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Margaret Kyle, BA
Ashley Blanchard, MD
Matthew Russell, MPH
Caleb Ing, MD
Carolyn DiGuiseppi, MD, MPH, PhD
Guohua Li, MD, DrPH

Children with autism spectrum disorder (ASD) are at increased risk of unintentional and intentional injury. A significant cause of injury in children is maltreatment, which is more common in children with disabilities, but there is limited data on maltreatment in children with ASD. This study sought to identify epidemiological factors associated with maltreatment in children with ASD aged 1-20 years using a national dataset of emergency department (ED) visits.

We utilized the National Emergency Department Sample (NEDS) data created by the Healthcare Cost and Utilization Project (HCUP). We included ED visits by children aged 1-20 years documented in NEDS from 2020-2021 and used ICD-10 codes to identify diagnosis of ASD (F84.0), suspected (T76.0-T76.9) and confirmed maltreatment (T74.0-T74.9), attention-deficit/hyperactivity disorder (ADHD; F90.X), and intellectual disability (ID; F70-F79). We computed the weighted total number of ED visits and visits with a diagnosis of suspected or confirmed abuse according to ASD, ADHD, and ID diagnoses, age, sex, hospital region, hospital urbanicity, and insurance payor, generating odds ratios (ORs) and 95% confidence intervals (CIs) for maltreatment associated with each variable. Using multivariable logistic regression, we estimated ORs and 95% CIs for maltreatment associated with ASD while adjusting for these variables.

The NEDS recorded a total of 11,788,975 ED visits in children aged 1-20 years in 2020-2021, generating a weighted total of 50,184,622 visits; of them, 542,815 (1.1%) had a diagnosis of ASD and 148,083 (0.3%) had a diagnosis of suspected or confirmed maltreatment. Sexual abuse accounted for 65.6% of maltreatment cases, followed by physical abuse (21.6%), psychological abuse (3.1%), and other abuse (9.7%). ASD was associated with 76% increased odds of maltreatment (adjusted OR: 1.76 (1.54, 2.00)). Other risk factors for maltreatment were female sex (adjusted OR: 2.99 (2.76, 3.23)), ID (adjusted OR: 2.48 (2.03, 3.02)), and ADHD (adjusted OR: 2.18 (1.96, 2.43)). In analyses stratified by sex, ASD was associated with 69% increased odds of physical abuse (adjusted OR: 1.69 (1.41, 2.04)) and 74% increased odds of sexual abuse (adjusted OR: 1.74 (1.26, 2.41)) among male children, and 59% increased odds of physical abuse (adjusted OR: 1.59 (1.17, 2.16)) but 23% increased odds of sexual abuse (adjusted OR: 1.23 (0.98, 1.55)) among female children.

Children with ASD are at heightened risk of maltreatment. Their risk varies by child sex and maltreatment sub-type, and the risk increase is greatest for physical and sexual abuse in males with ASD. Increased risk of maltreatment in children with ASD warrants targeted interventions for youth with ASD and their caretakers to prevent maltreatment-related injury.

1. Children with ASD have higher odds of maltreatment. 2. Odds of maltreatment vary by sex and type of maltreatment in children with ASD. 3. The greatest increase in odds of maltreatment in children with ASD is for physical and sexual abuse in males.

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Dylan P. Hurley, MPH, MAB, HEC-C
Elena Petkovska, MD
Wendy Pomerantz, MD, MS
Yin Zhang, MS
Maneesha Agarwal, MD

Approximately 40% of all nonfatal injuries are associated with consumer products. Autism spectrum disorder (ASD) affects 1 in 36 children, with prevalence continuing to rise. Children with ASD are at an increased risk of injury, but little is known about consumer product injuries in these children. The objective of this study is to better characterize consumer product–related injuries (PRIs) in children with ASD.

We extracted data from the US Consumer Product Safety Commission National Electronic Injury Surveillance System for all patients aged 0–21 years from 2005-2024. Case narratives were reviewed to identify whether the injured patient had documented ASD. Cases were classified as ASD if the narrative specifically mentioned: autism, autistic, autism spectrum disorder, ASD, Asperger, pervasive developmental disorder, PDD. Weighted rate per 100,000 children with ASD was calculated using prevalence data from the CDC and pediatric population. National estimates of injuries with 95% confidence intervals were calculated for overall injuries, demographics, and injury characteristics. Descriptive statistics were used to characterize the population. Top product categories implicated in PRIs in children with ASD as well as changes in PRIs in children with ASD over time were determined.

During the 20-year study period, 2,174 PRIs were identified in children with ASD, representing an estimated 60, 260 injuries nationwide (95% CI 42,908-77,613) (Table 1). The median age was 10.1 years (SD 0.27); more than one-third of children were aged 5-9 years, and approximately 80% were male. Most injuries occurred in the home, and 88% of children were treated and released. Laceration/puncture (20.5%) was the most common diagnosis, followed by internal organ injury (16.7%), and avulsion/crush/contusion/hematoma (13.2%) The most commonly injured body regions were head and face (44.8%), upper extremity (18.6%), and lower extremity 10.8%. During the study period, there was a statistically significant increase in weighted PRI rates in children with ASD from 23 to 246 cases per 100,000 children with ASD (slope = 7.4, 95% CI 5.7-9.1, p< 0.0001). The most commonly implicated products included bathroom stall walls (12.0%), floors (6.1%), and storm windows (6.0%) (Table 2).

Structural products such as walls, floors, and windows are the most common consumer products implicated in injury in the ASD population. These injuries often occurred in the home highlighting a need to explore prevention within the built environment for this vulnerable population.

