Skip to main content
Injury Prevention logoLink to Injury Prevention
. 2004 Feb;10(1):21–26. doi: 10.1136/ip.2003.002865

Disability and risk of school related injury

M Ramirez 1, C Peek-Asa 1, J Kraus 1
PMCID: PMC1756535  PMID: 14760022

Abstract

Objective: Approximately six million children with disabilities attend school in the United States. Cognitive and physical limitations may compromise their ability to handle environmental hazards and hence increase their risk for injury. The objective of this study was to describe the epidemiology of school related injury among children enrolled in 17 special education schools in one large, urban school district.

Design: Altogether 6769 schoolchildren with disabilities were followed up from 1994–98. Injury and population data were collected from pupil accident reports and existing school records. Associations were estimated through generalized estimating equations.

Results: A total of 697 injuries were reported for a rate of 4.7/100 students per year. Children with multiple disabilities had a 70% increased odds of injury compared with the developmentally disabled (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.3 to 2.3). The physically disabled (OR 1.4, 95% CI 1.0 to 1.9) had a modest increased odds of injury. Cuts, bruises, and abrasions composed almost three fourths of all injuries; almost half of these injuries were to the face. Falls (34%) and insults by other students (31%) were the most common external causes. More than a fourth of injuries were sports related, and 21% occurred on the playground/athletic field. Injury patterns differed across disabilities.

Conclusions: Although limited to one school district, the population studied is the largest cohort thus far of schoolchildren with disabilities. With this large study base, potentially high risk groups were identified and circumstances of injury described. This information is imperative for developing and improving school based injury prevention measures.

Full Text

The Full Text of this article is available as a PDF (237.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berggreen S. M. Accidents and surgical emergencies in a population of mentally retarded children. Acta Paediatr Scand. 1973 May;62(3):289–296. doi: 10.1111/j.1651-2227.1973.tb08105.x. [DOI] [PubMed] [Google Scholar]
  2. Bremberg S. Is school-based reporting of injuries at school reliable? A literature review and an empirical study. Accid Anal Prev. 1989 Apr;21(2):183–189. doi: 10.1016/0001-4575(89)90085-7. [DOI] [PubMed] [Google Scholar]
  3. Bryan E., Warden M. G., Berg B., Hauck G. R. Medical considerations for multiple-handicapped children in the public schools. J Sch Health. 1978 Feb;48(2):84–89. doi: 10.1111/j.1746-1561.1978.tb08077.x. [DOI] [PubMed] [Google Scholar]
  4. Burkett K. W. Trends in pediatric rehabilitation. Nurs Clin North Am. 1989 Mar;24(1):239–255. [PubMed] [Google Scholar]
  5. De Simone Eichel J., Goldman L. Safety makes sense: a program to prevent unintentional injuries in New York City public schools. J Sch Health. 2001 May;71(5):180–183. doi: 10.1111/j.1746-1561.2001.tb07312.x. [DOI] [PubMed] [Google Scholar]
  6. Dunne R. G., Asher K. N., Rivara F. P. Injuries in young people with developmental disabilities: comparative investigation from the 1988 National Health Interview Survey. Ment Retard. 1993 Apr;31(2):83–88. [PubMed] [Google Scholar]
  7. Gaebler-Spira Deborah, Thornton Lisa S. Injury prevention for children with disabilities. Phys Med Rehabil Clin N Am. 2002 Nov;13(4):891–906. doi: 10.1016/s1047-9651(02)00023-2. [DOI] [PubMed] [Google Scholar]
  8. Gratz R. R. School injuries: what we know, what we need. J Pediatr Health Care. 1992 Sep-Oct;6(5 Pt 1):256–262. doi: 10.1016/0891-5245(92)90024-x. [DOI] [PubMed] [Google Scholar]
  9. Krug E. G., Brener N. D., Dahlberg L. L., Ryan G. W., Powell K. E. The impact of an elementary school-based violence prevention program on visits to the school nurse. Am J Prev Med. 1997 Nov-Dec;13(6):459–463. [PubMed] [Google Scholar]
  10. Leland N. L., Garrard J., Smith D. K. Comparison of injuries to children with and without disabilities in a day-care center. J Dev Behav Pediatr. 1994 Dec;15(6):402–408. [PubMed] [Google Scholar]
  11. Newacheck P. W., Halfon N. Prevalence and impact of disabling chronic conditions in childhood. Am J Public Health. 1998 Apr;88(4):610–617. doi: 10.2105/ajph.88.4.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ohito F. A., Opinya G. N., Wang'ombe J. Traumatic dental injuries in normal and handicapped children in Nairobi, Kenya. East Afr Med J. 1992 Dec;69(12):680–682. [PubMed] [Google Scholar]
  13. Ramirez R. J., Behrends L. G., Blakeney P., Herndon D. N. Children with sensorimotor deficits: a special risk group. J Burn Care Rehabil. 1998 Mar-Apr;19(2):124–127. doi: 10.1097/00004630-199803000-00007. [DOI] [PubMed] [Google Scholar]
  14. Rehm Roberta S., Rohr Julie A. Parents', nurses', and educators' perceptions of risks and benefits of school attendance by children who are medically fragile/technology-dependent. J Pediatr Nurs. 2002 Oct;17(5):345–353. doi: 10.1053/jpdn.2002.127174. [DOI] [PubMed] [Google Scholar]
  15. Ricci F. Strategies for teaching safety education to children with special needs. Int J Trauma Nurs. 2000 Oct-Dec;6(4):129–132. doi: 10.1067/mtn.2000.110524. [DOI] [PubMed] [Google Scholar]
  16. Roberts I., Norton R. Sensory deficit and the risk of pedestrian injury. Inj Prev. 1995 Mar;1(1):12–14. doi: 10.1136/ip.1.1.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rodman J., Weill K., Driscoll M., Fenton T., Alpert H., Salem-Schatz S., Palfrey J. S. A nationwide survey of financing health-related services for special education students. J Sch Health. 1999 Apr;69(4):133–139. doi: 10.1111/j.1746-1561.1999.tb04169.x. [DOI] [PubMed] [Google Scholar]
  18. Sherrard J., Tonge B. J., Ozanne-Smith J. Injury in young people with intellectual disability: descriptive epidemiology. Inj Prev. 2001 Mar;7(1):56–61. doi: 10.1136/ip.7.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sherrard J., Tonge B. J., Ozanne-Smith J. Injury risk in young people with intellectual disability. J Intellect Disabil Res. 2002 Jan;46(Pt 1):6–16. doi: 10.1046/j.1365-2788.2002.00346.x. [DOI] [PubMed] [Google Scholar]
  20. Wood S. P., Walker D. K., Gardner J. School health practices for children with complex medical needs. J Sch Health. 1986 Aug;56(6):215–217. doi: 10.1111/j.1746-1561.1986.tb05736.x. [DOI] [PubMed] [Google Scholar]
  21. Woringer V. Les accidents scolaires. Rev Med Suisse Romande. 1995 Feb;115(2):153–156. [PubMed] [Google Scholar]
  22. Zeger S. L., Liang K. Y. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986 Mar;42(1):121–130. [PubMed] [Google Scholar]

Articles from Injury Prevention are provided here courtesy of BMJ Publishing Group

RESOURCES