Study highlights the importance of routine suicide risk screenings in children with ASD

Children with autism spectrum disorder (ASD) are twice as likely to report suicidal thoughts when screened for suicidal ideation during routine medical assessments, according to new research from the Kennedy Krieger Institute.

The study, which was published in the Journal of Developmental & Behavioral Pediatrics, highlights the importance of implementing suicide risk screenings as part of routine health care in children with neurodevelopmental disorders, and especially those with ASD, said Suzanne Rybczynski, MD, MSHCM, Kennedy Krieger's associate chief medical officer and the study's principal investigator.

We need talk about mental health, especially suicide, and work to destigmatize it. Mental health is not separate from overall health-;it's all one person. Performing suicide risk screenings along with routine medical screenings recognizes that mental health is as important as our physical health and a key part of our lives."

Dr. Suzanne Rybczynski, MD, MSHCM, Kennedy Krieger's associate chief medical officer

The study concluded that implementing a routine suicide risk screening for children with neurodevelopmental disabilities, identifying risk among those participants, and then providing follow-up mental health care to the patients who needed it were feasible steps to undertake as clinicians work to lower the risk of suicide among children and adolescents.

Suicide is the second leading cause of death for people ages 10 to 34 in the U.S.

In 2017, Kennedy Krieger clinicians instituted a four-question suicide risk screening for all patients ages 8 to 18 as part of every medical screening at the Institute's outpatient clinics. The suicide risk screening questions were developed by the National Institute of Mental Health. If patients answered yes to any of the four questions, a physician, nurse practitioner, psychologist, or social worker performed a suicide safety assessment. An appropriate mental health plan was formulated for the patient based on the assessment.

"Many early suicide prevention efforts among children and adolescents focused on typically developing children, but we need to consider children with neurodevelopmental disabilities as well," Rybczynski said. "Just because we don't think a patient is capable of having suicidal thoughts, doesn't mean they aren't having those thoughts."

The study examined the suicide risk screenings during a six-month period and found that children with neurodevelopmental disorders were as likely as their peers to experience suicidal ideation. However, children with ASD were twice as likely to report suicidal thoughts during these screenings, which correlates with other research on this population, Dr. Rybczynski said.

The next step is for researchers to further assess the validity of the study's suicide risk screening tools in children with neurodevelopmental disabilities and to continue to advocate for routine suicide risk screenings for all children to identify those that need our help, Dr. Rybczynski said.