Resting-state functional connectivity of the sensorimotor network in medication-naïve Chinese children with ADHD: cross-sectional associations with hyperactivity/impulsivity and executive function.

Unintentional injuries among children are defined as external, sudden, and unintended events that cause harm to their health and life (). The International Classification of Diseases, 10th Revision (ICD-10), categorizes unintentional injuries into 10 types based on external causes of morbidity and mortality, including falls, road traffic injuries, drowning, and others (). According to World Health Organization (WHO) data, in 2016 alone, injuries and violence caused over 640,000 deaths among children aged 0–14 years globally, representing the leading cause of mortality in this age group, with unintentional injuries accounting for more than 90% of these fatalities (). The Chinese Death Cause Surveillance Dataset (2021) reports an injury mortality rate of 8.86 per 100,000 among children aged 1–14 years, with unintentional injuries similarly accounting for more than 90% of these fatalities (). Furthermore, children aged 3–12 years are particularly vulnerable to unintentional injuries because of rapidly developing motor skills and limited risk-recognition abilities (, ). Unintentional injuries among children have serious consequences, ranging from mortality to trauma and disability, and thus impose significant burdens on individuals and society (). Existing evidence indicates that these injuries are preventable, with their risk significantly influenced by individual traits and social environmental factors (). Current research on children’s unintentional injuries predominantly focuses on the description of epidemiological characteristics and individual-level cognitive behavioral analysis (, ). Moreover, most of the research samples are from educational institutions in urban areas (), while in-depth investigation on vulnerability factors in rural western regions remains scarce. Vulnerability, defined as the susceptibility of individuals or groups to suffer harm when confronted with risks, is shaped by factors at the individual, familial, communal, and societal levels (). In rural southwestern China, child injury risks exhibit intricate regional characteristics driven by structural poverty, labor migration, and traditional cultural beliefs (). For example, Guizhou Province, a prominent labor-exporting region, harbors a substantial number of left-behind children, constituting nearly half of the rural child demographic (). These children encounter heightened injury risks and more severe consequences due to the absence of guardianship, restricted access to healthcare, and deficiencies in educational resources. Additionally, children with disabilities, who experience higher injury rates due to disabilities and unsuitable environments, have been largely overlooked in mainstream research (). These vulnerable populations urgently require targeted interventions.