Suicidal Thoughts and Behaviors in Elementary School–Aged Youth: A Pilot Study in 5- to 10-Year-Olds

Objective: Emerging evidence suggests that elementary aged children may experience suicidal thoughts and behaviors (STBs) at rates higher than previously expected. However, STBs, and developmentally appropriate STB measurement, in children are vastly understudied. We conducted a preliminary study to determine the feasibility, acceptability, and safety of asking about STBs and STB rates in a sample of children enhanced for potential adversity exposure. Method: To assess lifetime STBs, the Suicidal Ideation Questionnaire–Junior and the Self-Injurious Thoughts and Behaviors Interview–2 were administered to 98 children 5 to 10 years of age (mean = 7.53, SD = 1.41; 50% female; 52% non-White) and their caregivers (reporting about their child) during an in-home visit. We completed a phone follow-up 1 week later to assess potential iatrogenic effects. Results: One-week follow-up data showed no concerning iatrogenic effects. A total of 31 caregivers (31%) reported passive suicidal ideation in their children, and 34 children (34%) reported passive suicidal ideation (“wish never born”). Fourteen caregivers (14%) reported active suicidal ideation in their children, and 33 children (33%) reported active suicidal ideation (“want to kill self”). Two caregivers (2%) reported that their child made a suicide plan, and 5 children (5%) reported a suicide plan. One child reported that they had made a suicide attempt. Conclusion: Findings demonstrate that asking about STBs in families with children 5 to 10 years of age is feasible, generally acceptable, and safe. However, some families may need researchers to help mitigate discomfort relating to STB assessment in young children. STB rates were higher than expected, and highlight the need for continued developmental research on the course of child STBs. Plain language summary: Children as young as 5 years old may experience thoughts about suicide, but these behaviors are not well understood. This study involved 98 children 5 to 10 years of age, recruited for potential adversity exposure, and their caregivers, who answered questions about suicidal thoughts and behaviors (STBs) during an in-home visit, with follow-up a week later. Results showed that 33% of children reported thinking about wanting to kill themselves, and 5% reported having made a plan, with no harmful effects observed from asking these questions. These findings highlight the importance of more research to understand these behaviors early in development, particularly in children exposed to adversity.