Newswise — Autistic youth are two to three times more likely to experience suicidal thoughts and behaviors than their non-autistic peers. Yet most standard suicide prevention interventions were not designed to meet their unique needs.
Now, Children’s Hospital Los Angeles has launched a new clinical trial to test a suicide prevention intervention developed specifically for autistic youth and their families.
Supported by federal funding from the Health Resources and Services Administration with investigators at Children’s Hospital of Philadelphia, the trial addresses a common challenge clinicians face when working with autistic youth experiencing suicidal thoughts.
“We’ve developed an intervention that’s tailored to how autistic youth communicate and experience emotion,” says Jessica M. Schwartzman, PhD, a clinical psychologist at CHLA and lead investigator on the trial. “The goal is to make suicide safety planning more effective in real-world clinical settings for autistic youth.”
An intervention adapted to autistic youth
The new trial is testing the efficacy of two different interventions providers will use: a standard safety planning intervention currently given to most youth in the U.S. dealing with suicidality; and the new intervention for autistic youth, which Dr. Schwartzman developed and will test in collaboration with Douglas Vanderbilt, MD, MS, MBA, and autistic researchers.
The standard intervention includes steps that youth can take when they are experiencing a mental health crisis, such as recognizing warning signs, going somewhere to distract themselves, or calling a 24-hour crisis hotline. For the new intervention, Dr. Schwartzman and her colleagues have designed various adaptations for neurodiverse youth.
The standard intervention assesses warning signs of suicide risk in youth and identifies options to keep youth safe, including the development of coping skills, turning to trusted people for support, and more. But this approach does not account for the unique ways in which autistic youth communicate with others or display emotion. The adapted intervention accounts for the communication, social, emotional, and cognitive differences in autistic youth when identifying warning signs of suicide risk in autistic youth and provides alternate or adjusted options to keep youth safe.
“For example, the first step of the standard intervention involves naming the reasons why you are in crisis, but we know that up to 80% of autistic youth have a much harder time than non-autistic youth identifying and communicating what they feel,” Dr. Schwartzman says. “So we have adjusted this new intervention to start at a different point for autistic youth by first focusing on ways to identify what they are feeling before determining how to communicate that feeling to others.”
The efficacy of the interventions will be evaluated based on provider feedback regarding how feasible each approach is in practice and whether it increases the provider’s confidence in handling safety when an autistic youth is at risk.
Long-term research goals
If the study finds that the new intervention is more effective for autistic young people, Dr. Schwartzman plans for CHLA to be the first institution to host a new training opportunity for U.S. providers.
“The ultimate goal is to develop a virtual training program for providers across the U.S. that teaches them not only about autistic youth and the differences in their communication and emotional experiences, but also how to screen these youth for suicide and respond more effectively when they are at risk,” she says.
The training program would also be refined and co-facilitated by a community advisory board made up of autistic youth, their parents, and autistic adults.
Implementing a new suicide prevention intervention would require time and adjustment, Dr. Schwartzman acknowledges. But she views the work as an important step toward supporting safer, more effective responses to suicide risk among autistic youth.
“By adapting suicide safety planning to the needs of autistic youth,” she says, “we have an opportunity to improve how clinicians respond and support these young people when it matters most.”
Learn more about CHLA’s Behavioral Health Institute.