Emergency Visits for Autistic Children and Children With ADHD.

This study looked at why autistic children and children with ADHD visit emergency departments. Unlike other children who mainly visit for physical health problems, autistic children and those with ADHD often visit for mental health crises. Teenagers with autism or ADHD were more likely to visit for mood problems and self-harm. Younger autistic children visited more for behavior problems, while younger children with ADHD visited for mood issues.

This shows these children need better mental health support.

This large-scale analysis of US emergency department data (2008-2017) examined primary reasons for ED visits among autistic children and children with ADHD compared to a random sample. While typical pediatric ED visits primarily involved physical health conditions, autistic children and those with ADHD frequently presented for psychiatric conditions. Older children (13-18 years) with autism or ADHD showed significantly higher odds of presenting for mood disorders (10-15% of visits) and intentional self-harm. Younger autistic children more commonly presented with behavioral disorders (9.7% of visits), while younger children with ADHD presented more frequently with mood disorders (6.6% of visits).

The findings highlight elevated psychiatric emergency needs in these populations.

Emergency departments should implement autism and ADHD-informed protocols including suicide risk screening for teenagers and behavioral crisis management for younger children. Systematic psychiatric assessment and care coordination pathways are essential. Enhanced training for ED staff in neurodevelopmental conditions and trauma-informed care approaches may improve outcomes.

Study type not specified. Sample size not reported, limiting assessment of statistical power. Administrative data may have coding inaccuracies. No information on intervention effectiveness or long-term outcomes. Causality cannot be established from this observational design.

Autistic children and children with attention-deficit/hyperactivity disorder (ADHD) may have more frequent visits to the emergency department (ED). We aim to identify the primary reasons for ED visits among autistic children and children with ADHD, compared to a random sample of visits. Using 2008 to 2017 Nationwide Emergency Department Sample data, we assessed the most frequent primary diagnoses for ED visits among children (ages 3-12 and 13-18 years, separately) (1) with an autism diagnosis, (2) with ADHD, and (3) a random sample (1 000 000 visits). We regressed primary reasons for visits on autism or ADHD diagnosis, controlling for individual characteristics, to assess the odds of presenting for these reasons.

Although the 10 most frequent diagnoses among the random sample were physical health conditions, autistic children and children with ADHD often presented for psychiatric conditions. Older children with autism and with ADHD more frequently presented for mood disorders (10%-15% of visits; odds ratios [ORs] = 5.2-8.5) and intentional self-harm (ORs = 3.2-5.0). Younger children with ADHD more commonly presented with mood disorders (6.6% of visits; OR = 18.3) and younger autistic children more often presented with attention-deficit, conduct, and disruptive behavior disorders (9.7% of visits; OR = 9.7). Autistic children and children with ADHD have higher odds of presenting to the ED for psychiatric conditions than a random sample, including for self-harm.

Clinicians should treat these populations sensitively, recognize and assess the risk for self-harm, and facilitate continuing psychiatric care.