Accident Prone Kids and ADHD

Patient Expert

Many parents of children with ADHD will report that they'd taken their child to the ER more times than they care to remember. New studies coming out are now showing a correlation between early injuries and later diagnosis of ADHD.

One such study recently published in The British Medical Journal details how children who sustained injuries at a very young age are often later diagnosed with ADHD. The study followed 62,000 children who experienced both head and burn injuries before the age of two. By age 10, they were twice as likely to have been diagnosed with ADHD than children who did not have a head or burn injury in early childhood.

Specifically, the researchers found that children with early head injury have a 90 percent higher incidence of an ADHD diagnosis before they were 10, compared with children in the general population who did not experience such injuries. However, children with a burn injury also had a very high rate- 70 percent of those children received an ADHD diagnosis by age 10. This data shows that the head injury did not appear to cause the ADHD.

The study suggests that injuries in general can be a sign of ADHD behavior. The researchers acknowledged that it wasn't always clear what came first- the injuries or the ADHD.

Researchers studied data from 1988 to 2003, securing records from 300 medical practices, and found that both injuries resulted in later ADHD diagnosis compared to children with no history of such injuries. But among all three groups: head injuries, burn injuries and no injuries, those who had a brain injury after the age two had the highest risk of having an ADHD diagnosis by the age

of ten.

"There have been studies done that link moderate to severe traumatic brain injury in older children to ADHD," said lead researcher Dr. Heather Keenan, an associate professor of pediatrics at the University of Utah in Salt Lake City. "There has been some suggestion that mild traumatic brain injury could also be linked to ADHD."

Considering the fact that many children with ADHD exhibit risk-taking behaviors, it's not surprising that those active young children would experience injuries at such a young age. "It is hard to figure this out, because we don't know whether or not the kids would have gone on to develop ADHD regardless of the head injury," Keenan said. "We wanted to make sure that if we saw a relationship between head injury and ADHD, it wasn't just that kids with early injuries were showing behavioral traits that would make them more likely to be diagnosed versus the head injury itself."

The study suggests that since young children who experience head and burn injuries are at higher risk for having a later ADHD diagnosis should be screened by their physicians for a possible referral for an ADHD evaluation. "Children with early injury should receive routine developmental and behavioral surveillance by their pediatrician, as well as injury prevention counseling," Keenan said. "Early injury may be an indicator of attention problems in some children."

Dr. Jon A. Shaw, director of the Division of Child and Adolescent Psychiatry and Behavioral Sciences at the University of Miami, agrees that children who experience early injuries could later be diagnosed with ADHD.

"The finding that head injury or burn injury occurring before 2 years of age are equal risk factors for a diagnosis of ADHD before 10 years of age is a surprising, but interesting, finding," Shaw said.