Promoting safety in children with disabilities
- Patty P Huang, MD
Patty P Huang, MD
- Fellow, Developmental and Behavioral Pediatrics
- The Children's Hospital of Philadelphia
- Dennis R Durbin, MD
Dennis R Durbin, MD
- Associate Professor of Pediatrics and Epidemiology
- University of Pennsylvania
- Nathan J Blum, MD
Nathan J Blum, MD
- Associate Professor of Pediatrics
- University of Pennsylvania School of Medicine
Children with disabilities are at increased risk for accidental (unintentional) injuries, inflicted (intentional) injuries, and child neglect. Behavioral, physical, and cognitive characteristics of the child and environments that are not well adapted for individuals with disabilities contribute to the increased risk.
Given the prevalence of disability among children in the United States (approximately 8 percent) , it is important that parents, caregivers, and health-care providers understand the factors that increase the risk of injury and the potential strategies to minimize it. Primary care providers play a key role in improving the safety of children with disabilities through anticipatory guidance, counseling, treatment, and referral.
The epidemiology, contributing factors, and strategies to prevent unintentional and intentional injuries in children with disabilities will be reviewed here. The principles of injury control and the biologic implications of chronic conditions in childhood are discussed separately. (See "Overview of pediatric injury prevention: Epidemiology; history; application" and "Children with special health care needs".)
Epidemiology — Unintentional injuries are more frequent among children with disabilities than those without disabilities. In a cross-sectional survey of 7235 children in grades 6 to 10, 16 percent identified themselves as having a disability (defined by having at least one functional difficulty due to a health condition) . Students with disabilities reported more injuries than those without (67 versus 51 percent per year). They also sustained more severe injuries and required medical attention more frequently than their nondisabled peers, findings that have been noted in other studies [3-6].
Behavioral factors — Children with behavior disorders (eg, increased activity, impulsivity) are more likely than those without behavior disorders to engage in hazardous behaviors that may result in unintentional injury [7-9].
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- UNINTENTIONAL INJURY
- Predisposing factors
- - Behavioral factors
- - Intellectual factors
- - Biologic factors
- - Environmental factors
- Prevention of unintentional injury
- - Overview
- - Safe transportation
- - School safety
- - Fire safety
- - Water safety
- - Prevention of elopement
- MALTREATMENT OR NEGLECT
- Contributing factors
- - Stressors
- - Vulnerability
- - Foster care
- Prevention of maltreatment
- Management of suspected maltreatment
- INJURY IN THE CRIMINAL JUSTICE SYSTEM
- SUMMARY AND RECOMMENDATIONS