Parent-Reported Rates and Stability of Suicidal Ideation and Intent in School-Aged Children with Autism Spectrum Disorders
Objectives: This study (a) examined the frequency of parent-reported suicidality (ideation, intent) and self-harm behaviours in children with ASD across four time points (ages 7 to 11); and (b) endeavoured to document the age of emergence of suicidal ideation and behaviours to inform optimal service provision.
Methods: Data collected from 99 families across four time points from the Canadian Pathways in ASD study were included in the current analyses. Data were included if the CBCL was completed at all four time points. Participating parents completed the Child Behaviour Checklist 6-18 (CBCL) at four time points between ages 7.3 – 11.9 years. CBCL items included Item 18: Deliberately harms self or attempts suicide, and Item 91: Talks about killing self, were used to assess suicidality risk, with rating of 1 “somewhat /sometimes true” or 2 “very true/often true” considered endorsement. Descriptive statistics were compared across time points and a repeated-measures ANOVA was conducted to compare the mean frequency of parental item endorsement across time points.
Results: Repeated-measures ANOVA suggest no significant difference in endorsement of Items 18 or 91 over the four time points. Of the 99 participating parents, 15.2% reported self-harm at least once across the four time points, and 12% reported suicidal ideation. Regarding self-harm, 12% of parents reported this at one time point; 0% at two time points; 2% at three time points; and 1% at all four time points. Regarding suicidal ideation, 8.1% of parents reported this at one time point; 3% at two time points; 1% at three time points; and 0% at all four time points. Self-harm was endorsed most frequently at T1 and T4 (both n = 7), and ideation was endorsed most frequently at T3 (n = 6).
Conclusions: Parents of school-aged children with ASD reported relatively high rates of suicidal ideation and self-harm behaviour across all four time points in comparison to rates of parent-reported self-harm and suicidal ideation in neurotypical children (3% and 0.5%, respectively, compared to 15% and 12% in our sample) (Aitken et al., 2016). Scores did not change significantly across time points; however, suicidal ideation and self-harm were observed to persist in some children over time. Prior work has suggested similar rates of self-harm and suicidal ideation in adolescents with ASD (12% and 15.7%, respectively) (Culpin et al., 2017). This suggests that in children with ASD, suicidality (ideation and self-harm behaviour) may emerge during the early school years and may persist into adolescence. Further research is needed regarding supports and interventions to address emergent suicidality in children with ASD.