Toward a linguistic-cognitive perspective on suicidal thoughts in young children

Suicidal thoughts and behaviors (STB) in children as young as four to seven years old represent a growing public health concern, yet current assessment tools often overlook children's own linguistic expressions. This correspondence advances a linguistic-cognitive perspective by highlighting how children's narratives, metaphors, and discourse patterns may provide early markers of suicide risk. Building on recent clinical and developmental findings, we outline potential linguistic indicators such as recurring death themes, affective tone shifts, metaphorical reasoning, and disrupted narrative structures. To contextualize this approach, we summarize existing studies that link children's discourse with suicidal ideation and behavior across both psychiatric and developmental samples. We also introduce a preliminary coding rubric that organizes linguistic markers into thematic, emotional, structural, and grammatical domains, accompanied by illustrative examples and rating options. Furthermore, we discuss how this framework could complement established tools such as the Preschool Feelings Checklist, Berkeley Puppet Interview, and Columbia Suicide Severity Rating Scale by capturing subtler forms of expression that may precede overt behavioral symptoms. We emphasize the importance of distinguishing normative symbolic exploration in typically developing children from discourse patterns that reflect psychiatric risk. This perspective underscores the ethical imperative of listening directly to children's voices and integrating their communicative agency into psychiatric assessment. Taken together, the proposed framework broadens clinical interpretive tools, enhances developmental sensitivity, and provides a foundation for future empirical validation of language-based approaches to early suicide risk detection in young children.