Mortality in 787,666 school pupils with and without autism: A cohort study.
Gillian S Smith, Michael Fleming, Deborah Kinnear and 4 others
PMID 32830516WHAT IT FOUND
School-aged pupils with autism in Scotland did not have a higher overall risk of death than their peers.
The mortality rate was similar between groups, though neurological conditions like epilepsy were the most common cause of death in the autism group.
Key findings
01The standardised mortality ratio for pupils with autism compared to those without was 1.1, indicating no significant difference in overall mortality risk.
02Among pupils with autism who died, the most common underlying and contributing causes of death were diseases of the nervous system, such as epilepsy.
03Pupils with autism were more likely to require physical, communication, or curriculum adaptations at school compared to their peers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study had low statistical power for mortality outcomes because only six deaths occurred in the autism group, resulting in wide confidence intervals. Pupils with intellectual disabilities but no autism were excluded from the main analysis, which may limit generalisability to the full spectrum of autistic individuals. Sex-specific mortality rates could not be derived due to the small number of deaths. Cause of death details were restricted by disclosure control, preventing a deeper analysis of specific conditions.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by the MRC Mental Health Data Pathfinder Award.
The easy way to misread this
Do not conclude that autism carries no mortality risk at any age. This study only looked at school-aged pupils up to age 25 and had very few deaths in the autism group, so it cannot rule out increased risk in adulthood or detect small differences in childhood mortality.