Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings Y. Shilon, Y. Pollak, A. Aran, S. Shaked and V. Gross-Tsur Pediatric Neurology Unit, Shaare Zedek Medical Center, Jerusalem, Israel Accepted for publication 9 May 2011 Keywords accidents, ADHD, attention deficit hyperactivity disorder, developmental co-ordination disorder, injuries Correspondence: Yuval Shilon, MD, Pediatric Neurology Unit, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel E-mail: yuvalshilon@gmail.com Abstract Background Accidental injuries are a leading cause of paediatric morbidity and mortality. We hypothesized that attention deficit hyperactivity disorder (ADHD), a common childhood disorder characterized by behaviours such as hyperactivity and impulsivity, is a risk factor for accidental injuries. Previous retrospective studies suggested that children with ADHD have an increased injury rate, but controlled prospective studies are lacking. Methods We conducted a prospective case–control study of 29 school-aged children with ADHD and their same-sex, similarly aged, non-ADHD-affected siblings. All diagnoses were made by a paediatric neurologist according to DSM-IV criteria and the children and their parents underwent a structured psychiatric interview and a battery of complementary assessments including: Child Behavior Checklist (CBCL), ADHD Rating scale and Developmental Coordination Disorder Questionnaire (DCDQ). The parents were contacted by telephone every 3 months during a 9-month follow-up period and all injuries requiring medical attention were recorded. Incidence of injuries was compared between the pairs of siblings. Results During the follow-up period, a total of 13 injuries in 13 children with ADHD were reported, compared with six injuries in six children from the control group (Z =-2.11, P < 0.05). ADHD severity and subtype, CBCL, DCDQ and IQ scores were not predictive of injury risk. Conclusions School-aged children with ADHD are at higher risk of accidental injuries than their non-ADHD siblings, regardless of ADHD subtype, co-morbid psychiatric conditions, developmental co-ordination problems and environmental/familial conditions. Awareness and adequate education of parents and caregivers of children with ADHD concerning the increased injury risks are thus warranted. Introduction Injuries are the leading cause of morbidity and mortality in children older than 1 year. While motor vehicle accidents (as vehicle occupants or pedestrians) are the leading cause of injury deaths in children, falls are the most common cause of non-fatal injury in this population and 20–25% of children seek medical attention for such injuries each year(Rivara & Grossman 2007). Attention deficit hyperactivity disorder (ADHD) is a very common childhood neuropsychiatric disorder, with an esti- mated prevalence of 5.29% (Polanczyk et al. 2007). ADHD is often characterized by impulsive and risk-taking behaviours which, in the context of inattentiveness, may predispose to inju- ries. Despite the intuitive link between ADHD and childhood injury risk, no well-controlled prospective study has been pub- lished to substantiate this assumption. Child: care, health and development Original Article doi:10.1111/j.1365-2214.2011.01278.x © 2011 Blackwell Publishing Ltd 1