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Pediatric emergency medicine trisk 4212 4212

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carries a diagnosis of ASD Thirty-one percent have associated intellectual disability Clinical Considerations Predictable patterns of comorbid medical conditions have been described in those with ASD Investigators identify significantly higher rates of healthcare utilization among children with ASD for psychiatric, gastrointestinal, neurologic, and sleep disorders Eighty percent of children with ASD report at least one psychiatric diagnosis, including inattention and hyperactivity in 30% to 61%, anxiety in 11% to 40%, and depression in 7% to 26% Thirteen percent of emergency care visits among this population relates to psychiatric-related concerns as compared to 2% in children without ASD Families seek care most often for management of externalizing behaviors, such as physical aggression and disruptive conduct Similarly, many children with ASD require care for gastrointestinal and neurologic complaints Although 9% to 70% of individuals with ASD report concerning abdominal pain, constipation, chronic diarrhea, and symptoms of gastroesophageal reflux disease, there is no evidence for pathogenic mechanisms related to these conditions specific to ASD Notably, children with ASD and common gastrointestinal disorders may present atypically with behavior changes, irritability, disordered sleep, or new noncompliance with previously mastered demands Many individuals with ASD have restricted or selective diets and may be at risk for nutritional deficiencies causing illness Children with ASD frequently pursue neurologic intervention for impaired motor development and seizure management Epilepsy occurs in 25% to 46% of individuals with ASD Children with ASD in general have significantly higher rates of poisonings, self-injury, traumatic brain injuries, injuries to the face and neck, contusions, fractures, open wounds, and burns with lower rates of sprains and strains compared to peers without ASD Crucially, nearly half of children with autism are known to wander from caregivers with an associated risk for drowning being the most common cause of mortality in such circumstances Remarkably, two-thirds of children ages to 15 years report being bullied Self-injury is most common in patients with associated intellectual disability or limited functional communication abilities Such behavior may

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