Research In Action

The most common "problematic" behavior related to safety that I encounter in my practice is elopement, or wandering. It frequently causes stress in the family and is a priority at every visit, especially for parents of children with autism spectrum disorders (ASD). It's highly relevant to our readers because this group of children are at increased risk of being injured in traffic as a pedestrian.

Here are a few facts about elopement from a study that surveyed parents of more than 1,200 autistic children:

• Nearly half of the parents reported that their kids with ASD tried to elope at least once after the age of 4 years.
• Frequency of elopement peaked around age 5 years.
• Almost ¾ of the time, elopement occurred from the family’s house or a friend’s house.
• The purpose of elopement varied with specific diagnosis. Kids who were described as running away for the sake of running (and tended to be happy and playful) were more likely to have a diagnosis of autism or autism spectrum disorder. On the other hand, kids with Asperger syndrome were more likely to be reported as eloping to run away from an anxious situation and tended to be either anxious or sad while eloping.
• Of those who eloped, a bit over half of the kids actually went missing long enough to cause concern. And of those who went missing, 2/3 of parents reported that their kids encountered close calls with traffic injuries, and 1/4 of parents reported that their kids had close calls with drowning.
• Kids who were reported to have gone missing were more likely to be older, less likely to respond to their names, and had more delayed intellectual, social, and communication skills.
• Over half of parents reported that elopement was the most stressful behavior that they’ve had to manage, and a significant percentage reported that elopement made it difficult for the family to attend or enjoy outings.

In the Office

• The first step is to help families figure out why their kids are eloping. I always recommend that a behaviorist perform a functional behavioral assessment to determine both the triggers and the reinforcement behaviors that might occur when kids elope. Only then can the behaviorist develop an informed behavioral plan, which should be included in the child's Individualized Education Plan.
• An individual aide can be particularly important, particularly if elopement is occurring at school. Pennsylvania has a state-funded behavioral service that can send therapists and therapeutic staff support workers to the home, to the school, and to the community- to wherever the child is. This can be a really useful service for kids where elopement is a concern.
• I may recommend medication to reduce either impulsivity or even anxiety, if that’s determined to be the trigger for the elopement behavior.

Parents and Schools

• Adults should be assigned specific roles in the event of an elopement situation and should rehearse regularly.
• Identification tags should be worn, especially if kids have communication and/or cognitive deficits and cannot relay their name and/or address.
• Police and fire departments should be notified in advance that a child with special needs lives or attends school in the neighborhood.

Elopement is a potentially dangerous behavior but there are multiple strategies to help reduce its occurrence. Clinicians, schools, and parents should all work together to develop a comprehensive plan. For more information and resources, check out the Autism Speaks website and AWAARE collaboration website.

Source: Anderson, et al. Occurrence and Family Impact of Elopement in Children With Autism Spectrum Disorders. Pediatrics 2012;130(5).