Suicides among children under the age of 13 are still rare, but the number is increasing. ADHD and access to guns play roles in these tragedies.

Cyber bullying and the popular Netflix miniseries “13 Reasons Why” have brought renewed attention to the problem of teen suicide. But suicides among children as young as age 5 are a growing concern, too.

Suicide is the third leading cause of death among children ages 10 to 14, according to the U.S. National Institute of Mental Health.

It also is the 10th leading cause of death among children of elementary school age.

“Statistically, [suicide by children under age 10] is a rare event, but that doesn’t mean it doesn’t happen,” Julie Cerel, PhD, a professor at the University of Kentucky College of Social Work and president of the American Association of Suicidology, told Healthline.

Experts say parents should be aware of the warning signs for suicide, even in young children.

“People think that kids don’t know what death is. That’s a myth,” Cerel stated.

The U.S. Centers for Disease Control and Prevention (CDC) recorded at least 1,300 suicides among children ages 5 to 12 between 1999 and 2015.

The suicide rate among preteens is far lower (0.31 suicides per 100,000 children ages 5-12) than teens (7.04 suicides per 100,000 people ages 13-18).

But the CDC reported that the rate has risen in recent years, especially among 11- and 12-year-olds.

“Kids who say they want to kill themselves may grow up to be adolescents who die by suicide,” said Jonathan B. Singer, PhD, LCSW, associate professor at Loyola University’s School of Social Work, and chair of the National Association of Social Workers’ Children, Adolescents, and Young Adult specialty practice section.

Boys are far more likely to die by suicide, research shows. But the suicide rate among girls ages 10 to 14 rose from 0.5 per 100,000 in 1999 to 1.5 per 100,000 in 2014.

That change marks the largest percentage increase reported by the CDC in an analysis detailing an overall rise in suicides among Americans.

Access to firearms plays a role in youth suicides.

The CDC reports that 38 percent of the 1,300 firearms deaths among U.S. children are the result of suicide.

On the other hand, a recent analysis published in Pediatrics found that 64 percent of the early adolescent suicides reported between 2003 and 2012 involved hanging, strangulation, or suffocation.

Other factors include race, a history of mental illness and depression, and — notably — a diagnosis of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD), according to a study from the Center for Suicide Prevention and Research at Nationwide Children’s Hospital.

“With kids, and especially boys, impulsivity plays a role,” Cerel said.

Developmentally, “children take what has recently happened to them and magnify it,” she added. “They don’t have the long experience to know that things can get better. They don’t always have the ability to think through how to change things.”

That can lead to despair and potentially lethal choices.

Statistically, elementary age children who died by suicide were most likely to be black males who died by strangulation in their homes following an argument with friends and family, without leaving a suicide note, the Sheftall-led study noted.

Relationship clashes with family members and friends were more likely to be suicide triggers for early adolescents, while conflicts with boyfriends or girlfriends were more commonly associated with suicide among older adolescents.

“Parents are the most significant influence throughout a child’s life, but the ability of parents to influence is more significant in childhood than in adolescence,” noted Singer.

In Colorado, where suicide is the leading cause of death among children ages 10 to 17, the state Child Fatality Risk Prevention program, in 2016, called for a comprehensive school-based suicide prevention initiative.

The program teaches school personnel how to identify and respond to suicide risk factors.

“It becomes our job as mental health professionals to tell parents that if their kids feel this way, they need help,” said Cerel.

Anti-bullying programs create an environment where kids are more willing to stand up for each other and where children can feel secure in discussing their problems, up to and including suicidal thoughts, noted Singer.

“If your child is talking about killing themselves, saying they want to die, or that people would be happier if I was dead, take it seriously,” Singer advised parents. “Don’t be angry or brush it off. It may just be that they are looking for attention, but it’s also an opportunity to have a discussion about what it means to be suicidal.

“It’s a teachable moment and it tells kids that they can come to their parents with something that could be very scary,” he added. It’s a lesson that can carry over to middle school and high school, when social and academic pressures can pile up and raise the risk of suicide even higher.