Kids With Autism Twice As Likely to Consider Suicide

Key Takeaways

  • Children who are diagnosed with autism spectrum disorder are twice as likely to report thoughts of suicide as children who don’t have the condition, according to a new study.
  • Asking the kids questions about thoughts of suicide can give them an outlet to express those feelings and get help.
  • Early identification of suicidal thoughts and feelings can help save lives.

Suicide claims the lives of more than 700,000 people worldwide every year. In the United States, it’s the second leading cause of death in children and young adults ages 10 to 34. Millions of people, including those with neurodevelopmental disorders, deal with suicidal thoughts each day.  A new study notes that children diagnosed with autism spectrum disorder (ASD) consider suicide much more than their parents and officials may realize.

The study, published in the Journal of Developmental and Behavioral Pediatrics, found that children with ASD were twice as likely to report suicidal thoughts as children who don’t have the condition. Some characteristics of autism may make children more susceptible to struggling with thoughts of suicide.

“The research shows that people with mild autism may be more likely to have suicidal thoughts. The reason is that they can have difficulty with communication, which can impact their ability to connect with others. That lack of emotional connectivity can be a risk for suicide,” states Suzanne Rybczynski, MD, MSHCM, the associate chief medical officer at Kennedy Krieger Institute in Baltimore, Maryland.

Dr. Rybczynski, the lead author of the study, notes there are a number of other factors that can push a child diagnosed with autism to consider suicide. The study highlights the long-ignored problem of suicidal thoughts in children with autism, and also opens the discussion to other risk factors, what caregivers can look for in their children, and resources to get their children the help they need.

What Is Autism Spectrum Disorder?

Autism Spectrum Disorder is a condition that impacts individuals developmentally. The disorder can cause problems with communication, socialization, and behavior. About one in 54 children have been diagnosed with autism, and boys are four times more likely than girls to be diagnosed with the condition. It occurs across all racial and ethnic groups, at varying levels.

“It is a disorder that has a very wide spectrum. It is generally categorized in levels between one and three, with level one being the least severe and [individuals] are only mildly affected, to level three being the most severe and individuals requiring very substantial supports,” explains Jason Hangauer, PhD, NCSP, a licensed psychologist who specializes in ASD treatment at John Hopkins All Children’s Hospital.

A Closer Look at the Study

Experts say children with autism have not historically been screened for suicide risk. So, researchers with Kennedy Krieger Institute wanted to see if the screening could be done with the autistic population and if the kids would be able to communicate whether they were having suicidal thoughts.

When patients ages 8 to 18 years old visited Krieger’s outpatient clinics, nurses screened them as a part of the triage process. The questions came from the Ask Suicide-Screening Questions (ASQ) tool. The questions focus on whether the persons responding have had thoughts of killing themselves or have thought others would be better off if they were no longer alive. 

Jason Hangauer, PhD

This study highlights people with disabilities do in fact have thoughts of self-harm and could be at risk just as other populations.

— Jason Hangauer, PhD

Researchers gathered a total of 3854 screened responses from patients over a 6-month time frame, beginning in 2017. They included findings from their Center for Autism and Related Disorders, which focuses on diagnosing and treating children who have autism. Researchers found that despite earlier notions that children diagnosed with autism could not express suicidal thoughts, many kids were able to communicate their feelings.

“In our study of children who were screened in all neurodevelopmental clinics, 6.8% screened positive on the ASQ for suicidal risk. In the autism clinic, that rate was 12%. That rate is almost double,” Dr. Rybczynski states.

Although the study had a racially diverse sample group, the study did have limitations. Parents had the opportunity to opt-out of the ASQ screening for their kids, and those numbers could not be included in the final results. Also, some children were non-verbal and had challenges with communication or were unable to respond. Some kids also may have had difficulties understanding the concept of suicide, which could impact their responses. Despite the weaknesses of the study, the results are helpful in highlighting a problem that is often overlooked.

Experts note that the willingness to ask screening questions to children with ASD is a necessary step to addressing a public health issue. “It was really about incorporating mental health [as] a part of a person’s whole health. We’re hoping that helps destigmatize talking about suicide,” Dr. Rybczynski adds.

Suicide Rates in Children With Autism

The U.S. suicide rate in kids and young adults ages 10 to 24 years old jumped significantly in the past 10 to 15 years. The numbers rose from 6.8 deaths per 100,000 people in 2007 to 10.7 deaths in 2018. That’s an increase of almost 60%.

Research published from Denmark earlier this year showed that individuals diagnosed with autism were three times more likely to consider and attempt suicide than those without autism. A 2017 study from Taiwan noted that adolescents and young adults with ASD, ages 12 to 29, had an increase in suicide attempts than those without ASD.

The results from both pieces of previous research support the findings that children with ASD battle suicidal thoughts. The information also highlights the importance of mental health help for children who are struggling.

Contributing Factors

 Difficulty communicating with others can contribute to a feeling of loneliness in children who have ASD. They may struggle with feeling socially isolated. That inability to connect with others can lead to suicidal thoughts. Kids diagnosed with autism may behave and speak differently, which
can lead to another risk factor—bullying.

Suzanne Rybczynski, MD

We recognized that parents may have thought their child could never possibly have had suicidal thoughts. It’s so important to ask those questions. Early identification can really save lives.

— Suzanne Rybczynski, MD

As a parent who is plugged into your child’s normal behavior, you can be on the lookout for warning signs. “Symptoms to watch for are similar to other children without autism, such as a loss of interest in previously enjoyed activities, giving possessions away, speaking about a desire to die, and changes in behavior,” Dr. Hangauer advises.

Warning signs are a sign to get help. “Through our study, we recognized that parents may have thought their child could never possibly have had suicidal thoughts. It’s so important to ask those questions. Early identification can really save lives,” says Dr. Rybczynski.

Suicide Prevention Resources

A mental health professional who works with children with ASD can help your child understand and process their feelings, and pediatricians also have resources that can help. Experts also give some practical tips:

  • Ask children questions to find out what’s going on in their life and probe the thoughts they’re having. Experts note that asking questions does not increase the risk of suicide. Most children are relieved to have someone to talk to about their feelings.
  • Tell your child that it is okay to be upset and feel sad sometimes. Even share that you feel that way too.
  • Give them coping mechanisms to deal with their feelings. Is there a trusted adult they can talk to? Does writing help? Maybe they’d enjoy watching a funny video to relieve those feelings.
  • Put common-sense measures in place, like locking up weapons and keeping medications out of reach.
The National Suicide Prevention hotline is available 24 hours a day, at 988.

The information provided by this study impacts anyone who works with children who have neurodevelopmental disorders or intellectual challenges. The findings also impact parents and caregivers of children with ASD, giving insight on warning symptoms and understanding of how to get the help their child may need.

“This study highlights people with disabilities do in fact have thoughts of self-harm and could be at risk just as other populations,” Dr. Hangauer notes. “More care and attention to keep all children safe is needed,” he concludes.

What This Means For You

Children diagnosed with autism spectrum disorder communicate in different ways. Just because a child may not verbalize thoughts of distress, frustration, or suicide, doesn’t mean the thoughts are not present. Watch for signs of concern, ask questions about how your child is doing, and use your resources to get the help that’s needed.


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