The 988 Suicide & Crisis Lifeline has launched autism-specific training for counselors to better serve autistic callers in crisis. Over 1,200 counselors have accessed the voluntary webinar training developed by the Autism and Suicide Prevention Workgroup, which addresses communication barriers that autistic people face when seeking crisis support.

Autistic people are significantly more likely than neurotypical peers to experience suicidal thoughts and attempt suicide. Since its July 2022 launch, 988 has received roughly 25 million contacts nationwide. Emergency services are dispatched in fewer than 2% of calls.

Why Autistic Callers Face Communication Barriers

Many autistic people require extra processing time to respond to questions, particularly during stressful situations. They often interpret language literally, which can lead to misunderstandings when counselors use metaphorical or indirect phrasing.

Alexithymia, a trait common among autistic people, makes it exceptionally difficult to identify and describe emotions. When a counselor asks "How are you feeling right now?" an autistic caller with alexithymia may struggle to answer, not because they're unwilling, but because the question itself is hard to parse.

Without autism-specific training, counselors may misinterpret these communication differences as disengagement or even assume the call is a prank. That miscommunication can trigger unnecessary police dispatch or hospitalization.

What the Training Teaches Counselors

The training program was developed by Lisa Morgan and Dr. Brenna Maddox, who co-chair the Autism and Suicide Prevention Workgroup. Morgan is a trauma-informed consultant specializing in crisis supports for autistic people. Maddox is a clinical psychologist at UNC-Chapel Hill's TEACCH Autism Program.

Between 2023 and 2024, they published training guides for crisis workers that now form the basis of the 988 counselor webinar training. The training is administered by Vibrant Emotional Health, which runs the 988 system.

Counselors learn to ask clear, short, direct questions and allow ample response time. They're taught to adjust their approach rather than expecting autistic callers to adapt to standard crisis protocols.

In a survey by CARD and the Autism Society, almost 90% of autistic respondents said they'd be much more likely to call crisis hotlines if they knew workers had autism-specific training. The new 988 training directly addresses that gap.

What This Means for Families

If your autistic child or family member is in crisis, 988 counselors are now more likely to have received training that accounts for autism-specific communication needs. The training is voluntary, so not every counselor will have completed it, but over 1,200 have accessed the resources since they became available.

When calling 988, let the counselor know upfront that the caller is autistic. This signals the counselor to adjust their approach: shorter questions, more processing time, literal language.

You can also request that the counselor avoid dispatching emergency services unless absolutely necessary. In 98% of calls, 988 resolves the crisis without police involvement.

What Families Can Do Now

• Call or text 988 if you or your autistic family member is in crisis
• Mention autism at the start of the call so the counselor can adjust their communication approach
• Allow extra time for the caller to process and respond to questions
• Review the Autism and Suicide Prevention Workgroup's crisis support resources before a crisis occurs
• Share information about 988 with autistic teens and adults in your family who may need it

The 988 Suicide & Crisis Lifeline is available 24/7 by calling or texting 988. All calls are free and confidential.