Associations of Adaptive Behavior and Wandering with Serious Injuries in Young Children with Autism: Study to Explore Early Development.
C DiGuiseppi, B Holst, M Bolt and 9 others
PMID 40833658WHAT IT FOUND
For preschoolers with autism and significant early learning delays, wandering is associated with higher rates of serious injury.
Conversely, those with learning delays but normal adaptive behavior skills had higher injury rates than those with delays in both areas, possibly due to caregiver overestimation of safety awareness.
Key findings
01Among children with autism and significant early learning delays, those who wandered had 1.5 times higher prevalence of injury requiring an ED visit or hospitalization compared to those who did not wander.
02Among children with autism and significant early learning delays, those without delayed adaptive behavior had twice the prevalence of serious injury compared to those with delayed adaptive behavior.
03In children with autism without significant early learning delays, neither wandering nor delayed adaptive behavior was associated with serious injury after accounting for age and attention problems.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The outcome relied on maternal recall of injuries requiring ED visits or hospitalizations, which may be inaccurate for injuries treated in other settings or as time passes. The study did not collect data on injury prevention strategies (e.g., supervision levels, environmental modifications), so it could not determine if the observed associations were influenced by these factors. The definition of wandering was based on a single CBCL item ('wanders away') without a specific definition of elopement, which may affect the precision of this exposure. The cross-sectional nature of the analysis limits the ability to infer causality between adaptive behavior/wandering and injury.
Declared interests
The authors have no relevant competing interests to declare.
The easy way to misread this
Do not assume that children with autism and normal adaptive behavior scores are safe. In this study, children with significant early learning delays but normal adaptive behavior had higher rates of serious injury, suggesting that caregivers may overestimate the safety awareness of children whose cognitive abilities are higher than their adaptive skills.