{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:33:46Z","timestamp":1788968026770,"version":"build-2803163510"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241647-4\"><jats:title>Importance<\/jats:title><jats:p>Injuries are a major cause of morbidity and mortality among children with neurodevelopmental conditions. Identifying injuries associated with this vulnerable population could inform specific preventive actions.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241647-5\"><jats:title>Objective<\/jats:title><jats:p>To compare the injury risk among children with autism spectrum disorder (ASD), attention-deficit\/hyperactivity disorder (ADHD), or coexisting ASD and ADHD with children with typical development (TD).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241647-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This population-based cohort study involved 325\u202f412 children born between 2005 and 2009, followed up until the end of 2021. Data analysis was conducted from February 2 to November 14, 2023. The study data were extracted from the Clalit Health Service (CHS) database, which contains comprehensive clinical and sociodemographic data on all members of the CHS admitted to the emergency departments (EDs) of all hospitals in Israel during the study period. Children who were members of CHS born between 2005 and 2009 were classified into 4 groups: ASD, ADHD, ASD and ADHD, and TD (control).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241647-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Negative binomial regression models were used to assess incidence rate ratios (IRRs) of ED visits between the study groups and the control group. These models were adjusted for birth year, sector, and socioeconomic status. IRRs for specific injuries were also assessed. The statistical significance of IRRs was assessed using 95% CIs.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241647-8\"><jats:title>Results<\/jats:title><jats:p>A total of 325\u202f412 children (163\u202f183 boys [50%]) were included in the study. Children with ASD, ADHD, or both had significantly higher ED visit rates than children with TD (IRR, 1.48 [95% CI, 1.42-1.55], 1.45 [95% CI, 1.39-1.52], and 1.29 [95% CI, 1.28-1.30], respectively). Children with ADHD had also higher rates of ED visits due to physical injuries compared with controls (IRR, 1.18 [95% CI, 1.16-1.20]), whereas children with ASD with or without ADHD did not (IRR, 0.96 [95% CI, 0.89-1.05] and 0.91 [95% CI, 0.83-1.00], respectively). A focused analysis of the injury profiles revealed that children with ASD or comorbid ASD and ADHD had higher rates of ingestion and inhalation injuries (IRR, 1.57 [95% CI, 1.06-2.25] and 1.80 [95% CI, 1.28-2.48], respectively) and lower rates of orthopedic injuries (IRR, 0.78 [95% CI, 0.69-0.89] and 0.83 [95% CI, 0.74-0.93], respectively), and animal-inflicted injuries (IRR, 0.44 [95% CI, 0.22-0.79] and 0.92 [95% CI, 0.60-1.35], respectively) than controls.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241647-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this large cohort study, different types of injury were associated with children with ASD and ADHD. The causes underlying these associations should be further investigated to develop effective approaches for injury reduction among these children.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.59029","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T16:01:24Z","timestamp":1739203284000},"page":"e2459029","source":"Crossref","is-referenced-by-count":7,"title":["Injury Rates Among Children With Autism Spectrum Disorder With or Without Attention-Deficit\/Hyperactivity Disorder"],"prefix":"10.1001","volume":"8","author":[{"given":"Dorit","family":"Shmueli","sequence":"first","affiliation":[{"name":"Child Development, Clalit Health Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talish","family":"Razi","sequence":"additional","affiliation":[{"name":"Community Medical Services Division, Clalit Health Services, Tel Aviv, 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