People with autism face many challenges in their lives, but chief among those challenges is that simply having autism spectrum disorder (ASD) is a risk factor for a lower average lifespan. Autism itself is not a cause of a shortened lifespan, but conditions related to the disorder can affect mortality.

Autism & Lifespan

A March 2016 study published in the British Journal of Psychiatry documented that adults with an autism spectrum disorder who have a learning disability are 40 times more likely to have a lower average lifespan (that is, to die early) due to a neurological condition than adults in the general population who are not on the spectrum and have no learning disabilities.

Furthermore, the study found out that adults with autism who do not have a learning disability were up to nine times more likely to die by suicide than adults at similar ages who did not have autism.

People with autism spectrum disorder tended to die at age 54, which is 16 years sooner than the average age of mortality. Adults who have both autism and one or more learning disabilities died almost 30 years sooner than people who had neither, at an average age of 39.5 years old. Those with autism, but no learning disability, died at an average age of 58.

Autism & Suicidal Ideation

Past research has shown that the rates of suicidal ideation among people with ASD is much higher than in the general population.

The rates tend to be higher among girls with autism and people with milder forms of disorder. In the latter case, it is usually because people who are higher-functioning have a greater awareness of the limitations and frustrations of their autism than those with severe cognitive deficiencies.

Additionally, the Journal of Autism and Developmental Disorders writes that many people on the spectrum (children and adolescents primarily, but also adults) are victimized by bullying, sometimes on a daily basis. This often leads to the development of anxiety conditions and depressive disorders.

Those conditions, on their own, are leading factors in suicidal ideation and behavior. When combined with the challenges of living with autism, it significantly increases the risk factors for people with autism spectrum disorder.

Increased Stress for People With Autism

Other research has suggested that the general population tends to have better overall health than people with autism.

There are connections between autism spectrum disorder and other medical conditions, like gastrointestinal disorders and heart disease. One of the connections may be stress, resulting from discrimination and bullying because of the autism, distress from sensory overload, and alienation due to the socio-emotional and communication limitations caused by the autism.

Many people who have autism experience being in a chronic state of “fight or flight” when it comes to situations that would be considered “normal” for neurotypical individuals. Everything from having a job interview to attending a social engagement can be mentally debilitating, causing a number of physical and medical problems. Some adults struggle with stress and anxiety for the rest of their lives, even as they deal with the realities of living with autism.

Violence From Caregivers

The stress of looking after someone with autism can manifest in the caregivers, leading to shocking and tragic outcomes. Cases of filicide (the act of a parent killing their own child) in families with autistic children were examined by the International Journal of Offender Therapy and Comparative Criminology as long ago as 2003. More recently, the Journal of Child Neurology looked at “filicide-suicide involving children with disabilities.”

High-profile instances of a parent killing their autistic child have made news, such as a murder-suicide case in 2012 of a woman telling her neighbor that she “felt overwhelmed by caring for her adult autistic son.” This has led to debates within various autistic communities about how the early deaths of autistic people, at the hands of their caregivers, muddies the waters on the already complicated nature of providing adequate health care for people on the spectrum. When autistic children or youths are killed by their caregivers, media coverage tends to spotlight the “burden” of caring for the patients, leading to more sympathy being shown to the perpetrator.

Psychology Today notes that people with autism spectrum disorder are 40 times more likely to die as the result of various injuries, including but not limited to drowning, asphyxiation, and suffocation. Children with autism between 5 and 7 years of age are at the greatest risk of dying by drowning. Given that wandering off or running away is a common occurrence with this demographic, a family with access to a body of water (anything from a swimming pool to a pond, lake, or river) will have to invest in swimming lessons and water safety precautions.

Substantially Heightened Risks for Individuals With Autism

In 2018, Sarah Kurchak penned an essay for Vox where she discussed facing mortality at age 36, “the average age when people like me die.” People with autism face challenges that neurotypical adults may never be aware of, she writes. While many might assume that those challenges end with socio-emotional language limitations, the fact that autistic people have a higher mortality rate adds to the burden.

For example, the American Journal of Public Health wrote that people with autism “appear to be at substantially heightened risk for death from injury” due to getting lost, not being able to ask for help, not being able to give their name or emergency contact information, or becoming so overstimulated that they panic and put themselves in harm’s way.

The lower-than-average lifespan for autistic people also has racial and gender overtones. Autism is a “deadly hazard when dealing with the police,” writes Forbes magazine, because of a number of cases where police officers have taken noncompliant and noncommunicative behaviors from autistic people to be signs of suspicion and, in the case of overstimulation, hostility.

In describing the story of a 15-year-old boy with Asperger’s syndrome who was killed by police, the Chicago Reader notes that “people with autism spectrum disorder are seven times more likely to encounter police” than people who have no such conditions. When the patients in question are Black, Latinx or otherwise non-white, those encounters are more likely to result in death.

Autism & ‘Medical Complexities’

Scott Wright, a researcher at the University at Utah and editor of a book about autism spectrum disorder in middle age and later life, said that the “medical complexities” of patients with autism, coupled with their limitations in language and communication, can lead to physicians, hospitals, and the health care system at large not being capable of providing the best level of care. It might be possible that patients with severe forms of autism spectrum disorder don’t even seek help for their ailments because they are overwhelmed by the awkwardness of talking with other people about themselves.

