Autism Spectrum Disorder (ASD) is a neurodevelopmental condition affecting how a person communicates, interacts with others, and experiences the world. While ASD is not a physical disease that directly causes death, research consistently shows a significantly reduced life expectancy associated with the condition. This disparity in lifespan is a serious public health concern rooted in a combination of co-occurring medical issues, environmental risks, and mental health challenges faced by the autistic population.
Autism is Not a Terminal Illness
Autism Spectrum Disorder is a difference in brain development and function, not a progressive disease that directly causes organ failure or physical death. The diagnosis itself does not carry a terminal prognosis in the medical sense. However, autistic individuals face a higher risk of premature mortality compared to the general population, leading to the term “hidden mortality crisis.” Studies indicate that the average lifespan for autistic individuals is notably shorter, particularly for those with a co-occurring intellectual disability. This disparity in survival is primarily attributed to associated conditions and external hazards rather than the core features of autism.
Elevated Risk from Co-occurring Physical Health Conditions
A significant portion of the mortality risk for autistic people comes from higher rates of co-occurring physical health conditions. Neurological conditions like epilepsy and seizure disorders are particularly common, representing a major cause of death, especially for those who also have a learning disability. Complications from these disorders contribute directly to early mortality due to the higher frequency of seizures in the autistic population. Gastrointestinal (GI) issues, metabolic disorders, and cardiovascular concerns are also observed at increased rates.
Challenges in accessing and receiving appropriate healthcare amplify these risks. Difficulties in communication or sensory sensitivities can make routine medical visits stressful, leading to skipped appointments and delays in diagnosis. This issue, sometimes called “diagnostic overshadowing,” means that serious physical symptoms may be mistakenly attributed to an individual’s autism or behavioral issues. This delay can prevent timely treatment for life-threatening conditions.
External Hazards and Unintentional Injury
Unintentional injury is a major factor contributing to the shorter lifespan of autistic individuals, with deaths from injury nearly three times more likely than in the general population. This heightened risk is linked to certain autism-related behaviors and sensory differences. Children with autism are significantly more likely to die from drowning than the general pediatric population. This extreme drowning risk is often a consequence of elopement or “wandering,” which is reported in nearly half of autistic children.
Individuals with ASD may be drawn to water sources because of sensory interest or may lack a clear sense of danger, leading them away from safety. Accidental drowning accounts for a large percentage of deaths resulting from wandering incidents. Other injury-related causes of death are also disproportionately high, including suffocation and asphyxiation. Pica, which involves the ingestion of non-food items, can create choking hazards or lead to accidental poisoning.
Mental Health Crisis and Self-Harm
For autistic individuals without a co-occurring intellectual disability, the leading cause of premature mortality is often suicide. The risk of death by suicide is substantially elevated, with autistic adults two to seven times more likely to die by suicide than their non-autistic peers. This crisis stems from high rates of co-occurring mental health conditions like anxiety and depression. Many autistic people engage in “masking,” consciously suppressing their natural traits to fit into a neurotypical world. This constant effort leads to severe burnout and a negative impact on mental well-being, which is directly associated with increased suicidal ideation.
Social isolation, bullying, and a lack of appropriate support also contribute to this overwhelming mental health burden. Challenges in accessing mental health services that are not tailored to autistic needs can deepen feelings of despair and lack of belonging. Anyone experiencing a mental health crisis or thoughts of self-harm should seek immediate support by contacting resources like the 988 Suicide & Crisis Lifeline in the United States.