Swimming an ‘imperative survival skill’ for children with autism

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Children with autism are 160 times as likely to die from drowning as the general paediatric population, according to a new study carried out by researchers at Columbia University’s Mailman School of Public Health.

The team of researchers screened over 32 million death certificates in the US National Vital Statistics System and identified 1,367 individuals (1,043 males and 324 females) with a diagnosis of autism who died between 1999 and 2014.

Of the deaths in individuals with autism, 28 per cent (381) were attributed to injury, most often by suffocation (90), followed by asphyxiation (78) and drowning (74). More than 40 per cent occurred in homes or residential institutions.

Given the exceptionally heightened risk of drowning for children with autism, swimming classes should be the intervention of top priority,’ said Guohua Li, MD, DrPH, Mailman School Professor of Epidemiology and senior author of the study.

‘Once a child is diagnosed with autism, usually between two years and three years of age, pediatricians and parents should immediately help enrol the child in swimming classes, before any behavioral therapy, speech therapy, or occupational therapy. Swimming ability for kids with autism is an imperative survival skill,’ Dr Li said.

Wandering is a common autistic behavior, and Dr. Li, who is also the founding director of the Center for Injury Epidemiology and Prevention at Columbia, makes the point that many children with autism have an affinity to bodies of water:

With impaired communication and social skills, autistic kids tend to seek relief of their heightened anxiety from the serenity of water bodies. Unfortunately, this behavior too often leads to tragedies.

The study also found that the average age at death for individuals with autism was 36 compared with 72 for the general population and that the annual number of documented deaths for individuals with ASD increased sevenfold over the period studied.

While earlier research reported a higher mortality rate overall for individuals with autism, until now injury mortality in the autism spectrum disorder (ASD) population had been understudied. Despite the marked increase in the annual number of deaths occurring, autism-related deaths still may be severely underreported, particularly deaths from intentional injury such as assaults, homicide, and suicide.

Said Dr Li.

Joseph Guan, the lead author and a master of public health degree student in Epidemiology at the Mailman School of Public Health, added:

Our study was limited to death certificate data. While the numbers are startling, autism as a contributing cause of death is likely undercounted because of the accuracy of information on death certificates filed by coroners varies.

In the US the estimated prevalence of ASD is about four times as common in males as in females and higher among non-Hispanic white children and in children of highly educated parents. From 2000 to 2012, the rate of diagnosis has more than doubled.

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