1. Describe the epidemiology and injury characteristics of consumer product–related injuries among children and adolescents with autism spectrum disorder (ASD).
2. Identify the consumer products and environmental features most frequently implicated in injuries among children and adolescents with ASD.
3. Consider opportunities for injury prevention within the home and built environment based on patterns of product-related injuries in children and adolescents with ASD.

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Spencer Poston, MSc

Sleep-related infant deaths, including suffocation and SIDS, remain the leading cause of post-neonatal mortality in the United States despite decades of public health education promoting infant safe sleep. While many professionals who work with infants and families receive foundational education on safe sleep recommendations, fewer receive role-specific training on how to apply this knowledge in practice. Professionals across disciplines – including child welfare workers, home visitors, childcare providers, first responders, nurses, and doulas – routinely encounter families in settings where unsafe sleep practices can be identified, discussed, and addressed. However, many report uncertainty regarding how safe sleep fits within their professional role, how to communicate recommendations effectively, and how to navigate common barriers faced by families.

Cribs for Kids developed the Professional Training Series, a multidisciplinary educational initiative designed to provide targeted, accessible safe sleep training tailored to the unique roles, responsibilities, and settings of professionals who support families with infants. Completion of the organization’s Safe Sleep Ambassador training serves as a prerequisite to provide consistent foundational knowledge. Each module incorporates evidence-based safe sleep education, profession-specific case scenarios, assessment strategies, strengths-based communication techniques, and practical, customizable tools designed for real-world use. Each module is reviewed by a multidisciplinary advisory board to ensure content is realistic and impactful to the intended audience.

Since launching in June 2025, the Professional Training Series has enrolled over 600 participants across all included disciplines (as of May 2026). Participants complete a post-test and evaluation survey following each module. Early feedback demonstrates high satisfaction, with an average participant rating of 4.8 out of 5 stars. Qualitative feedback highlights increased confidence in initiating safe sleep conversations and integrating safe sleep support into routine professional practice.

Profession-specific safe sleep training may help bridge the gap between theoretical knowledge and practical implementation by equipping providers with the tools and problem-solving strategies needed to support families effectively. This program offers a broadly accessible, sustainable model for integrating standardized education across systems that interact with families. Strengthening workforce preparedness through targeted training may enhance consistency in safe sleep messaging, preserve trust in client-provider relationships, improve early identification of unsafe sleep practices, and support broader injury prevention efforts aimed at reducing sleep-related infant deaths.

1. Describe key gaps in traditional safe sleep education that contribute to inconsistent implementation of safe sleep practices across professional settings.
2. Identify the core components of a multidisciplinary professional training model designed to promote safe sleep, strengthen risk perception, and improve communication with families.
3. Discuss opportunities to implement and integrate standardized safe sleep training into existing systems that support infants and families.

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Enjuli Chhaniara, DO, MPH
Natalie Pardo, DO, MPH
Veronica Gullapalli, MD
Phung Dang, DO
Sara Horan, MD
Hailey Nelson, MD, FAAP, IBCLC
Stacey Nolan, BS

Burn and fire-related injuries remain a leading and preventable cause of morbidity and mortality among children in the United States. Nationally, approximately 80,000 pediatric burn injuries are treated in emergency departments annually, resulting in nearly 300 pediatric deaths each year. Children under five years of age account for over half of burn-related hospital visits, with scald injuries from hot liquids and steam being the most common mechanism. In California’s Central Valley, risk is further increased by multigenerational households, frequent home cooking, high ambient temperatures, and limited access to culturally and linguistically appropriate prevention education. Given that more than half of the population identifies as Latino/Hispanic, bilingual, accessible caregiver education is essential for effective injury prevention.

A community-engaged, social media–based burn prevention program was developed in partnership with CAL FIRE, which provided subject-matter expertise and dissemination support. The program targeted caregivers and families of young children in the Central Valley. A needs assessment and review of existing digital resources identified four priority prevention domains: kitchen safety, scald prevention, emergency fire preparedness, and campfire safety. Educational content was co-developed by pediatric residents and faculty and disseminated through a pediatric hospital blog, residency and hospital-wide social media platforms, and CAL FIRE’s official social media channels. Materials included bilingual (English and Spanish) infographics, short educational videos, and written posts designed to maximize accessibility, engagement, and cultural relevance.

Program evaluation is ongoing and will use a mixed-methods approach to assess both reach and clinical impact. Digital engagement metrics include blog page views, unique visitors, geographic reach within the Central Valley, time on page, and social media impressions, shares, comments, saves, and engagement rates. Broader dissemination will be assessed through amplification via CAL FIRE’s established digital networks. Clinical outcomes will be evaluated by comparing pediatric burn-related emergency department visits before and after implementation, including subgroup analyses by burn mechanism. In addition, caregiver feedback and chart review will be used to identify knowledge gaps and inform iterative improvements to educational content.

This interprofessional, digitally delivered injury prevention initiative demonstrates a scalable and cost-effective model for improving pediatric burn safety education. Collaboration between pediatric clinicians and public safety partners enables rapid dissemination of culturally responsive, bilingual educational materials. The integration of structured digital engagement metrics with clinical outcome evaluation provides a framework for assessing impact and supports potential replication in other high-risk communities.

1. Identify key risk factors for pediatric burn injuries in high-risk communities such as California’s Central Valley.
2. Describe how a social media–based, bilingual education program can be used for pediatric injury prevention.
3. Outline methods for evaluating both digital engagement and clinical outcomes in a community-based prevention program.