Years ago, I posted about elopement, or wandering, in children on the autism spectrum. Unfortunately, it remains a highly relevant topic for some of my current patients. Some have wandered a significant distance from home or school, requiring police involvement. Thankfully, all have remained safe, but it can certainly be a traumatizing event for many families.
In addition to discussing prevention measures, such as trying to figure out the trigger for the elopement behavior, and thus strategizing how to reduce or manage those triggers, parents often will also ask about safety technology, such as electronic tracking devices (ETDs). These wearable devices that can track a child’s location in real time, using technology, such as cellular networks, global positioning system satellites, and Bluetooth. Not knowing much about the data around ETDs, I read with interest a recent study in the Journal of Developmental and Behavioral Pediatrics that explored the impact of ETDs on the frequency of wandering, the frequency of risk for serious injury as a result of wandering, and the quality of life for the family.
What They Did
An anonymous online survey was distributed via organizations that provide support services for households with dependents on the autism spectrum. The data was collected for over 1,400 families with autistic children (4 to 18 years old) who had wandered at least once. Survey questions included data regarding:
- severity of autism spectrum disorder and other co-occurring diagnoses
- whether other non-ETD interventions had ever been used (e.g,. baby gates, temporary ID tattoos, swimming lessons)
- whether an ETD had ever been used (including reasons why or why not), the burden and cost of using an ETD, and any reasons for discontinuing an ETD
- elopement behavior (frequency, duration, risk of serious injury as a result)
- household quality of life
What They Found
- The mean age of children in this sample was 9.4 years (SD 5 4.0), and the sample was 79.6% male.
- The sample was 83.4% white, 12.5% Hispanic/Latino, 10.3% black, and 2.8% Asian.
- Families reported using an average of 4 non-ETD interventions in the last year, with nearly all families reported using at least 1 non-ETD intervention within the last year.
- Roughly a quarter of caregivers reported current use of an ETD, with about 6% reporting past use of an ETD, and 68% reported never using an ETD.
- Among users of an ETD:
- About half had used an ETD for at least 1 year.
- The most commonly reported "very important" reason for using an ETD was peace of mind (81%).
- 29% reported a lifetime spending of $1,000 or more for ETD intervention..
- The most commonly reported reason for discontinuing ETD use was that the child did not like wearing it or it did not fit.
- Current and past ETD users reported that while using ETD:
- Frequency of elopement from home, another person’s home, school, and another public place was significantly lower.
- Average duration of elopement behaviors, as well as the duration of the longest elopement behavior, were significantly lower.
- Frequency of risk of serious injury from elopement was significantly lower.
- Almost all current ETD users (93%) reported an overall improvement in quality of life, as well as improvement in each of the 5 quality of life measures within the survey, even after adjusting for income, co-occurring diagnoses, and severity of autism spectrum disorder.
While the study found a significant reduction in elopement frequency and duration among ETD users, the authors note that it’s not possible to discern from this study whether this was from the ETD itself or potentially due to concurrent effects of other non-ETD interventions. In addition, the impact of non-ETD interventions alone was not assessed as part of this study.
More research is needed to explore the specific impact of ETDs alone on wandering rates. Still, I likely will use some data from this study to discuss the pros and cons of ETDs with my families, particularly if it seems that a family has utilized many non-ETD interventions already and are still experiencing or are very worried about elopement.
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