'Overwhelming stress' cited by parents who kill autistic children, highlighting need for support

June 2, 2021
The stress of caring for an autisic child is one of the many factors to contributing to higher rates of abuse among autustic children. Here, an autistic boy is helped by a preschool teacher. (AP Photo/LM Otero)

The stress of caring for an autisic child is one of the many factors to contributing to higher rates of abuse among autustic children. Here, an autistic boy is helped by a preschool teacher. (AP Photo/LM Otero)

Children with autism spectrum disorder, a developmental disability that involves deficits in social communication and interaction, are more likely to be killed by their parents than by any other group of adults, and most often in response to the stress of having to care for the child, according to a recent analysis of 706 news media articles on homicide incidents involving autistic child victims in the United States.

In a paper published May 13 in the Journal of Autism and Developmental Disorders, a team of researchers examined reports from the last 20 years involving a child with autism spectrum disorder being killed. They found that news articles about these incidents are growing in number, and that violence against children with autism most often comes from immediate family members and other caregivers, Guohua Li, senior author of the paper and Finster Professor of Epidemiology and Anesthesiology at Columbia University, told The Academic Times.

Parents and caregivers of children with autism spectrum disorder have reported feeling misunderstood by health care providers and family members in their struggles to raise a child with a disability. While social support can help these caregivers manage challenges and stressors, violence against children with autism remains unfortunately common. Li noted that such violence is under-studied. 

"Children with autism are known to be much more prone than the general pediatric population to certain types of injury, such as drowning and self-harm, according to studies published in recent years by our team and others," he explained. "Recent reports also indicate that children with autism are at an increased risk of maltreatment and abuse."

The authors noted in their paper that in previous studies, the parents of children with autism frequently experienced stress because of the child's behavioral and developmental challenges, their uncertainty regarding the causes of autism spectrum disorder, significant financial burdens due to the disease and access to treatment services, among other factors. And population survey data suggest that the parents of people with autism spectrum disorder frequently have psychiatric issues that include schizophrenia and personality disorders.

In the paper, Li and his colleagues noted that children with autism are 2-10 times more vulnerable to premature death than the general population. They added that while prior studies have also found that they are at an increased risk of self-injury and suicidal behavior, the risk of homicide among children with autism spectrum disorder has remained unclear.

"We decided to expand autism research by exploring the risk of homicide, which has not been studied before, so that we could better protect this vulnerable population," Li said. 

The research team originally began its search for data in injury surveillance systems such as the National Violent Death Reporting System and the National Vital Statistics System, but none collected substantial or reliable data for the study topic, Li said. So the researchers turned to the Nexis Uni database, which contains articles from more than 15,000 news, business and legal sources.

The search gathered 706 relevant news media articles on 52 homicide incidents involving autistic victims younger than 21 years old, published between 2000-2019 in the U.S. Information on the homicides came from the articles, as well as supplemental Google News and social media searches. 

Male children made up 90.4% of the victims, and 63.5% of the suspects, or alleged perpetrators, were identified as a parent of the child. Siblings, legal guardians, caregivers, police officers, pastors and physicians were also identified as perpetrators. Across the total sample, 23.1% of the victims died from gunshot wounds, 19.2% from drowning and 19.2% from suffocation, strangulation or asphyxiation.

Factors contributing to the homicide were mentioned in 34 of the 52 incidents. In 47.1% of those 34, "overwhelming" stress associated with caring for an autistic child was cited. And 26.5% of the 34 cited a reaction to the child's behavior as reason for the homicide. Four of the suspects were reported to have been diagnosed with a mental illness.

"Our results indicate that news media reports of homicide incidents involving children with autism spectrum disorder in the United States have increased in recent years. This could be due to the increased prevalence and awareness of ASD since early 2000," the authors said in the paper, noting that 63.5% of the reported homicides they studied occurred between 2010-19.

Li explained that while the number of male victims versus female victims was high, this was possibly due to the fact that boys are nearly four times as likely as girls to be diagnosed with autism spectrum disorder. There are also notable differences in autistic symptoms and behaviors between the two, Li said, such as in social communication and interaction, or restricted and repetitive behaviors.

"These findings underscore the urgent need to expand services for children with ASD to include mental health and financial support for family members and caregivers to promote and sustain family strength and resilience," Li said.

The authors highlighted the need for more social support efforts, such as offering respite care, which is care intended to provide short-term relief for primary caregivers, and training parents to be more mindful. They also urged that intervention programs should include mental health services for parents and caregivers of children with autism spectrum disorder. "Access to affordable, targeted intervention programs for children with ASD as well as financial assistance may help decrease parents' stress and support parental resilience," they said. 

"Our understanding of the injury risk facing the autism population is very limited. There are many unanswered questions in this subject area," Li said "The first step toward closing the knowledge gap is to establish an injury surveillance system for people with autism."  

A dedicated injury surveillance system for people with autism would help researchers, clinicians and the general public to better understand the epidemiology of violence against children with autism, the authors said. They noted that existing data sources, such as the National Violent Death Reporting System, could also be fine-tuned to yield better data as to the risks faced by children with autism and other developmental disorders.

"Our findings could help inform public policy for autism care and supporting services, enhance autism training for caregivers, clinicians, teachers and law enforcement personnel, and increase public awareness and acceptance of autism," Li said.

The study, "Homicide incidents involving children with Autism Spectrum Disorder as victims reported in the US news media, 2000–2019," published May 13 in the Journal of Autism and Developmental Disorders, was authored by Joseph Guan, Rush Medical College; Ashley Blanchard, Stanford Chihuri and Guohua Li, Columbia University; and Carolyn G. DiGuiseppi, Colorado School of Public Health.

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