Injury-related treatments and outcomes in preschool children with autism spectrum disorder: Study to Explore Early Development (SEED)

Carolyn DiGuiseppi, Katherine R. Sabourin, Susan E. Levy, Gnakub N. Soke, Li-Ching Lee, Lisa Wiggins, Laura A. Schieve

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number101413
JournalResearch in Autism Spectrum Disorders
Volume66
DOIs
StatePublished - Oct 1 2019

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Preschool Children
Wounds and Injuries
Emergency Medical Services
Developmental Disabilities
Injections
Hospitalization
Population
Autism Spectrum Disorder
Odds Ratio
Pain Threshold
Unconsciousness
Local Anesthetics
Analgesics
Cross-Sectional Studies
Logistic Models

Keywords

  • ASD
  • Emergency care
  • Injuries
  • Injury outcomes
  • Surgery
  • Treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Injury-related treatments and outcomes in preschool children with autism spectrum disorder : Study to Explore Early Development (SEED). / DiGuiseppi, Carolyn; Sabourin, Katherine R.; Levy, Susan E.; Soke, Gnakub N.; Lee, Li-Ching; Wiggins, Lisa; Schieve, Laura A.

In: Research in Autism Spectrum Disorders, Vol. 66, 101413, 01.10.2019.

Research output: Contribution to journalArticle

DiGuiseppi, Carolyn ; Sabourin, Katherine R. ; Levy, Susan E. ; Soke, Gnakub N. ; Lee, Li-Ching ; Wiggins, Lisa ; Schieve, Laura A. / Injury-related treatments and outcomes in preschool children with autism spectrum disorder : Study to Explore Early Development (SEED). In: Research in Autism Spectrum Disorders. 2019 ; Vol. 66.
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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.",
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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.

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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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