Journal of Autism and Developmental Disorders

, Volume 48, Issue 2, pp 461–472 | Cite as

Injuries in Children with Autism Spectrum Disorder: Study to Explore Early Development (SEED)

  • Carolyn DiGuiseppi
  • Susan E. Levy
  • Katherine R. Sabourin
  • Gnakub N. Soke
  • Steven Rosenberg
  • Li-Ching Lee
  • Eric Moody
  • Laura A. Schieve
Original Paper


This study examined caregiver-reported medically-attended injuries among 30–68 month old children with autism spectrum disorder (ASD) compared to general population (POP) and non-ASD developmental disorders (DD) controls in the Study to Explore Early Development. Injuries were common in ASD cases (32.3%) as well as POP (30.2%) and DD (27.8%) controls; most resulted in an emergency visit or hospitalization. After accounting for sociodemographic, health, IQ and behavior differences, odds of injury in ASD cases were significantly higher than DD controls but similar to POP controls. Attention problems mediated the relationships. Clinicians caring for children with both ASD and attention problems should consider providing targeted safety advice. Differences in injury risk between children with ASD vs. other developmental disorders need further study.


Injuries Autism spectrum disorder Developmental delays and disorders Epidemiology Prevalence 



This research is supported by the Centers for Disease Control and Prevention (CDC), Centers for Autism and Developmental Disabilities Research, Study to Explore Early Development through six cooperative agreements: Cooperative Agreement Number U10DD000180, Colorado Department of Public Health/University of Colorado School of Medicine; Cooperative Agreement Number U10DD000181, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U10DD000182, University of Pennsylvania; Cooperative Agreement Number U10DD000183, Johns Hopkins University; Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000498, Michigan State University. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Selected, preliminary results were presented at the International Meeting for Autism Research, Baltimore, MD, May 2016, and at the World Conference on Injury Prevention and Safety Promotion, Tampere, Finland, September 2016.


The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author Contributions

CD, SEL, SR, L-CL and LAS contributed to conceptualization and design of the SEED study and oversaw acquisition of data. EM and GNS contributed substantially to data acquisition. CD, SEL, and KRS coded injury data. CD, KRS and GNS designed the statistical analyses, and KRS and GNS performed statistical analyses. CD and KRS drafted the manuscript. All authors participated in the interpretation of data, critically revised the manuscript for important intellectual content, and approved the final version to be published.

Compliance with Ethical Standards

Conflict of interest

The author declares that they have no conflict of interest.

Ethical Approval

This study was approved by Institutional Review Board (IRB)-C, CDC Human Research Protection Office; Kaiser Foundation Research Institute (KFRI) Kaiser Permanente Northern California IRB, Colorado Multiple IRB, Emory University IRB, Georgia Department of Public Health IRB, Maryland Department of Health and Mental Hygiene IRB, Johns Hopkins Bloomberg School of Public Health Review Board, University of North Carolina IRB and Office of Human Research Ethics, IRB of The Children’s Hospital of Philadelphia, and IRB of the University of Pennsylvania. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed written consent was obtained from all participating families included in this study.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Epidemiology, Colorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraUSA
  2. 2.The Children’s Hospital of Philadelphia at University of PennsylvaniaPhiladelphiaUSA
  3. 3.National Center on Birth Defects and Developmental DisabilitiesCenters for Disease Control and PreventionAtlantaUSA
  4. 4.Department of Psychiatry, School of MedicineUniversity of Colorado Anschutz Medical CampusAuroraUSA
  5. 5.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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