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Accidental injuries are more common in children with attention deficit hyperactivity disorder compared with their non-affected siblings


Yuval Shilon, MD, Pediatric Neurology Unit, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel. E-mail:


Background  Accidental injuries are a leading cause of paediatric morbidity and mortality. We hypothesized that attention deficit hyperactivity disorder (ADHD), a common childhood disorder characterized by behaviours such as hyperactivity and impulsivity, is a risk factor for accidental injuries. Previous retrospective studies suggested that children with ADHD have an increased injury rate, but controlled prospective studies are lacking.

Methods  We conducted a prospective case–control study of 29 school-aged children with ADHD and their same-sex, similarly aged, non-ADHD-affected siblings. All diagnoses were made by a paediatric neurologist according to DSM-IV criteria and the children and their parents underwent a structured psychiatric interview and a battery of complementary assessments including: Child Behavior Checklist (CBCL), ADHD Rating scale and Developmental Coordination Disorder Questionnaire (DCDQ). The parents were contacted by telephone every 3 months during a 9-month follow-up period and all injuries requiring medical attention were recorded. Incidence of injuries was compared between the pairs of siblings.

Results  During the follow-up period, a total of 13 injuries in 13 children with ADHD were reported, compared with six injuries in six children from the control group (Z=−2.11, P < 0.05). ADHD severity and subtype, CBCL, DCDQ and IQ scores were not predictive of injury risk.

Conclusions  School-aged children with ADHD are at higher risk of accidental injuries than their non-ADHD siblings, regardless of ADHD subtype, co-morbid psychiatric conditions, developmental co-ordination problems and environmental/familial conditions. Awareness and adequate education of parents and caregivers of children with ADHD concerning the increased injury risks are thus warranted.