Soke3, Li-Ching Lee4, Lisa Wiggins3, Laura A Schieve3. 1. University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Department of Epidemiology, Aurora, CO 80045 United States. 2. The Children's Hospital of Philadelphia at University of Pennsylvania, Philadelphia, PA 19104 United States. 3. Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA 30341 United States. 4. Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD 21205 United States.
Abstract
BACKGROUND: Evidence about injury management and outcomes in children with autism spectrum disorder (ASD) is limited. METHOD: Cross-sectional analyses included children aged 30-68 months with at least one medically attended injury. Standardized diagnostic instruments determined ASD cases. Parent-reported injury treatments and outcomes were examined in ASD cases (n = 224) versus developmental delays/disorders (DD) (n = 188) and population (POP) (n = 267) controls, adjusting for child and family characteristics using logistic regression. RESULTS: Injury characteristics were similar between groups. Most children (82.5%) had emergency care (EC) or hospitalization after injury. Nearly half (46.4%) ever received a medication or injection, mostly analgesics (53.4%) and local anesthetics (23.8%), while 9.4% ever received surgery, most often for open wound (47.0%) or fracture (16.7%). ASD group children were less likely than DD group children to receive medication/injection (41.1% vs. 53.2%, adjusted odds ratio [aOR] = 0.60 [0.40, 0.90]); receipt of EC/hospitalization and surgery were comparable. Children with ASD more often had surgery than POP children (14.3% vs. 4.9%, aOR = 2.62 [1.31, 5.25]); receipt of EC/hospitalization and medication/injection were similar. Loss of consciousness was uncommon (ASD = 6.3%, DD = 5.3%, POP = 3.4%), as was long-term or significant behavior change (ASD = 5.4%, DD = 3.2%, POP = 3.2%); differences were not significant. CONCLUSIONS: Injured children with ASD received fewer medications/injections than children with non-ASD developmental delays/disorders and more surgical treatments than general population children. Injury management was otherwise similar between groups. Understanding whether these results reflect child or injury characteristics or provider perceptions about behaviors and pain thresholds of children with ASD, and how these may influence care, requires further study.
BACKGROUND: Evidence about injury management and outcomes in children with autism spectrum disorder (ASD) is limited. METHOD: Cross-sectional analyses included children aged 30-68 months with at least one medically attended injury. Standardized diagnostic instruments determined ASD cases. Parent-reported injury treatments and outcomes were examined in ASD cases (n = 224) versus developmental delays/disorders (DD) (n = 188) and population (POP) (n = 267) controls, adjusting for child and family characteristics using logistic regression. RESULTS: Injury characteristics were similar between groups. Most children (82.5%) had emergency care (EC) or hospitalization after injury. Nearly half (46.4%) ever received a medication or injection, mostly analgesics (53.4%) and local anesthetics (23.8%), while 9.4% ever received surgery, most often for open wound (47.0%) or fracture (16.7%). ASD group children were less likely than DD group children to receive medication/injection (41.1% vs. 53.2%, adjusted odds ratio [aOR] = 0.60 [0.40, 0.90]); receipt of EC/hospitalization and surgery were comparable. Children with ASD more often had surgery than POP children (14.3% vs. 4.9%, aOR = 2.62 [1.31, 5.25]); receipt of EC/hospitalization and medication/injection were similar. Loss of consciousness was uncommon (ASD = 6.3%, DD = 5.3%, POP = 3.4%), as was long-term or significant behavior change (ASD = 5.4%, DD = 3.2%, POP = 3.2%); differences were not significant. CONCLUSIONS: Injured children with ASD received fewer medications/injections than children with non-ASD developmental delays/disorders and more surgical treatments than general population children. Injury management was otherwise similar between groups. Understanding whether these results reflect child or injury characteristics or provider perceptions about behaviors and pain thresholds of children with ASD, and how these may influence care, requires further study.
Authors: Eric Rubenstein; Rebecca Edmondson Pretzel; Gayle C Windham; Laura A Schieve; Lisa D Wiggins; Carolyn DiGuiseppi; Andrew F Olshan; Annie G Howard; Brian W Pence; Lisa Young; Julie Daniels Journal: J Autism Dev Disord Date: 2017-10
Authors: Diana E Schendel; Carolyn Diguiseppi; Lisa A Croen; M Daniele Fallin; Philip L Reed; Laura A Schieve; Lisa D Wiggins; Julie Daniels; Judith Grether; Susan E Levy; Lisa Miller; Craig Newschaffer; Jennifer Pinto-Martin; Cordelia Robinson; Gayle C Windham; Aimee Alexander; Arthur S Aylsworth; Pilar Bernal; Joseph D Bonner; Lisa Blaskey; Chyrise Bradley; Jack Collins; Casara J Ferretti; Homayoon Farzadegan; Ellen Giarelli; Marques Harvey; Susan Hepburn; Matthew Herr; Kristina Kaparich; Rebecca Landa; Li-Ching Lee; Brooke Levenseller; Stacey Meyerer; Mohammad H Rahbar; Andria Ratchford; Ann Reynolds; Steven Rosenberg; Julie Rusyniak; Stuart K Shapira; Karen Smith; Margaret Souders; Patrick Aaron Thompson; Lisa Young; Marshalyn Yeargin-Allsopp Journal: J Autism Dev Disord Date: 2012-10
Authors: Carolyn DiGuiseppi; Susan E Levy; Katherine R Sabourin; Gnakub N Soke; Steven Rosenberg; Li-Ching Lee; Eric Moody; Laura A Schieve Journal: J Autism Dev Disord Date: 2018-02