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 Parents and caregivers need to be aware of this increased risk and
do what they can to reduce the chances of preventable injuries, for
example by helping children with autism to learn to swim as early as
possible, the study team writes in American Journal of Public
Health.
There may be many reasons that children with autism are at greater
risk for injury, including higher rates of ADHD and engaging in
risky behaviors in attempts to soothe themselves, said lead author
Guohua Li of Columbia University Mailman School of Public Health in
New York.
“Wandering is a common autistic behavior, present in about 50
percent of the afflicted children,” Li said by email, adding, “While
wandering, these children have an affinity to bodies of water, such
as pools, ponds, and lakes.”
About one in 68 children have autism spectrum disorder (ASD), which
includes autism as well as Asperger syndrome and other pervasive
developmental disorders, according to the U.S. Centers for Disease
Control and Prevention. It is more often diagnosed in boys than in
girls.
People with autism often have problems with social, emotional and
communication skills. They might repeat certain behaviors and might
not want change in their daily activities. Many people with autism
also have different ways of learning, paying attention or reacting
to things.
Past studies have found higher mortality rates in people with ASD,
but the causes of these excess deaths are not always clear and are
sometimes related to other conditions like epilepsy or depression
that are present in addition to autism.
To assess what part injuries play in the deaths of people with
autism, researchers analyzed data on nearly 40 million deaths in the
U.S. recorded by the National Vital Statistics System between 1999
and 2014.
They identified the causes of death for everyone in the database and
also identified those who had a diagnosis of autism in their medical
record. Over the 16-year study period, 1,367 people with an autism
diagnosis died, with 381 of these deaths due to injuries.
People with autism died significantly younger than the general
population, at a mean age of 36 years old, compared to 72 in the
general population. Among injury deaths specifically, autistic
people died at a mean age of 29, while the mean age among those
without autism was 55.
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About 40 percent of fatal injuries among people with autism occurred
in homes or residential institutions. The most common causes were
suffocation, choking and drowning.
Children in particular were at the greatest risk. While people with
autism had three times the rate of death from accidental injury,
overall, compared to the general population, the rate was 42 times
higher among children under age 15.
“Persons with autism may be at higher risk for injury due
sensorimotor difficulties (that is, difficulties in sensing their
surroundings or in their movements) which may make it harder for
them to detect or avoid danger,” said Diana Schendel, a professor at
Aarhus University in Denmark who studies causes of death among
autistic people.
“They may also be at greater risk due to behavioral problems that
may make them behave impulsively or to be hyperactive,” said
Schendel, who was not involved in the study.
“Since unintentional injury can be prevented, parents and care
providers need to be aware of the high risk and to carry out
rigorous injury prevention measures which may need to be designed
especially for the kinds of challenges that persons with autism may
have,” Schendel said.
“Once a kid is diagnosed with autism, usually at age 2-3 years, the
first step parents and caregivers could and should take is to teach
the kid how to swim, preferably by enrolling the kid in swimming
classes,” Li said. “Swimming ability might be the most important
survival skill for children with autism.”
SOURCE: bit.ly/2oaW6b8 American Journal of Public Health, online
March 21, 2017.
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