PFA Tips: Communication Tips for Supporting an Autistic Person in Crisis

Autistic people experience thoughts and behaviors related to suicide at high rates, and by the very definition of autism, all autistic people will experience communication differences. Because supporting someone experiencing suicidality relies necessarily on communication, it is important to consider autistic people’s unique communication needs.

Miscommunication creates distress
Miscommunications are common between autistic and non-autistic people. They can happen while ordering lunch or navigating relationships, and even ordinary misunderstandings are hard to untangle on the best of days. But during a crisis, the stakes are high.

Communication barriers worsen distress, and distress worsens communication barriers. So in order to effectively support an autistic person experiencing suicidality, we need to consider their communication needs. The good news is that the opposite is also true. Reducing communication barriers reduces distress, and reducing distress reduces communication barriers.

Not everyone reacts the same way
There can be a mismatch between different people’s expectations of how someone expresses distress, which can cause misunderstandings and miscommunications. For instance, someone might ‘seem fine’ but be in a crisis. Or someone might be very direct about their suicidal thoughts and others may think they are exaggerating or seeking attention.

About half of all autistic people may have trouble describing their emotions. This is known as alexithymia, which is present in the general population at about 10%, but in the autistic population at about 50%.

Allow for processing time
Autistic people may benefit from extra processing time. This reflects the often trees-before-forest processing of an autistic brain vs the forest-before-trees processing of a non-autistic brain. This means an autistic person may need to sort through many details in incredible depth (the trees) before coming to a conclusion (the forest). Someone may need 20, 30, 40 seconds (or more) to process each question or statement.

Communication is more than verbal
Keep in mind that communication goes beyond words. And communication with words can happen in many modalities. Augmentative and Alternative Communication (AAC) can be beneficial even for speaking adults because speech can cost a lot of energy and be unreliable. Someone might lose words. You can offer communication beyond words such as texting, typing, nodding, writing, etc. Consider self-injurious behaviors, behaviors that challenge, and elopement as communication.

Suggestions for facilitating communication about suicidality

Keep in mind the saying that “if you’ve met one autistic person, you’ve met one autistic person” so these suggestions may not be true for every individual, but here are some communication suggestions based on research, lived experience, and practice-based evidence.

Alternative communication

• ensure access to communication devices and supporters
• even if a person is speaking, offer non-spoken communication such as texting, typing, nodding, pointing, writing, etc.

Unambiguous language

• be concrete and factual
• avoid platitudes

Take their word for it

• listen literally
• trust their self-knowledge
• believe their experiences
• validate their thoughts and emotions

Indicate your intention

• state clearly what is implied
• state clearly what you are expecting
• provide predictability wherever possible

Short, specific sentences

• establish shared definitions
• reduce irrelevant information

Time for processing / regulation

• allow ample time to build trust
• allow ample time for processing
• allow ample time for regulation

Interest-based coping

• ask them about what they really love

Closed-ended questions

• narrow the scope
• offer choices

Collaboration

• promote self-determination
• collaborate on safety

Co-regulate

• stay calm
• remind them that it is not wrong to feel this way

Comfort items

• wherever possible, maintain access to their comfort items, foods, and routines

Remember that supporting an autistic person through suicidality isn’t about doing it perfectly. It’s about creating enough safety that they can be who they are and communicate in a way that works for them. This takes practice, and that’s okay. The autistic person is the expert on their own experience and validating that experience is one of the most powerful things you can do. What matters most is that the autistic person in your life knows you’re willing to meet them where they are.

 

Additional Resources

PFA Tips: Autism and Suicide

PFA Tips: Supporting an Autistic Person Experiencing Suicidality

Autism and Suicide Prevention Workgroup

Suicide Prevention for Autism Neuro-affirming Toolkit – for providers

Autistic Communication Suggestions

Autism Adapted Safety Plans

Rae is an autistic self-advocate leading peer support groups for adults to process and discuss what it’s like to be autistic in the world.  

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