title: A comparison of school injuries between children with and without disabilities.
abstract: OBJECTIVE
  The aim of this study was to compare rates, nature, and mechanisms of school injuries in children with and without disabilities.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Iowa Injury Prevention Research Center, Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa 52242-5000, USA. marizen-ramirez@uiowa.edu
authors.forename: Marizen
authors.initials: M
authors.lastname: Ramirez
authors.forename: Erin
authors.initials: E
authors.lastname: Fillmore
authors.forename: Alex
authors.initials: A
authors.lastname: Chen
authors.forename: Corinne
authors.initials: C
authors.lastname: Peek-Asa
mesh_terms: D002648:Child; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D004519:Education, Special; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology; D015141:Los Angeles; D008297:Male; D012189:Retrospective Studies; D012574:Schools; D014947:Wounds and Injuries / Q000453:epidemiology*