Abstract
Introduction
Although autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) have been associated with higher risk of specific types of burns, mechanisms and circumstances of injury should be investigated for prevention and education.
Methods
A multisite retrospective review of 841 patients treated at pediatric burns hospitals assessed a subsample of Burn Outcomes Questionnaire (BOQ) data collected from years 2001 to 2010. Demographic and clinical characteristics of burn injury were compared. The current study evaluates burn mechanisms and patients diagnosed with ASD/ADHD as indicated in the co-morbid conditions field of the BOQ through logistic regression analyses.
Results
Of the 841 patients who completed the BOQ, there were 227 patients with diagnoses of ASD/ADHD. Age is not statistically significant when considering burn injury due to Play, which includes match play, fire play, and similar behaviors (P=0.36). However, patients with ASD/ADHD were older than the reference group (10.2 years, 8.32 years, P< .0001) and the same pattern is observed when considering burn injury due to Self-Infliction (10.7 years, 8.04 years, P< .001), Play (10.7 years, 8.27 years, P< .01), and Self-Infliction Not Play (10.7 years, 4.40 years, P=.03). Pediatric burn patients with ASD/ADHD are 1.80 times as likely to have sustained burn injury due to Play than the reference group and have 2 times the odds (odds ratio [OR]: 2, [95% confidence interval (CI): 1.32, 3.03], P< .001). Additionally, pediatric patients with ASD/ADHD are 4.06 times as likely to have sustained burn injury due to Self-Infliction Not Play and have 4.18 times the odds (OR: 4.18, 95% CI (1.47,11.89), P< .01).
Conclusions
The research suggests that pediatric burn patients with ASD/ADHD are more likely to sustain burn injury through Play and other methods of Self-Infliction. Pediatric patients with ASD/ADHD are older than the reference group. Difference in age is partly due to older patients who sustained burn injury secondary to seizure. Though more research is needed for burn circumstances, these secondary injuries mostly present as contact and scald burns occurring in outdoor settings or kitchens. Patients without ASD/ADHD and burn injury due to Self-Infliction Not Play were predominantly toddler and preschool aged, and presented with scald and contact burns related to bathing and feeding.
Applicability of Research to Practice
Further research is needed to better understand ASD/ADHD and burns, with particular emphasis on differentiating the 2 diagnoses and burn circumstances. Patients with ASD/ADHD and caregivers may benefit from research in burn injury risk for prevention and counseling.
Risk factors for low adherence to methylphenidate treatment in pediatric patients with attention-deficit/hyperactivity disorder