What researchers want families to know about autistic children and suicide

As diverse as the experiences of children and adolescents on the autism spectrum are, one striking fact remains true: Autistic youth More likely to think about suicide and dieand In earlier agescompared to their neurotypical peers.

The Times spent months interviewing autistic advocates, families, doctors and researchers to understand the factors behind this crisis and the changes that could better support young people and their families.

Solutions are still in their infancy, but autism researchers and advocates are working to develop screening tools, safety plans and treatments based on the unique strengths and differences of the autistic brain.

An important first step is to educate parents, pediatricians, and other community professionals about the unique risks and challenges facing autistic youth, and why considering neurodiversity can help reduce the number of young lives lost.

Here are some key findings:

Autistic youth are more likely to have suicidal thoughts and mental health conditions than non-autistic children.

suicide is leading cause of death For children between the ages of 10 and 18 in the United States. For autistic teenagers and children, the risk is higher. one 2023 meta-analysis found that about 10% of autistic children and adolescents had attempted suicide, a rate more than double that of their non-autistic peers.

About 20% of US high school students have disclosed suicidal thoughts by 2023, According to the Centers for Disease Control and Prevention. When the Kennedy Krieger Institute in Baltimore asked caregivers of 900 autistic children between the ages of 8 and 17 whether the children had thought about ending their lives, 35% said yes. Almost 1 in 5 said their child made a plan.

Children along the autism spectrum are more likely to be diagnosed with mental health conditions than their autistic, or non-autistic, counterparts.

A 2021 study A study of more than 42,000 children ages 3 to 17 found that 78% of autistic children had at least one psychiatric condition, compared to 14% of non-autistic children. Contributing factors include the stress of living in a world that is emotionally overwhelming or socially unacceptable.

Autistic children are at high risk without intellectual disability.

Autism Diagnostic Definition has grown over the years And now it includes children who cope by “masking”: consciously or unconsciously suppressing autistic traits in order to fit into a school or social environment. For children who tend to mask it, autism is often diagnosed in childhood or even adulthood.

Most children who wear masks can participate in mainstream classes or activities. But constantly interpreting and duplicating social responses is cognitively and emotionally exhausting. Masking is closely related With depression, anxiety And suicide

“Masking is actually a risk factor for suicide for autistic people, and it has a negative impact on someone’s mental health,” Lisa Morgan said. Autism and Suicide Prevention Task Forcewho is autistic himself.

Research has found that autistic people with high IQs are both More likely to mask And more likely to suffer from anxiety and other mental health conditions.

at the A 2023 study According to the University of Iowa, autistic children with an IQ of 120 or higher are nearly six times more likely to have suicidal thoughts than autistic children with an average IQ. For non-autistic children, the opposite was true: higher cognitive ability was associated with a lower risk of suicide.

Crisis warning signs often appear different in autistic children, and mental health interventions designed for neurotic youth may not be effective for them.

Most mental health interventions begin with a deceptively simple verbal question to the provider: What are you feeling?

But up to 80% of autistic children Has alexithymiaor difficulty identifying and describing one’s inner emotional state. For this reason, “it makes sense that all interventions that are designed for neurotypical youth may not translate the same way for autistic youth,” said Jessica Schwartzman, director of training and research at the Children’s Hospital Empowerment Neuroscience Laboratory and assistant professor of pediatrics at the USC School of Medicine.

Recognized by the Neurodiverse Working Group of Researchers Crisis warning signs Specific to autistic people, including a significant reduction in verbal communication skills.

“A lot of times it’s assumed that someone is really angry or showing a lot of emotional distress when they’re talking about death,” said Daniel Rubinoff, an associate professor in the Child and Adult Anxiety and Mood Disorders Program at the University of North Carolina at Chapel Hill, North Carolina. “An autistic individual might not do it. They might say it truthfully, or they might have a really hard time articulating it.”

Asking about suicide can save lives.

there is A common misconception Asking about suicide can put the idea in a child’s head and cause further harm. However, the researchers said, it is protective.

Ask clearly, directly and in whatever form a child is most comfortable with, Schwartzman said. Some toddlers may prefer text or written correspondence, for example, rather than direct verbal communication.

Researchers are looking for low-cost ways to tailor existing treatments to better serve autistic children, and to educate the medical community on the need for their use.

Experts are currently working on changes A standard screening tool Which providers use to identify suicide, as well as the Stanley Brown Safety Planwhere patients list coping strategies and contacts on one page that can be easily accessed in a crisis. Studies are underway on the effectiveness of prescriptions for autistic people.

Changes in the way providers interact with autistic children can also make a difference. Sensory dominance can be unstable, and an autistic child may first need a quiet place with dim lighting to calm down, and additional time to process and formulate answers to questions.

The most effective way to reduce depression, anxiety and masking mental damage is to make sure autistic children have the support they need, advocates and doctors say, and don’t feel like they have to change everything about themselves to fit in.

“Suicide prevention for autistic people is being accepted for who they are, being able to be who they are without being masked,” Morgan said.

If you or someone you know is experiencing suicidal thoughts, help is available. Call 988 to connect with trained mental health counselors or text “HOME” to 741741 in the US and Canada to reach a crisis text line.

This article was reported with support from the USC Annenberg Center for Health Journalism with support from the Christie Hamam Fund National Fellowship for Health Journalism.