Investigating mental health crisis in youth with autism spectrum disorder.
One in three youth with autism will hit, bolt, or self-injure within three months — know the age pattern and prep now.
01Research in Context
What this study did
Mulder et al. (2020) asked 462 parents of youth with autism if their child had a mental-health crisis in the last three months.
A crisis meant running away, hurting themselves, or hurting others.
Parents filled out an online survey about what happened and how old their child was.
What they found
One out of every three kids had a crisis in only three months.
Little kids mostly ran off or hurt themselves.
Teens mostly hit, kicked, or broke things.
How this fits with other research
Mazzone et al. (2013) already showed that kids with autism feel as sad as kids with major depression.
The new numbers say the sadness can boil over fast.
Carter Leno et al. (2019) add that teens who struggle to read minds are the ones most likely to hurt themselves.
Boudreau et al. (2015) seems to disagree: they say youth with autism plus ID "thrive less." The gap is simple — Boudreau et al. (2015) looked only at kids who also have intellectual disability, while Mulder et al. (2020) counted every child with autism.
Bellon-Harn et al. (2020) carry the story into adulthood: the same four triggers — frustration, pain, change, and feeling cornered — still set off aggression.
Why it matters
If you work with kids or teens with autism, plan for a crisis before it happens. Ask parents which form it usually takes: running, self-hitting, or aggression. Add brief theory-of-mind drills for the self-hitting group, and teach older kids safe ways to ask for a break instead of lashing out.
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02At a glance
03Original abstract
Evidence suggests that youth with autism spectrum disorder (ASD) are at increased risk for experiencing a mental health crisis. Yet, limited systematic research exists on this topic. This study examines the prevalence, phenomenology, and correlates of mental health crisis in children, adolescents, and young adults with ASD. Participants included 462 parents of individuals with ASD (83% male, 86% Caucasian, M = 13.7 years, SD = 4.7) who were enrolled in the Interactive Autism Network, a large online registry of families of individuals with ASD. Parents completed the Mental Health Crisis Assessment Scale, a psychometrically sound measure of mental health crisis for youth with ASD, as well as measures of parental depression, family quality of life, and mental health treatment history. Overall, 32% of parents reported that their child had experienced a mental health crisis during the last 3 months. In the younger group, elopement (88%) and self-injury (81%) were the most frequent behaviors contributing to crisis; physical (60%) and verbal (42%) aggression were the most frequent crisis behaviors in the older group. Correlates of crisis included younger age, increased parental depressive symptoms, and lower family quality of life. Approximately 75% of individuals in crisis had seen a psychiatrist or behavioral therapist/psychologist within the last 3 months and 25% were not engaged in any mental health treatment. In summary, mental health crises were quite prevalent in this online sample of youth with ASD. Identification and treatment of these serious events is critical to reduce morbidity in this population. Autism Res 2020, 13: 112-121. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examines the prevalence and characteristics of mental health crisis in children, adolescents, and young adults with autism spectrum disorder. We found that 32% of individuals in our study had experienced a mental health crisis within the last 3 months. Younger age, increased parental depression, and lower quality of life were associated with crisis. These findings emphasize the importance of developing child and family-based interventions to prevent and treat the mental health crisis in this population.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2224