TY - JOUR
T1 - Injury-related treatments and outcomes in preschool children with autism spectrum disorder
T2 - Study to Explore Early Development (SEED)
AU - DiGuiseppi, Carolyn
AU - Sabourin, Katherine R.
AU - Levy, Susan E.
AU - Soke, Gnakub N.
AU - Lee, Li Ching
AU - Wiggins, Lisa
AU - Schieve, Laura A.
N1 - Funding Information:
This research was supported by the Centers for Disease Control and Prevention (CDC), United States , through six cooperative agreements: U10DD000180, Colorado Department of Public Health; U10DD000181 , Kaiser Foundation Research Institute; U10DD000182, University of Pennsylvania; U10DD000183 , Johns Hopkins University; U10DD000184 , University of North Carolina at Chapel Hill; and U10DD000498, Michigan State University . CDC investigators contributed to study design, data collection, analysis and interpretation, and critical feedback on the manuscript. The lead author (CD) made the decision to submit the manuscript for publication. The report’s findings and conclusions are those of the authors and do not necessarily represent CDC’s official position.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/10
Y1 - 2019/10
N2 - 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.
AB - 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.
KW - ASD
KW - Emergency care
KW - Injuries
KW - Injury outcomes
KW - Surgery
KW - Treatment
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U2 - 10.1016/j.rasd.2019.101413
DO - 10.1016/j.rasd.2019.101413
M3 - Article
AN - SCOPUS:85068423442
SN - 1750-9467
VL - 66
JO - Research in Autism Spectrum Disorders
JF - Research in Autism Spectrum Disorders
M1 - 101413
ER -