The answer to the question “Can Autism Kill You?” is complex but direct: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition, not a terminal illness. Individuals with ASD do not die from autism. However, people on the autism spectrum experience a significantly reduced average lifespan compared to the general population. This mortality gap is caused by the high prevalence of co-occurring medical conditions, mental health crises, and elevated environmental vulnerabilities that frequently accompany the diagnosis. Understanding these secondary risks is necessary to grasp the actual threat to longevity within the autistic community.
Statistical Reality of Reduced Life Expectancy
The reduced life expectancy for individuals with ASD is a documented public health reality, with mortality rates consistently higher than in the neurotypical population. While the exact number of years lost varies, some older studies suggested a lifespan reduction of up to 16 years on average. Newer, more detailed research provides a clearer picture by separating the population based on intellectual ability. Autistic adults without a co-occurring intellectual disability still face a reduced lifespan, often by several years. The life expectancy gap becomes significantly wider for autistic individuals who also have an intellectual disability. For this group, the reduction in average lifespan can be decades, with some studies reporting the average age of death in certain subgroups to be as low as 39 years.
Co-occurring Physical Health Conditions
A major factor contributing to the mortality gap is the high rate of co-occurring physical health conditions that are often poorly managed. Epilepsy and seizure disorders are highly prevalent in the autistic population, and the risk of sudden unexpected death in epilepsy (SUDEP) is greatly increased. Cardiac abnormalities and metabolic disorders are also found at higher rates, creating an elevated risk for sudden illness. Gastrointestinal (GI) issues, such as severe constipation, chronic diarrhea, and abdominal pain, occur significantly more often in autistic individuals. These conditions pose a threat because the symptoms are frequently atypical, leading to missed or delayed diagnosis. Severe abdominal pain may not be communicated verbally but may instead manifest as behavioral changes like increased aggression or self-injury. If medical providers mistake these physical symptoms for purely behavioral issues associated with ASD, the underlying medical problem remains untreated.
Elevated Vulnerability to External and Accidental Harm
The interaction between core ASD traits and the environment creates a heightened vulnerability to accidental death. Injuries and poisoning are leading causes of mortality in the autistic population, particularly during childhood and early adulthood. Wandering, or elopement, is a common behavior in children and adolescents with ASD, often driven by a desire to reach a special interest or escape sensory overload. Elopement frequently leads to drowning, which is the single highest cause of accidental death in children with ASD. Children on the spectrum are estimated to be 160 times more likely to die from drowning than the general pediatric population. Other significant external risks include accidental suffocation and asphyxiation, which can be linked to seizure events. Traffic accidents are also a concern, as difficulties with hazard perception can compromise safety near roadways.
Mental Health Crises and Mortality Risk
Mental health crises, particularly depression and anxiety, are common in individuals with ASD and present a substantial risk factor for premature death. The risk of death by suicide is significantly elevated, especially among autistic adults who do not have a co-occurring intellectual disability. This increased risk is often linked to the pervasive challenges of navigating a neurotypical world. A major contributing factor is “masking,” or camouflaging, which is the effort to hide autistic traits to fit in socially. This constant effort to appear neurotypical is psychologically draining, leading to exhaustion, emotional burnout, and a profound sense of isolation. The sustained mental distress from masking and social marginalization can directly fuel the development of severe depression and suicidal ideation. Lack of mental health support, social isolation, and late diagnosis further compound this distress.
Strategies for Improving Longevity and Safety
Closing the mortality gap requires a multi-pronged approach focused on proactive healthcare and safety planning. Implementing a comprehensive and coordinated healthcare model is paramount for managing physical comorbidities. This “medical home” approach ensures that primary care physicians, specialists, and mental health professionals communicate effectively to prevent conditions from being missed or misdiagnosed. Regular, specialized screening for mental health conditions is necessary, particularly for autistic adults who may be masking distress. Clinicians must recognize that self-injury or extreme behaviors can be non-verbal expressions of severe physical pain or psychological distress. Proactive safety measures, such as water safety training and swimming lessons, are recommended as life-saving interventions for children who elope. Utilizing tracking devices and creating formal safety plans for elopement provides an additional layer of protection.