NCT05398250

Brief Summary

Rates of suicide have increased significantly over the past two decades, particularly among youth. Compared to the general population, autistic people are significantly more likely to think about suicide, attempt suicide, and die by suicide. Autistic individuals have identified suicide prevention as a top research priority; however, little is known about how to best help autistic youth at risk for suicide. The purpose of this study is to compare the effectiveness, feasibility, and acceptability of two suicide prevention strategies tailored for autistic individuals: the Safety Planning Intervention tailored for Autistic individuals (SPI-A) and SPI-A plus structured follow-up contacts (SPI-A+).

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,665

participants targeted

Target at P75+ for not_applicable

Timeline
18mo left

Started Aug 2022

Longer than P75 for not_applicable

Geographic Reach
1 country

5 active sites

Status
enrolling by invitation

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress71%
Aug 2022Nov 2027

First Submitted

Initial submission to the registry

May 25, 2022

Completed
6 days until next milestone

First Posted

Study publicly available on registry

May 31, 2022

Completed
3 months until next milestone

Study Start

First participant enrolled

August 23, 2022

Completed
5.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2027

Last Updated

February 10, 2026

Status Verified

February 1, 2026

Enrollment Period

5.2 years

First QC Date

May 25, 2022

Last Update Submit

February 5, 2026

Conditions

Keywords

Suicide PreventionAutism Spectrum DisorderSafety Planning Intervention

Outcome Measures

Primary Outcomes (1)

  • Change in suicidal ideation and behavior

    The Columbia-Suicide Severity Rating Scale (C-SSRS) is a clinical interview that measures suicidal ideation (range 0-5, with higher scores indicating more severe ideation) and suicidal behavior (count of total number of actual attempts, interrupted attempts, aborted attempts, and preparatory acts or behavior). The C-SSRS will be administered at baseline, 1-month follow-up, 6-month follow-up, and 12-month follow-up.

    Through 12 months of follow-up

Secondary Outcomes (9)

  • Change in mental health treatment utilization

    Up to 12 months

  • Change in quality of life

    Up to 12 months

  • Change in well-being

    Up to 12 months

  • Change in skills to manage suicidal ideation

    Up to 12 months

  • Change in access to lethal means

    Up to 12 months

  • +4 more secondary outcomes

Study Arms (2)

Safety Planning Intervention Tailored for Autistic Individuals

ACTIVE COMPARATOR

The Safety Planning Intervention Tailored for Autistic individuals (SPI-A) is a brief collaborative intervention that results in an individually tailored plan designed to lower the short-term risk of suicide in autistic youth.

Behavioral: Safety Planning Intervention tailored for Autistic Individuals

Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

ACTIVE COMPARATOR

The Safety Planning Intervention Tailored for Autistic individuals plus structured follow-up contacts (SPI-A+) is a multi-component intervention comprised of SPI-A and structured follow-up consisting of at least 2 brief contacts.

Behavioral: Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

Interventions

To develop the SPI-A, clinicians work collaboratively with patients, and when indicated, their family members, to create a list of concrete coping mechanisms to be enacted leading up to or during a crisis. This list can be depicted in writing or pictorially, depending on patient preference. As part of the intervention, patients (and family members, when appropriate) also identify warning signs that signal the need to use the safety plan, as well as a detailed plan for reducing access to lethal means. SPI-A is a stand-alone intervention without a follow-up component.

Also known as: SPI-A
Safety Planning Intervention Tailored for Autistic Individuals

SPI-A+ includes SPI-A plus a structured follow-up component. The structured follow-up component of SPI-A+ includes three elements: 1. A brief risk assessment and mood check 2. Review and, if needed, revision of SPI-A 3. Support related to outpatient mental health treatment initiation

Also known as: SPI-A+
Safety Planning Intervention Tailored for Autistic Individuals Plus Structured Follow-Up Contacts

Eligibility Criteria

Age12 Years - 99 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • years old

You may not qualify if:

  • A.2 - Enhanced EHR-Only Arm:
  • Receives one of the interventions being studied (SPI-A or SPI-A+) as part of routine clinical care
  • A.3 - Active PRO Arm:
  • Referred to the study team by a consented clinician
  • Able and willing to provide informed consent (age 18+) or assent and parental/guardian consent (age \< 18)
  • Able to speak English (and, if applicable, at least one guardian also able to speak English)
  • (B) Clinician Participants
  • Employment as a provider serving autistic patients at one of the study sites
  • Employment in a role that involves suicide risk intervention with youth patients at a participating clinic
  • Able to read and speak English
  • Able and willing to provide informed consent
  • (C) Health System Leader Participants
  • Health system or clinic leader at one of the study sites
  • Employed in a role that provides administrative oversight to clinicians conducting safety plans with patients
  • Able to read and speak English
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Kennedy Krieger Institute

Baltimore, Maryland, 21113, United States

Location

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, 27510, United States

Location

Nationwide Children's Hospital

Columbus, Ohio, 43205, United States

Location

Children's Hospital of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Seattle Children's Hospital

Seattle, Washington, 98105, United States

Location

MeSH Terms

Conditions

Suicidal IdeationSelf-Injurious BehaviorSuicideAutism Spectrum DisorderSuicide Prevention

Interventions

lambda Spi-1

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorChild Development Disorders, PervasiveNeurodevelopmental DisordersMental Disorders

Study Officials

  • Danielle Roubinov, PhD

    University of North Carolina, Chapel Hill

    PRINCIPAL INVESTIGATOR
  • Shari Jager-Hyman, PhD

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 25, 2022

First Posted

May 31, 2022

Study Start

August 23, 2022

Primary Completion (Estimated)

November 1, 2027

Study Completion (Estimated)

November 1, 2027

Last Updated

February 10, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

Deidentified individual data that support the results will be shared after the publication of the final research report, for a period of at least 7 years, provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Deidentified individual data that support the results will be shared after the publication of the final research report, for a period of at least 7 years.
Access Criteria
Investigator has approved IRB, IEC, or REB and an executed data use/sharing agreement with UNC.

Locations