281 - Challenges of suicide risk screening research via telemedicine in children with neurodevlepmental disorders

Poster Number: 281
Publication Number: 281.346

Suzanne Rybczynski, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Mwuese R. Ngur, Kennedy Krieger Institute, Baltimore, MD, United States; Carmen Lopez, Kennedy Krieger Institute, Baltimore, MD, United States; Patrick C. Ryan, National Institutes of Health, Bethesda, MD, United States; Nathan J. Lowry, National Institute of Mental Health, Bethesda, MD, United States; Mihee Bay, Kennedy Krieger Institute, Baltimore, MD, United States; Sneha Jadhav, Kennedy Krieger Institute, Baltimore, MD, United States; Kate McCalla, Center for Autism and Related Disorders, Kennedy Krieger Institute, BALTIMORE, MD, United States; Colleen M. Lenz, Kennedy Krieger Institute, White Hall, MD, United States; Audrey Thurm, NIMH, Bethesda, MD, United States; Lisa M. Horowitz, National Institute of Mental Health, Bethesda, MD, United States; Paul H. Lipkin, Kennedy Krieger Institute, Baltimore, MD, United States

Background: Suicide is the second leading cause of death for youth aged 10-24 years. Research suggests youth with autism and other neurodevelopmental disorders (A/NDD) are at higher risk for suicide. Screening tools are available to detect suicide risk in youth in outpatient medical settings. However, none are designed or validated for telemedicine nor validated for youth with A/NDD. The COVID-19 pandemic has impacted medical research and required protocol adjustments to adapt to remote research

Objective: Describe the feasibility of conducting a suicide risk screening validation study using telemedicine during the COVID-19 pandemic.

Design/Methods: Participants were recruited from 4 clinics serving youth at a large tertiary neurodevelopmental health facility. Eligible children aged 8-17 years, English-speaking, and verbally fluent were recruited during remote video triage or by clinician referral. Once enrolled, research staff administered by remote videoconference the Ask Suicide-Screening Questions (ASQ), a brief 4-item tool as well as 10 candidate items developed specifically for A/NDD youth, preferably without parent present. Afterwards, each participant underwent a blinded clinician interview via remote videoconference using the ASQ Brief Suicide Safety Assessment. Children who screened positive for suicide risk followed standard clinic procedures, including notifying the parent(s) and discussing a safety plan. If necessary, follow-up visits for the same or next day were scheduled. A check-in with parents was conducted one week later to document the presence of child’s persistent thoughts on suicide.

Results: Of 109 eligible subjects and their parents/guardians approached for enrollment (figure), 66.1% scheduled an appointment for consent. Of those scheduled, 83.3% attended. 57.7% were enrolled and 95% completed the study. 70.2% were alone without a parent present for the interview. 64.9% of parents completed the one-week check-in. See table for sample characteristics. Only 1 parent reported challenges using the videoconference platform. When needed, research staff and study clinician coordinated safety management of participants at risk.Conclusion(s):
The use of remote video to conduct research on suicide risk screening is highly feasible. Challenges included high non-participation in those who expressed interest, common parental presence during screening, and follow up contact. Technology challenges were minimal. Our study supports the use of telemedicine for safely detecting and managing suicide risk among children with neurodevelopmental disorders.
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