TOPLINE:

Youth and young adults with autism spectrum disorder (ASD), intellectual disability, or cerebral palsy experienced higher mortality than the general population. The causes of death varied, with external injuries and nervous system disease being the most common causes mentioned.

METHODOLOGY:

• Researchers analyzed data from 32,787 children between ages 8 and 29 years identified through the Autism and Developmental Disabilities Monitoring Network across multiple US sites starting in 2000 through 2016.
• Individuals were linked to death certificates through 2021 using the National Death Index, with 145 deaths among 23,393 people with ASD, 285 deaths among 14,031 people with intellectual disability, and 123 deaths among 1612 people with cerebral palsy during youth or young adulthood.
• Cases with multiple conditions were included in each group for which they qualified, and general population data were matched to participating sites and ages.
• Outcome measures were death and causes of death based on diagnostic codes from death certificate linkage.
• Analysis included stratification by sex, race, and ethnicity and by co-occurring intellectual disability for ASD and cerebral palsy groups.

TAKEAWAY:

• Cumulative survival from 8 to 29 years of age was 98.4% in the general population, 97.7% in the ASD group, 94.7% in the intellectual disability group, and 90.5% in the cerebral palsy group.
• Mortality patterns by sex showed a higher mortality among men than among women in the general population (hazard ratio [HR], 2.34; 95% CI, 2.29-2.40) and a lower mortality among men than among in the intellectual disability group (HR, 0.72; 95% CI, 0.57-0.91).
• Mortality was higher among women with co-occurring ASD and intellectual disability than in the general female population (HR, 5.04; 95% CI, 3.21-7.91). Compared with sex-specific mortality in the general population, mortality was also elevated among men with cerebral palsy and intellectual disability (HR, 10.00; 95% CI, 7.18-13.93) and in men with just cerebral palsy (HR, 5.37; 95% CI, 3.89-7.41).
• Nervous system diseases were the most common causes of death among individuals with intellectual disability and cerebral palsy. Individuals with ASD or intellectual disability experienced higher mortality from unintentional drowning and submersion than the general population (ASD: HR, 3.34; 95% CI, 1.58-7.03; ID: HR, 5.49; 95% CI, 2.60-11.57).
• Mortality from cardiac arrest was higher in the ASD (HR, 2.77; 95% CI, 1.63-4.68), intellectual disability (HR, 17.27; 95% CI, 13.13-22.71), and cerebral palsy (HR, 42.18; 95% CI, 27.94-63.67) groups than in the general population.

IN PRACTICE:

“Public health and healthcare strategies could help prevent disparities in mortality associated with developmental disabilities,” the authors wrote.

SOURCE:

The study was led by Kelly A. Shaw, PhD, of the National Center on Birth Defects and Developmental Disabilities at the US CDC in Atlanta. It was published online on February 9, 2026, in JAMA Pediatrics.

LIMITATIONS:

The quality of the data relied on the availability and completeness of records. Surveillance was not conducted at all locations or in all years, likely underestimating co-occurrence. 

DISCLOSURES:

One author disclosed the funding for collection and analysis of data in this manuscript from the CDC. Three authors disclosed receiving grants from the CDC, and one of them received grants from various other sources during the conduct of the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.