Institute of Epidemiology & Health Care


Children with autism at increased risk of depression and self-harming

14 August 2020

New research from ICLS' Mariko Hosozawa, Noriko Cable and Amanda Sacker shows that children with autism spectrum disorder are at increased risk of depression and self-harming behaviours.

autism spectrum disorder

Children with Autism Spectrum Disorder (ASD) are at increased risk of depression and self-harming according to research just published in the Journal Autism.

The study, Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder looked at the links between adolescents suffering from depression or who were self-harming and parents' reports of the timing of diagnosis for ASD. It made use of data from more than 11,000 participants in the Millennium Cohort Study, 396 of whom had been diagnosed with autism by the age of 14. 

Those children diagnosed between the ages of 7 and 11 were twice as likely as children in the wider population to show symptoms of depression. Where diagnosis took place after the age of 11, this rose to more than three times as likely. The findings for self-harming were similar, with children diagnosed after the age of 11 being most likely (three times) to hurt themselves deliberately.

Explaining the findings and their implications, lead researcher, Mariko Hosozawa said:

"Simply put, the later the diagnosis of ASD, the greater the risk of depression and self-harming behaviour. Our findings suggest that interventions targeting the earlier diagnosis of ASD are essential, particularly among those without cognitive delays and those diagnosed late."

Previous work from the team showed that  many children (79 per cent) in the UK are not diagnosed until school entry and 28 per cent until secondary school. Among those not diagnosed until secondary school, 75 per cent had already been identified at age five by a parent and/or teacher as having socio-behavioural difficulties. Children with a typical-range of cognitive ability were twice as likely, compared to those with cognitive delays, to be diagnosed later whilst at secondary school. 

The researchers say the findings represent a warning for healthcare and educational practitioners that high numbers of children, particularly those without cognitive delays and from poorer families, are likely to remain undiagnosed and therefore miss the opportunity for timely intervention and support for ASD before reaching adolescence. 

Co-researcher Noriko Cable added: 

"Not receiving ASD diagnosis in early years is clearly detrimental to this group of children’s mental well-being. Strategies that promote earlier identification among school-aged children are needed and targeting children at primary school entry age would benefit those who would otherwise be diagnosed later.  Further encouragement and support for parents who have young children with difficulties is also essential."