Background
Reducing harmful levels of alcohol consumption among children is an important public health concern internationally and in many high income countries. Little is known about levels and predictors of alcohol use among children with intellectual disability.

Method
Secondary analysis of child self-report data at age 11 years collected in the UK’s Millennium Cohort Study.

Results
Children with intellectual disability were significantly more likely to: have used alcohol in the last four weeks; to have had five or more alcoholic drinks on one occasion; to have had five or more alcoholic drinks or been intoxicated on one occasion; to have more positive attitudes about the psychological and social benefits of drinking; to have less negative attitudes about the social and physical costs of drinking. Potentially harmful levels of drinking (intoxication or 5+ alcoholic drinks on one occasion) among children with intellectual disability were associated with child smoking, having friends who use alcohol, reporting that drinking makes it easier to make friends and reporting that drinking reduces worrying. Children with intellectual disability accounted for 9% of all children with potentially harmful levels of drinking.

Conclusion
Public health interventions to reduce potentially harmful drinking among children in general must recognise that children with intellectual disability are a potentially high risk group and ensure that interventions are appropriately adjusted to take account of their particular needs and situation. Future research in this area is needed to untangle the causal pathways between attitudes toward alcohol and alcohol use among children with intellectual disability and the extent to which levels of alcohol use and predictors of alcohol use may be moderated by severity of intellectual disability.