Increased risk of injury in children with developmental disabilities.
Injury risk doubles to triples for preschoolers with autism or ADHD—bake safety skills into every behavior plan.
01Research in Context
What this study did
Lee et al. (2008) pulled medical records for 3- to young learners in Taiwan. One group had autism, ADHD, or other delays. The other group had typical development. They counted how many kids visited a doctor or hospital for an injury in one year.
What they found
Preschoolers with autism or ADHD were twice to three times as likely to get hurt badly enough to need medical care. Cuts, burns, and falls were common. Kids with both diagnoses had the highest risk.
How this fits with other research
McGonigle et al. (2014) extends the picture: the same preschoolers with ASD plus high ADHD symptoms also show more tummy aches and sadness. Tonizzi et al. (2022) meta-analysis adds why—those kids have weaker working memory and poorer impulse control, making safety rules harder to follow.
Leezenbaum et al. (2019) and Takashima et al. (1994) show the skill gap: autistic preschoolers wait less time for rewards and obey “don’t touch” rules less often. These lab deficits line up with the real-world injuries Li-Ching found.
Hamama et al. (2021) and Bush et al. (2021) carry the story into dollars: by high school, youth with ASD rack up $4–5k extra medical costs each year, partly from injury-related visits.
Why it matters
When you write a behavior plan for a preschooler with ASD or ADHD, add a safety goal. Teach “stop, look, ask” before touching. Use pictures and role-play. Reward safe choices on the playground, kitchen, and street. The data say extra practice now can prevent the ER later.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one safety rule with visual prompt and immediate praise for safe play during free time.
02At a glance
03Original abstract
The objective of this study was to examine injury risk in children with autism, ADD/ADHD, learning disability, psychopathology, or other medical conditions. Children aged 3-5 years who participated in the National Survey of Children's Health were included. Six study groups were analyzed in this report: autism (n=82), ADD/ADHD (n=191), learning disability (n=307), psychopathology (n=210), other medical conditions (n=1802), and unaffected controls (n=13,398). The weighted prevalence of injury in each group was 24.2% (autism), 26.5% (ADD/ADHD), 9.3% (learning disability), 20.5% (psychopathology), 14.6% (other medical conditions), and 11.9% (unaffected controls). Compared to unaffected controls, the risk of injury was 2.15 (95% confidence interval (CI): 1.00-4.60), 2.74 (95% CI: 1.63-4.59), 2.06 (95% CI: 1.24-3.42), and 1.26 (95% CI: 1.00-1.58) in children with autism, ADD/ADHD, psychopathology, and other medical conditions, respectively, after adjusting for child sex, child age, number of children in the household, child race, and family poverty level. Children with autism, ADD/ADHD, and other psychopathology were about 2-3 times more likely to experience an injury that needs medical attention than unaffected controls. Future studies need to clarify the extent to which injuries in young children with autism, ADD/ADHD, and psychopathology are related to core symptoms, comorbid conditions, associated behaviors, or unintentional injuries due to lack of additional supervision from caregivers.
Research in developmental disabilities, 2008 · doi:10.1016/j.ridd.2007.05.002