ORIGINAL PAPER Injury Treatment among Children with Autism or Pervasive Developmental Disorder Suzanne McDermott Æ Li Zhou Æ Joshua Mann Published online: 10 August 2007 Ó Springer Science+Business Media, LLC 2007 Abstract This study examined the differences in the frequency and type of injury for children with autism and pervasive developmental disorder (PDD) compared with typically developing peers, when both groups are insured by Medicaid. The relative rate (RR) of emergency/hospital treatment of injury for children with autism or PDD com- pared to controls was 1.20 [95% Confidence Interval (CI) 1.04–1.39] after controlling for age and gender. Children with autism or PDD had a higher rate for head, face, and neck injuries (RR 1.47, 95% CI 1.13–1.90) and lower rate for sprains and strains (RR 0.54, 95% CI 0.32–0.91). Treatment for poisoning was 7.6 times as frequent, and self-inflicted injury was also 7.6 times as frequent for children with autism or PDD. Keywords Autism Á Injury Á Epidemiology Á IDC9 codes Á E-codes Introduction Children with autism and pervasive developmental disor- ders (PDD) have challenges related to their environment which could put them at risk for injuries. Their risk might differ from children without autism in terms of frequency and type of injury but there has been little evidence available to evaluate their injury pattern. There is one article on causes of death in autism that identifies seizures, circulatory disease, congenital anomalies, cancer and ner- vous system diseases as having higher standardized mortality ratios (SMRs) compared to the general popula- tion. Overall the SMR is higher for males compared to females with autism and the only external causes (E-codes) of death with larger SMRs for those with autism were drowning and suffocation (Shavelle et al. 2001; Pickett et al. 2006). There are no data on treatment of injury requiring emergency department or hospital admission for children with autism. PDD include autistic disorder, Asperger disorder, childhood disintegrative disorder, and Rett disorder, with autism the most prevalent diagnosis (Dalton et al. 2004). PDD is most notably characterized by a qualitative impairment in communication and in reciprocal interac- tions. There is a body of literature on self-injurious and other challenging behaviors for children with autism, but this is not presented in terms of injury risk (McClintock et al. 2003; Murphy et al. 2005). Injuries in children are a leading cause of death and disability. In 2003 the overall all cause nonfatal injury rate for children 1–17 years in the US was 1.19 per 100,000 (America’s Children in Brief 2006). Disparities in injury prevalence based on disability has been studied for children with mental retardation (MR) and the results indicate a higher proportion of children and adolescents with MR were injured compared to children without this disability (Dunne et al. 1993; Sherrard et al. 2002; Braden et al. 2003; Slayter et al 2006). We were able to use administrative data from Medicaid to describe the injury treatment rates for children insured by Medicaid, using emergency department and hospital S. McDermott (&) Á J. Mann Department of Family and Preventive Medicine, Family Medicine Center, School of Medicine, University of South Carolina, 3209 Colonial Drive, Columbia, SC 29208, USA e-mail: suzanne.mcdermott@palmettohealth.org L. Zhou Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA 123 J Autism Dev Disord (2008) 38:626–633 DOI 10.1007/s10803-007-0426-9