New research suggests that more than a third of children with autism ages 8 and under have had suicidal thoughts and not all of these kids are necessarily displaying warning signs.

In a survey of 968 caregivers of kids with autism ages 8 to 17 across the nation, more than 40% reported that their child wanted to die.

The findings were even more striking when researchers looked specifically at children ages 8 and younger. Among this group, 36.2% reported wanting to die, 35.3% reported wanting to end their own life and 18.1% reported having a suicide planned.

“The results are concerning,” said Dr. Benjamin Schindel, a fellow in neurodevelopmental disabilities at the Kennedy Krieger Institute who led the research published this month in the journal JAMA Pediatrics. “We were very surprised to find that the expression of suicidal ideation began so young in these children with ASD. This rate seems to be significantly higher compared to their neurotypical peers.”

For the research, caregivers of kids with autism were asked to complete a questionnaire about mental health and suicidal behaviors between May and October 2017. All of the caregivers who responded were participants in the Interactive Autism Network, a web-based autism registry that collected data from about 55,000 families of children and adults with autism between 2006 and 2019.

The high rate of suicidal thoughts identified among young kids is particularly worrisome, the researchers said, because validated suicide risk screening tools and interventions for this age group are lacking. And, while they noted that the National Institute of Mental Health says suicide warning signs in children can include changes in behavior like extreme mood swings, withdrawing from friends and family and giving away belongings, not everyone with autism who is at risk shows signs.

Researchers at Kennedy Krieger said they are now screening patients with autism starting at age 8.

“Suicide is complicated, tragic and also preventable,” Schindel said. “It is important for parents to check in on their children’s mental health and alert their health care providers if there are concerns so that they can be connected to preventive mental health services, like counseling and, in some cases, medication.”

If you or someone you know needs help, call or text 988 to reach the 988 Suicide and Crisis Lifeline.