We are pleased to announce the publication of our latest paper, “A Qualitative Analysis of Unintentional Injuries in Autism Spectrum Disorder.” The study was led by Dr. Casie Morgan, with contributions from trainees Alecia Mercier and Bri Stein, who are affiliated with the CEDD at UAB. The team received mentorship from Dr. David Schwebel, Dr. Kristi Guest, and Dr. Sarah O’Kelley.
Why Are Autistic Children More Prone to Injury?
Prior research has shown that children with autism are at least three times more likely to experience fatal unintentional injuries than their non-autistic peers. However, less is known about the specific reasons behind this elevated risk. This study aimed to uncover these details by examining the perspectives of 15 mothers raising autistic children, and systematically identify common themes presented throughout the interviews.
KEY FINDINGS
Autistic Children are likely to experience an unintentional injury
- 80% of mothers reported that their child experienced an injury needing care in the past six months.
- Throughout their child’s lifetime, 73% of their children had an injury requiring a doctor, dentist, or emergency room visit.
Autism Traits Contribute to Injury Risk
Mothers identified several autism-related characteristics that may increase injury vulnerability:
- Communication Difficulties: Many autistic children struggle to understand safety rules or communicate when they are hurt. This can make it harder for parents to teach injury prevention or recognize when their child is in pain.
- Lack of Danger Awareness: Some children do not recognize hazardous situations, such as traffic or sharp objects, making them more prone to accidents.
- Restricted or Repetitive Behaviors and Interests: Many children are drawn to sensory-seeking behaviors—like spinning, climbing, or running—which can result in falls or collisions. Others have fixations on things like water, which increases the risk of drowning.
Co-Occurring Conditions and Behaviors Amplify Risk
Many autistic children are also diagnosed with conditions like ADHD, intellectual disabilities, or sensory processing issues, which increases concerns for behaviors that may increase the likelihood of injury. For example:
- Elopement (Wandering): Some children tend to run away from caregivers, putting them at risk for traffic crashes or getting lost.
- Motor Coordination Challenges: Many parents described their children as clumsy or uncoordinated, leading them to worry about potential fall-related injuries.
- Hyperactivity and Impulsivity: High energy levels and difficulty with impulse control can lead to reckless behaviors, such as jumping off furniture or running without looking.
The Heavy Stress on Parents
Mothers expressed high levels of stress and anxiety related to preventing child injuries. They reported feeling constantly on high alert and struggling to balance their child’s need for independence with safety concerns. Some even described the need to modify their homes—such as installing tall fences—to keep their children safe.
What Can Be Done?
This study highlights the urgent need for tailored safety interventions for autistic children. Potential solutions include:
- Visual safety cues: Using visual aids and social stories to teach safety rules in a way that autistic children can understand.
- Specialized water safety and swim lessons: Considering many autistic children are drawn to water, formal water safety programs tailored for autistic children could help reduce drowning risk.
- Technology-based solutions: GPS trackers and electronic monitoring tools can assist parents in preventing elopement incidents.
- Motor and spatial training: Occupational or physical therapy can help children develop better body awareness and coordination, potentially reducing accidental falls.
Final Thoughts
This study underscores that injury risk in autistic children may relate to specific traits and co-occurring conditions. While most parents work very hard to keep their children safe, they need better resources and support systems to manage these challenges effectively. By developing evidence-based safety strategies, healthcare professionals, educators, and caregivers can work together to create a safer environment for autistic children and minimize the pressure parents feel to keep their children safe from injury.
To read the published article, see https://rdcu.be/d89cW
