Autistic kids are at higher risk of suicide. Why don't their parents and doctors know? Many youngsters mask, which can exact a powerful psychological toll on autistic kids, and is strongly correlated with depression, anxiety and suicide. Medics are seeking ways to help. Los Angeles (tca/dpa) – When Anthony Tricarico was diagnosed at 7 with autism spectrum disorder, his parents, Neal and Samara , were told that he might need extra support at school, so they made sure he got it. When doctors suggested therapies for his speech and motor skills, they sought those out too. But when their kind, popular, accomplished boy began to experience depression and suicidal ideation as a teenager, no one told them that the same thinking patterns that powered many of Anthony's achievements might also be amplifying his most harmful thoughts, or that the effort of masking his autism could be hurting his mental health. None of the people or organizations they contacted for help said Anthony might benefit from therapies or safety plans adapted for autistic people, or even that such things existed. They did not say that he might not show the same warning signs as a non-autistic teenager. And only after he died from suicide in May 2024 did the San Diego County couple discover that autistic kids — particularly those like Anthony, whose disability is not immediately apparent from the outside — aremore likely to think about and die from suicide , andat earlier ages , than their neurotypical peers. "Our son has always been different. So why wouldn't how we approach suicide be different?" Neal said. Suicide is aleading cause of death in the US for kids aged 10 to 18. Prevention strategies that take neurodiversity into account could go a long way toward reducing the number of young lives lost too soon. Autism researchers and advocates are working to develop better screening tools and interventions based on the unique strengths and differences of an autistic brain. A crucial first step is educating the people best positioned to help kids when they're in crisis, like parents, counselors, pediatricians and social workers. "These are kids that are experiencing all sorts of heightened risk," said Danielle Roubinov , an associate professor and director of the Child and Adolescent Anxiety and Mood Disorders Program at University of North Carolina at Chapel Hill . "We're aware of the need for tailored approaches. We're doing this research. We're trying to get the word out. And [suicidality] is something that is treatable. This is something that responds to intervention." The percentage of US children with an autism diagnosishas risen steadily in recent decades, from 1 in 150 8-year-olds in 2000 to 1 in 31 in 2022. The diagnostic definition haschanged dramatically in that time, inscribing children with a broad range of abilities, needs and behaviors within a single term: autism spectrum disorder. Today, the diagnosis includes children whose autism was previously overlooked because of their propensity for "masking," the act of consciously or unconsciously suppressing autistic traits in order to blend in. For autistic children without intellectual disabilities, like Anthony Tricarico , masking often enables them to participate in mainstream classes or activities. It's also why many children, especially girls, aren't diagnosed with autism until later in childhood. Masking can exact a powerful psychological toll on autistic kids, and is strongly correlatedwith depression, anxiety and suicide. Children across the autism spectrum are far more likely tostruggle with mental health conditions than their allistic, or non-autistic, peers. A2021 study of more than 42,000 caregivers of children ages 3 to 17 found that 78% of autistic children had at least one co-occurring psychiatric condition, compared with 14% of non-autistic kids. Contributing factors include the stress of living in a world that's sensorially overwhelming or socially impenetrable. Lights, noises, smells and crowds that others barely notice may cause incapacitating anxiety. For kids who cope by masking, constantly deciphering and mimicking social responses is often cognitively and emotionally exhausting. "Masking is actually a risk factor of suicide for autistic people," said Lisa Morgan , founder of theAutism and Suicide Prevention Workgroup , who is autistic herself. Autistic people at all agesare more likely to die by suicide than those who aren't autistic. That disparity begins early. One2024 meta-analysis found that some 10% of autistic children and teens had attempted suicide, a rate more than twice that of non-autistic peers. Their struggles are often invisible. Neal and Samara had never heard of masking. They saw how Anthony thrived on schedules and sameness. He rose precisely at 5 am for a long workout, chugged the same protein shake afterward, took a shower at 7 am on the dot. At the time they thought he was extremely disciplined; they believe now it was also Anthony's way of fulfilling his need for routine and predictability, a common autistic trait. They also saw that he preferred to keep his diagnosis a secret. In middle school, Anthony announced that he no longer wanted any accommodations for his autism: no more individualized education program, no more behavioral therapy, no more telling new friends or teachers about his diagnosis. "It's my belief he just wanted all that to go away, and to just be like everyone else," Neal said. The pandemic hit Anthony hard. He couldn't work out at his favorite spots or fish, a beloved pastime. Other kids might have defied the closures and gone anyway, but Anthony followed rules with inflexible intensity, Neal said, especially the ones he set for himself. His mental health started to decline. In 2022, during his freshman year, Neal and Samara learned that Anthony told a friend he was having thoughts of suicide. They called the California suicide hotline , where a volunteer told them to contact his school. A counselor determined that since Anthony didn't have a plan, he wasn't at immediate risk. When Neal and Samara asked him about it, he sounded almost dismissive. It was fleeting, he said. It wasn't real. It's impossible to know Anthony's true thoughts. What is known is that suicidal ideationcan look very different in autistic kids. About a decade ago, psychiatrist Dr. Mayank Gupta started noticing an uptick in a particular type of patient at the western Pennsylvania inpatient facilities in which he worked: bright children from stable home environments who began having serious suicidal thoughts in early adolescence. They showed few of the typical youth-suicide risk factors, like substance use or histories of neglect. A surprising number had autism diagnoses. At the time, Gupta associated autism with behaviors like minimal verbal communication and noticeable differences in body language or eye contact. Nothing in his training or continuing education discussed the breadth of the autism spectrum, or how it might relate to children's mental health. He searched the literature, and was stunned to findhow much published work there was on autism and suicide. "In the last seven to eight years, there's been more and more evidence, and more and more research," he said. But not enough of it has made its way to the local psychologists, psychiatrists and pediatricians that parents are most likely to turn to for help with a struggling child. Adults often assume that a child who can speak fluently on a variety of subjects can explain their thoughts and feelings with a similar level of insight. But up to 80% of autistic kidshave alexithymia , or difficulty identifying and describing one's own internal emotional state. For this reason, "it makes sense that all of the interventions that have been designed for a neurotypical youth probably aren't going to translate in the same way to autistic youth," said Jessica Schwartzman , an assistant professor of pediatrics at USC's Keck School of Medicine a…
(The article has been published through a syndicated feed. Except for the headline, the content has been published verbatim. Liability lies with original publisher.)
