Children and adolescents with autism three times more likely to drown

Published August 2020

Royal Life Saving research shows that children and adolescents with Autism Spectrum Disorder (ASD) are three times more likely to drown than children without ASD.

This is one of the key findings of a paper published in Archives of Disease in Childhood by Dr Amy Peden, Royal Life Saving Senior Research Fellow, and Stacey Pidgeon, Royal Life Saving’s National Manager for Research and Policy.

This study, which explored unintentional fatal drowning among children and adolescents aged between 0 and 19 years diagnosed with ASD in Australia, found that the highest rates of drowning were seen in children aged 0 to 4 years and that over half of all ASD-related drowning deaths were due to an unintentional fall into water.

Compared with children without ASD, children with ASD aged 5 to 9 years were significantly more likely to drown than any other age group, and most deaths were likely to occur in lakes/dams and during winter.

Pre-existing medical conditions are known to increase the risk of drowning. This study concurs with other international research, which indicates that people with ASD have an increased risk of premature death and that children with ASD are at greater risk of unintentional injury, particularly drowning.

The Australian Bureau of Statistics (ABS) suggests an increased diagnosis of ASD in recent years in Australia; in 2009, 64,600 people had a diagnosis of ASD compared with 164,000 in 2015, and in 2018 this rose to 205,200. Autism Spectrum Australia cites that 1 in 70 people in Australia are diagnosed with ASD.

Drowning prevention advice for parents and carers

The study suggests that parents and carers of children with diagnosed ASD or with suspected ASD should be made aware of the increased risk of drowning and advised on how to reduce the risk. This includes highlighting the importance of active adult supervision for all ages, the erection of barriers to restrict access to water (eg, four-sided pool fencing) and the creation of child safe play areas in locations where the risk of drowning is posed by natural waterways. Adults with ASD should always swim with a friend.

It is, however, important to note that with the right support and learning environment, people with ASD can learn to swim. Find out more about how to stay safe if you or someone you care for has ASD.

Further research

This study notes that the data collected and recorded in coronial files for those with ASD needs to improve to build a better and more accurate picture about the relative risk of drowning in this population. In particular, it highlights the fact that a diagnosis of ASD often does not occur until a child is aged five years, which means that the results in the study may be an underestimate.

Further reading

Peden, A. E. & Willcox-Pidgeon, S. (2020) Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Archives of Disease in Childhood