An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines

Objectives: Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). Methods: This retrospective chart review examined injury characteristics for children with ASD receiving treatment in a pediatric emergency department between 2014 and 2016. Bivariate statistics determined injury demographic correlates. Chart narratives were also coded using traditional content analysis to determine the mechanism that caused the home injury. Results: The sample (27 cases) was mostly male (89%), Black (48%), with a mean age of 7.8 (SD, 4.9) years. The most common mechanism was a fall (44%), followed by self-injurious behavior (33%), and then burns (22%). All cases identified at least 1 mechanism contributing to the injury, in 2 cases, 2 items were mentioned. Of the 29 items identified, most involved a house feature that was not stairs (24%); some included stairs, furniture, or a combination of foreign object and grill (21%); and few identified food/beverage/liquid (11%). Conclusions: Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.