Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Ass
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S.I.: SUICIDALITY AND SELF-HARM IN AUTISM
Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Assessment Tools Stephanie J. Howe1,2 · Katie Hewitt1,2 · Jessica Baraskewich1,2 · Sarah Cassidy3 · Carly A. McMorris1,2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Individuals with autism are at heightened risk for experiencing suicidality compared to those without autism. Despite this, it is unknown what tools are used to assess suicide risk in research and clinical practice among children and youth with autism. This systematic review examined tools commonly used to measure suicidality in children and youth with and without autism spectrum disorder. Four databases were searched. We identified five tools (C-SSRS, PSS, SITBI, SIQ-JR, BSS) commonly used with youth in the general population; however, we did not identify any tools that were commonly used autistic children and youth. Results highlight the lack of available tools utilized to measure suicidality in autistic children and youth. We propose a framework to facilitate research to fill this gap. Keywords Autism spectrum disorder · ASD · Suicidality · Risk assessment tools · Children · Youth
Introduction Suicidality (suicidal thoughts and behaviours) is exceptionally common and often overlooked in individuals with autism spectrum disorder (ASD), affecting upwards of 66% of individuals (Cassidy et al. 2014, 2018a, b; Cassidy and Rodgers 2017). Importantly, individuals with ASD are more likely to die by suicide, with the risk of death by suicide * Carly A. McMorris [email protected] Stephanie J. Howe [email protected] Katie Hewitt [email protected] Jessica Baraskewich [email protected] Sarah Cassidy [email protected] 1
Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB T2N1N4, Canada
2
Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada
3
School of Psychology, University of Nottingham, Nottingham, UK
being seven times higher in individuals with ASD than the general population (Hirvikoski et al. 2016). Currently, no commonly used or validated suicide risk assessment measures exist for adults with ASD (Cassidy et al. 2018a, b), which can result in inappropriate and ineffective diagnosis (Au-Yeung et al. 2018). Untreated suicidal behaviour can lead to crisis (White et al. 2012), emergency room visits (Durbin et al. 2018), and inpatient hospitalizations along with significant and lifelong mental health difficulties (Leyfer et al. 2006), decreased quality of life for the youth and their family, and a heavy financial burden for individuals, government, and wider society. Not only are valid instruments necessary for clinical practice, they are essential for future research studies aiming to better understand and prevent suicide in autistic people. This includes identifying risk and protective factors, determining accurate prevalence rates,
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