Disability Status, History of Suspensions, and Early Suicide Risk Among Children

Background and Purpose:

Although suicidal behaviors in young children (ages 5-12) are rare, in 2021 in the U.S., suicide was the fifth leading cause of death among this population. Research supports that children with disabilities are at elevated risk for suicide-related behaviors in comparison to their general education peers, but what is lacking is research investigations that focuses on the effect of cumulative risks such as disability status, history of suspension/expulsion, negative peer relationships, and school disconnection in relation to early suicide risk. According to the cumulative risk model, exploring risk factors within children is of utmost importance to understanding how certain factors, in culmination, correlate to depict specific adverse outcomes. As such, this study examined disability status, negative peer relationships, and school disconnection on suicidal ideation and attempts among children with and without a history of suspension/expulsion.

Methods:

Data used were from the Future of Families and Child Wellbeing Study which includes a large sample of children disproportionately from minoritized and disadvantaged backgrounds. This longitudinal birth cohort study recruited parent-child dyads in 20 U.S. cities with populations >200,000. Data collection occurred at child’s birth (baseline), and again at ages 1, 3, 5, 9, 15, and 22. Baseline (1998-2000) and age 9 (2007-2010) interview data were used. Analytic sample (n=2,463) consisted of 52% males with an average age of 9.3 years (SD = .37). Racial/ethnic breakdown was 81% non-White (Black & Hispanic) and 19% White. Data were analyzed using multivariate logistic regression, including subgroup analysis for children with and without a history of suspensions/expulsions.

Results:

Among children, 2% experienced suicidal ideation and 2% experienced suicide attempts. Ten percent had a disability status, and when looking exclusively at children with a history of suspensions/expulsions by age 9 disability status increased to 19%. Negative peer relationships (AOR = 1.12; 95% CI = 1.01-1.25 p = .020) and being male (AOR = 2.26; 95% CI = 1.06-4.82 p = .034) were associated with suicidal ideation in children without a history of suspension and expulsion. In addition, disability status was not statistically associated (AOR = 2.15; 95% CI = 0.87-5.36; p = .099). On the contrary, children with a history of suspension/expulsion and a disability status had three times higher odds of suicidal ideation (AOR = 3.02; 95% CI = 1.07-8.47; p = .036) in comparison to children with no disability status. For suicide attempts, we found similar patterns of associations; however, the overall model fit of children with (X²(14, n=456)=22.65, p = .066) and without (X²(14, n=2,007)=23.02, p = .060) a history of suspension/expulsion were not statistically significant.

Conclusion and Implications:

Research findings provide empirical support for the effect of cumulative risk factors on suicide ideation in children which fills in critical gaps in the literature. Findings raise awareness to important developmental risks that are key to accurate assessment and screening in preventing early suicide risk. Assessing cumulative risks among children can inform school-based interventions designed to promote mental health and suicide prevention.