Improving Emergency Department Care for Suicidality in Autism: Perspectives from Autistic Youth, Caregivers, and Clinicians.
Paige E Cervantes, Lawrence A Palinkas, Greta R Conlon and 4 others
PMID 38819705WHAT IT FOUND
Autistic youth and caregivers reported that rushed, abstract questioning and sensory overload in emergency departments hindered disclosure of suicide risk.
They recommended concrete language, visual supports, and predictable routines to build trust, though ED clinicians noted time constraints make these changes difficult to implement.
Key findings
01Participants reported that unclear language, open-ended questions, and reliance on verbal expression of internal states led to miscommunications that may prevent autistic youth from disclosing suicide symptoms.
02Recommendations included using direct and concrete language, providing visual supports, accommodating processing speed, and reducing sensory demands in the emergency department environment.
03Emergency department clinicians found these recommendations useful but cited time constraints, competing priorities, and lack of standardized materials as major barriers to implementation.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was very small (17 participants) and self-selected, which limits the generalizability of the findings. Most participants (four of six youth) had not actually sought emergency department care, so their recommendations for the ED were based on hypotheticals or general mental health experiences rather than direct ED encounters. The study was conducted in an urban area in the Northeastern United States, which may not reflect barriers in rural or other geographic settings. Autism diagnoses were not formally verified; they relied on caregiver report. All participants were verbally fluent, so the findings do not apply to autistic youth with limited or no verbal language.
Declared interests
The study was funded by the National Institute of Mental Health and the Organization for Autism Research. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume these recommendations have been tested for effectiveness or safety. This is a qualitative study of perspectives, not an intervention trial. Implementing these changes requires adaptation to local resources, and the ED clinicians in the study explicitly noted that many of these modifications are currently difficult to achieve within standard emergency department time constraints.