Poisoning-related emergency department visits in children with autism spectrum disorder.
Kids with autism—especially 5- to 9-year-olds on several meds—are 60 % more likely to visit the ER for poisoning, so lock up and count every pill.
01Research in Context
What this study did
Farley et al. (2022) pulled a huge Medicaid file. They counted how many kids with autism landed in the ER for poisoning.
They split the kids by age and by other diagnoses like ADHD or intellectual disability.
What they found
Kids with autism were 60 % more likely to visit the ER for poisoning than other kids.
The risk peaked at ages 5–9. Three-quarters of the cases came from swallowing medicine.
How this fits with other research
Scherf et al. (2008) saw the same warning sign first. Their Medicaid study found poisoning rates seven times higher in autism, using older data. The new paper tightens the math to 1.6-fold odds and pins the danger zone on early elementary years.
Nakao et al. (2015) used the same big-data trick but counted dental ER trips. They found no extra visits for kids with autism, showing the poisoning spike is not just general clumsiness—it's drug-related.
Cidav et al. (2013) also mined Medicaid and showed that as kids with autism age, their overall care costs climb. E et al. zoom in on one costly slice: ER poison events that start rising around age five.
Why it matters
If you serve school-age kids with autism, treat every pill bottle like a loaded gun. Lock meds, log doses, and teach families the five-minute poison-proof routine. A simple cabinet latch or weekly pill count could prevent the 60 % bump in ER trips these data show.
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02At a glance
03Original abstract
<h4>Background</h4>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, and its prevalence has increased markedly in the past two decades. Research indicates that people with ASD are at increased risk for premature mortality from injuries. Often, children with ASD are prescribed multiple medications, increasing their risk for intentional and unintentional poisonings. We examined the epidemiologic patterns of emergency department (ED)-treated poisonings in children with ASD and the association of ED-treated poisonings with ASD according to common co-occurring conditions.<h4>Methods</h4>We analyzed data from the Nationwide Emergency Department Sample for 2016-2018 to estimate the frequencies of ED-treated poisonings among autistic children aged 1-20 years and adjusted odds ratios of ED-treated poisoning associated with ASD in the presence or absence of co-occurring attention-deficit hyperactivity disorder (ADHD) or intellectual disability (ID). The ICD-10-CM external cause-of-injury matrix was utilized to identify poisoning cases.<h4>Results</h4>During 2016-2018, there were an estimated 523,232 ED visits in children with ASD aged 1-20 years, including 12,152 (2.3%) visits for poisoning. Of ED-treated poisonings in children with ASD, 73.6% were related to pharmaceutical drugs, such as psychotropic medications and prescription opioids, 16.6% were intentional, 36.5% were unintentional, and 47.0% were undetermined. Among children with ASD, those aged 5-9 had the highest odds of poisoning-related ED visits compared to all other age-groups (adjusted OR = 3.41; 95% CI 3.15, 3.68). The odds of poisoning for children with ASD were 59.0% greater than for their peers (adjusted OR = 1.59; 95% CI 1.53, 1.66) and varied significantly with age and co-occurring ADHD or ID.<h4>Conclusions</h4>Children with ASD are at a significantly increased risk of poisoning, particularly among those aged 5-9 years. Co-occurring ADHD or ID with ASD further increases the risk of poisoning. Interventions to reduce poisoning in children with ASD should prioritize the safety of prescription medications.
, 2022 · doi:10.1186/s40621-022-00402-9