A comparison of school injuries between children with and without disabilities

The aim of this study was to compare rates, nature, and mechanisms of school injuries in children with and without disabilities.

We conducted a retrospective cohort study with repeated measures of 269 919 children with and without disabilities who were enrolled in 35 adapted schools from a large urban school district. Reports of injuries sustained from 1994 to 1998 were collected by the district's insurance division, and disability was assessed using special education guidelines determined by the California Department of Education. A generalized estimating equations model was used to estimate rate ratios, accounting for the repeated, nested nature of the data.

Children with disabilities had more than double the rate of injury reported than children without disabilities (incidence density ratio [IDR] 2.3, 95% CI, 2.2-2.5). Almost one third of these injuries were due to fights, roughhousing, and assaults. Among all disabled children, those with orthopedic disabilities had the highest risk, with rates over 5 times that of children without disabilities (IDR 5.4, 95% CI, 4.4-6.6). Children with cognitive disabilities had comparatively lower rates of injury than children with physical disabilities.

For children with disabilities, physical impairment may play a greater role than cognitive impairment in managing risk for injury at school. Individual education programs (IEP), developed for children in special education, could be tailored to include injury prevention strategies.