Talking About Death or Suicide: Prevalence and Clinical Correlates in Youth with Autism Spectrum Disorder in the Psychiatric Inpatient Setting.
Lisa M Horowitz, Audrey Thurm, Cristan Farmer and 6 others
PMID 28624965WHAT IT FOUND
Among 107 inpatient youth with autism who could use sentences, parents reported 17 talked often and 7 very often about death or suicide.
Anxiety and mood disorders, not age or IQ, were associated with more frequent reports.
Key findings
01Of the 107 analysed, parent report was 'often' for 17, 'very often' for 7, 'sometimes' for 43, and 'never' for 40.
02Anxiety disorder (OR 2.32, 95% CI 1.10–4.93) and mood disorder (OR 2.71) were associated with the collapsed 'often' or 'very often' response.
03Sex, race, age, and non-verbal IQ were not related to the parent-reported frequency.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a single parent-report item, 'talks about death or suicide', not a validated suicide risk measure or direct youth assessment. The item includes death, so talk about death may reflect restricted interests, social pragmatics, or abstract understanding rather than suicidal ideation. The sample was inpatient psychiatric youth, mostly male and white, and admitted mainly for externalizing behaviour, so findings may not apply to community or outpatient ASD youth. Analyses excluded youth younger than 10, minimally verbal youth, and those with non-verbal IQ below 55, so they say little about those groups. The authors collapsed 'often' and 'very often' and noted this may under-report thoughts of death or suicide. Missing independent-variable data were handled by listwise deletion.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not treat the parent-reported item as a suicide screen. It asked whether the youth talked about death or suicide, not about suicidal ideation, and youth with autism may discuss death because of restricted interests or communication differences.