"He is always hurting himself," Ben’s mother said. "Every time he walks up the steps he trips up the stairs. He walks into furniture and can trip just walking across the floor. He is only 10 and we have already been to the ER more times than I can count. A broken arm from falling out of the swing, a sprained wrist when he jumped off the jungle gym and stitches when he fell off his bike - and those are just the most recent injuries." Ben isn’t alone. Children with ADHD are accident-prone.
According to a study completed in 2011, children with ADHD are twice as likely to be injured. Parents of children completed questionnaires about ADHD symptoms and injuries. Parents of children who scored high on the ADHD assessment were twice as likely to report that their child had been injured in the last year.
David Schwebel, the author of the study explains, "ADHD is a disorder that’s associated with impulsive behaviors-children do things without thinking. It’s associated with inattention-they’re not really paying attention to risks in their environment. And it’s associated with executive function-planning ahead, thinking ahead and having inhibition when you need it. Children with ADHD are poor at those skills, and that combination of things is leading them to take risks and behave impulsively, which leads to getting hurt." 
So, besides having your doctor and local emergency room on speed dial, what can parents do to help keep their kids with ADHD safe? The following tips may help:
- Create a safe play environment. If you have a back yard, set up a child safe playset, have games and activities that are safe available and be sure to put away any tools or sharp objects. For younger children who tend to wander, make sure the yard is supervised at all times.
- Review the rules before your playtime. Frame your conversation around what your child should do, rather than what he shouldn’t do. For example, if indoors state, "Remember we walk when in the house," rather than saying, "No running." Your child may listen better when you frame discussions in this way.
- Discuss the consequences for inappropriate behaviors. For example, what is going to happen if your child climbs to the top of the playset, or dares his friend to, and then jumps? This type of behavior increases the chances of an injury and for most children with ADHD, leaping before looking happens more often than looking before leaping.
- Insist your child use the proper safety equipment for the current activity. For example, when riding a bike, your child should have a helmet on at all times. Knee, elbow and wrist pads as well as helmets should be used when skateboarding. Take the time to research proper safety equipment for the activities your child does. Let your child know what the consequences will be for not using the proper equipment.
- Go over rules for crossing the street. One study found that children with ADHD look both ways but may take more risks, such as crossing the street quickly when a car is coming rather than waiting for it to pass. 
- Make sure your child wears appropriate shoes. Open toed shoes, heels or shoes that don’t fit properly can cause injuries on the play ground or when running outside. Sturdy, properly sized shoes can help reduce injuries.
- Have an emergency plan. If you do need to head to the ER, is there someone available to watch your other children? Check in advance if the ER in your local hospital takes your insurance. Ask your pediatrician which hospital is best for dealing with childhood injuries.
Besides the practical steps, you might want to keep your home childproofed. This means making sure breakable items are kept out of reach. Stick with stain-repellant or easy to clean paints and wallpapers. Make sure any items that are poisonous are kept locked up. While most people think of childproofing for households with babies and toddlers, as any parent of a child with ADHD knows, childproofing may not always prevent accidents, but it might make the accidents that do happen easier to clean up and deal with.
For more information:
"ADHD & Summer Safety and What Dangers Can Be Presented," 1022, June, Dr. Anthony Tanoma, Delta Psych Group
  "ADHD Doubles a Child’s Risk of Injury," 2011, Sept. 16, Jenifer Goodwin, USA Today
Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.