Suicide is a leading cause of death among children and young people in the United States. While much research has focused on understanding suicide risk in the general population, children with neurodevelopmental disabilities (NDDs), such as Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Intellectual Disability, have been largely overlooked. These children are often excluded from studies or grouped together as if they all face the same risks, despite the fact that many have multiple disabilities and unique challenges. This lack of research limits our ability to effectively identify which children with NDDs are at the greatest risk for suicidal thoughts and behaviors (STBs). Individuals with disabilities are recognized by the NIH as experiencing significant health disparities, and advancing our understanding of suicide risk in this population has been identified as a priority area for AFSP research funding for 2024-2026. Our project aims to fill this gap by studying how different factors, such as specific co-occurring diagnostic profiles and difficulties with thinking, behavior, and emotional regulation, affect risk for suicidal thoughts and behaviors among children with NDDs. We also seek to understand how other aspects, like family background, neighborhood environment, and access to resources, contribute to that risk. By studying the unique contributions of a child’s development and their environment, we hope to create a more complete picture of what specific characteristics and factors put children with NDDs at risk for STBs. The central aim of this study is to identify the children with NDDs at the greatest risk of STBs, focusing on those who fall within the overlapping center of diagnostic, dimensional, and environmental factors.
We will use a large, diverse dataset of over 3,000 children who have been evaluated and received universal suicide screening within the Center for Neuropsychological and Psychological Assessment at Kennedy Krieger Institute, a large, urban institution that specializes in serving pediatric populations with NDDs. This center is an ideal setting to examine these questions because children seen within the center have undergone evaluation and testing by psychologists. As a result, we have detailed information about their neurodevelopmental diagnoses, cognitive and emotional functioning, and family circumstances. These data provide a rare opportunity to explore suicide risk among children with NDDs, including those from historically underserved communities. A key innovation of this study is our focus on understanding not just whether a child has a specific diagnosis, but how different transdiagnostic challenges, such as difficulty with learning, impulsivity, or emotion regulation, may combine to heighten their risk of STBs. Our findings will help medical and mental health providers better identify children within the NDD population who are at the greatest risk, enabling closer monitoring and potentially earlier, more targeted interventions for suicide prevention.