Wright suggests that a parent or a caregiver should find a specialist or a primary care physician who has training in working with autistic patients or otherwise demonstrates the necessary awareness and empathy for what the experience must be like for an autistic person. Beyond that, Wright recommended that there be more training for health care professionals so that autism can be recognized and appropriately responded to in a clinical setting.

Additionally, too many people continue to associate autism with pediatrics when in reality many people with an autism spectrum disorder receive the proper diagnosis in adulthood. Wright concluded that autism is an issue for every level of health care. It’s problematic at the pediatric level, but also at the levels of internal medicine, primary care, clinical practice, and geriatric care. It’s ultimately “a life course issue that we should all be aware of.”

For most people with autism spectrum disorder, continues Sarah Kurchak in Vox, the stress and exhaustion of living with autism are the more insidious contributors to shorter lifespans. Autistic people have to develop many different coping strategies to have a healthy life, build self-esteem, defy stereotypes, or simply make it through the day. Autism has been connected to sleep disorders, which can cause insomnia, chronic fatigue, and a number of other physical and psychological problems, particularly when combined with the anxiety that many people on the spectrum have.

Increasing Health Factors for People With Autism

One way that this problem can be addressed is by educating parents, caregivers, and health care professionals to recognize the signs of depression in autistic individuals as early as possible while continuing to improve their social relationships and skills.

Treating social anxiety disorder (which has “partially overlapping symptoms,” according to the Journal of Autism and Developmental Disorders) can also help people manage the limitations they experience with social development and help them control their compulsion to avoid social situations, like scheduling a doctor’s appointment. This can further teach people with autism how they can cope with the feelings of isolation and frustration that naturally arise from having autism spectrum disorder. If suicidal ideation arises, they have a system in place to process those thoughts in a healthy manner and to get support.

Bullying also has to be addressed. Physical and verbal attacks prevent autistic children and adolescents from developing socially, and they can lead to depression and suicidal ideation on their own.

Parents concerned about this can seek out school programs that offer integrated classrooms, where students with special needs are part of the general education classrooms. This naturally helps children with autism who have difficulty fitting in. It also gives non-autistic children a chance to know children with autism, so they are less likely to see those children as targets.

For adults with autism, the Centers for Disease Control and Prevention recommends following the same health care principles that are recommended for neurotypical people. These include getting regular sleep, participating in regular exercise, eating a balanced diet, drinking lots of water, and maintaining regular physical and dental checkups.

Specialized Care

As said earlier, it is important (or even necessary) to work with providers who know how to work with autistic individuals. From the array of health concerns that can present with autism to simple symptoms like not making eye contact, it can be helpful to have a professional who understands how to interact with a person with autism. In the words of Sarah Kurchak, “we’re not really comfortable with eye contact and are tired of being forced to make it.”

Health care professionals with knowledge of autism and experience with autistic individuals will be able to have more honest and open conversations with autistic patients. If the patient feels comfortable, they are more likely to open up with the medical professional, helping issues to get effectively identified and addressed.

Addressing Factors That Influence Lifespan

While people with autism tend to have shorter lifespans on average than neurotypical individuals, this doesn’t mean that you will. Talk to your doctors and other treatment providers about how to assess your lifestyle and make any changes that can boost your overall health and decrease the likelihood of an earlier death.

Remember that autism itself does not cause a shortened lifespan. You can take steps to minimize your risk.

References

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Premature Mortality in Autism Spectrum Disorder. (January 2018). The British Journal of Psychiatry.

The Link Between Suicide and Autism. (February 2019). Psychology Today.

Autism Spectrum Disorder And School Bullying: Who Is the Victim? Who Is the Perpetrator? (January 2019). Journal of Autism and Developmental Disorders.

Gastrointestinal Issues in Autism Spectrum Disorder. (March/April 2014). Harvard Review of Psychiatry.

Preventing Filicide in Families With Autistic Children. (February 2003). International Journal of Offender Therapy and Comparative Criminology.

Filicide-Suicide Involving Children With Disabilities. (July 2012). Journal of Child Neurology.

Sunnyvale Mom Kills Autistic Son, Self, Police Say. (March 2012). SFGate.

If a Parent Murders an Autistic Child, Who Is to Blame? (September 2013). Forbes.

Autism, Health Care and Life Expectancy — What a New Study Reveals. (April 2016). University of Utah Health.

Early Death in Those With Autism Spectrum Disorder. (October 2018). Psychology Today.

Reported Wandering Behavior Among Children With Autism Spectrum Disorder And/or Intellectual Disability. (July 2017). Journal of Pediatrics.

Why Police Need Training to Interact With People on the Spectrum. (June 2018). Spectrum.

When the Police Stop a Teenager With Special Needs. (February 2020). The New York Times.

I’m Autistic. I Just Turned 36 — The Average Age When People Like Me Die. (February 2018). Vox.

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Mortality in Individuals With Autism, With and Without Epilepsy. (April 2011). Journal of Child Neurology.

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Injury Mortality in Individuals With Autism. (May 2017). American Journal of Public Health.

No Justice, No Speech: Autism a Deadly Hazard When Dealing With Police. (June 2020). Forbes.

Black, Autistic, and Killed by Police. (December 2015). Chicago Reader.

Autism and Sleep Disorders. (October-December 2015). Journal of Pediatric Neurosciences.

Autistic Traits and Symptoms of Social Anxiety Are Differentially Related to Attention to Others’ Eyes in Social Anxiety Disorder. (2017). Journal of Autism and Developmental Disorders.

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What Is Autism? National Autism Association.