Children with Autistic Spectrum Disorder (ASD) are less likely to be seriously injured than children with Attention Deficit Hyperactivity Disorder (ADHD), according to a new study by Israeli researchers.
Although children with ASD can sometimes exhibit hyperactivity and impulsivity, the behaviors are more common — and often more extreme — in children with ADHD.
The findings were published in the journal JAMA NETWORK OPEN in February 2025.
Researchers from Ben-Gurion University of the Negev, Clalit Health Services, and Loewenstein Rehabilitation Medical Center analyzed data from 325,412 children born between 2005 and 2009 in Israel.
The researchers compared injury rates among children with ASD, ADHD, both ASD and ADHD (ASD+ADHD), and typically developing children.
Key Findings
• Higher Overall ED Visits: Children with ASD, ADHD, and ASD+ADHD had higher rates of overall Emergency Department (ED) visits compared to typically developing children.
• Injury Patterns: Children with ADHD alone had the highest rates of ED visits due to any type of injuries. Children with ASD had higher rates of ED visits due to inhalation and ingestion injuries but lower rates of orthopedic or animal-inflicted injuries.
• Unexpected Finding: Children with ASD, including those with co-occurring ADHD, had similar or lower injury rates compared to typically developing children.
Possible Explanations
• Anxiety: The researchers suggest that anxiety, a common trait in ASD, may deter children from engaging in activities that increase the risk of injury.
• Increased Supervision: Children with ASD often receive more intensive supervision from caregivers, educators, and therapists, potentially reducing their risk of injury.
• Decreased awareness of the risk of burns and inhalation injuries. Children with autism are less aware of the risk of burns and inhalation injuries that mostly occur at home.
Study Implications:
The findings emphasize the need for tailored injury prevention strategies for each condition.
“Injuries are a major cause of morbidity and mortality among children with neurodevelopmental conditions,” the researchers wrote. “Identifying injuries associated with this vulnerable population could inform specific preventive actions.”
Study Authors
• Prof. Idan Menashe, PhD, Ben-Gurion University of the Negev
• Dorit Shmueli, MD, Clalit Health Services
• Talish Razi, MPH, Clalit Health Services
• Moran Almog, MD, Clalit Health Services
• Aviva Mimouni Bloch, MD, Loewenstein Rehabilitation Medical Center