Reducing Wandering & Elopement

According to www.nationalautismassociation.org nearly half (49%) of all children with Autism will attempt to elope from a safe or known environment. That is a SCARY number.

All children may wander away from adult supervision at one time or another, particularly very young children. What makes this issue so much more critical for children with Autism is they may not respond to their name, they may have a poor understanding of danger, and they may be unable to communicate with help providers such as a policeman.
Lack of public information also makes this issue so critical. Most people don't know how to effectively communicate with a child who does not talk. If an unknown adult tried to get safety information from your child (such as "Hey kid, where are your parents?") would your child respond at all? Or would your child walk/run away?

 For this post, the word Elopement describes:

• The individual leaves or wanders away from the home, or from a known adult while out in public

Elopement isn’t always the individual running away from you at full speed. I've had clients who hide from me in public settings, try to get into other peoples cars, or sneak out of their homes at night when everyone is asleep.

The issue of elopement & Autism is very serious. All you have to do is read the newspaper or watch the evening news to hear about children, adolescents, and adults with Autism wandering away from home and being gone for hours or even days. Sometimes these stories have tragic endings, that leaves everyone wondering "What could we have done differently to avoid this??".

It can be hard to know what is motivating individuals with Autism to wander away from home, especially if the individual has no means to communicate thoughts and feelings. Also, a child with Autism is more likely to go away from people if they get lost, than towards people like a NT child would.

Just like any other behavior there are many different ways you can reduce the risk of your child wandering away from the house, or bolting away from you when you are out in public.

I explain these terms in my For Related Professionals post, but for any behavior you want to manage you can intervene on the Antecedent or the Consequence.
Antecedent means what happens before the behavior. Consequence means what happens after the behavior. The approach that will work best will depend on the individual who is eloping and their particular motives for wandering away.

This is such a serious topic that I want to emphasize that elopement should be extinguished using a comprehensive behavior plan that addresses prevention strategies as well as consequence strategies. In other words, how will we prevent wandering? As well as, how will we find the child if they successfully escape?

*The suggestions included in this post do not negate the need to conduct a full FBA to deal with consistent, ongoing elopement attempts. A FBA will help reveal the reason why elopement behavior is persisting*

The main techniques I will address are: Reducing Risk, Antecedent Interventions, and Consequence Interventions.

Dealing with Elopement in Public

Reducing Risk- Before you go out in public with your child, explain to them where you are going. Use simple language at their cognitive level and talk about your expectations for their behavior. Explain that they need to stay with you, and may need to hold your hand. I have had parents tell me "But my child won't hold my hand". Well... it isn't optional. State your expectation for behavior, and tie it to reinforcement and consequences. For example "You need to hold my hand in the store, and then you can have iPad", as well as "If you won't hold my hand then it's time to leave the store". Teach the child to respond to their name (a vocal or motor response), and provide praise for them staying near you in public. Plan the outing in advance, know where the exits are, roughly how crowded it will be, if its near a busy street, etc. If possible take another adult with you to help catch the child if they attempt to elope. Consider getting an ID badge or bracelet for your child, and carry a recent photo ID of your child with you at all times. If the child has a communication system, teach them to respond to safety questions such as “What’s your name”, “What’s your phone number”, and “What’s your address”.

Antecedent Interventions- This would involve changing the triggers that precede the child eloping. Some individuals wander away when they see an interesting object. Some children wander away because it’s loud and crowded, and they are seeking a quiet place. Pay attention to how your child acts before they attempt to elope, such as covering ears, walking very slowly behind you, staring intently at items or objects, etc. Be on the alert so you can step in when you see a trigger. Get on your child’s level and ask them if they need to take a break. If the child can communicate, they can learn to request a break. Particularly in public settings like festivals, malls, or outdoor concerts, children with Autism may elope to escape from unwanted noise or large crowds.

Consequence Interventions- This would involve changing the way you react to your child wandering away, or attempting to wander away. Some children may wander away to gain your attention. Other children may wander away to escape you. It will vary. Once you determine why they are eloping, be sure not to give them the response they are seeking. If your child bolts at the grocery store because you strike up a conversation with another shopper, then do not provide huge amounts of attention for their elopement behavior. Go get the child with minimal eye contact and language, and bring them back to where the cart is. You also want to be sure to show them how to get your attention appropriately. You can teach them to request your attention appropriately, such as tapping your shoulder or using ASL to sign "Excuse me".

Dealing with Elopement in the Home

Reducing Risk- Modify the home environment to make it safer. Install heavy duty deadbolt locks on the doors and windows. Install an alarm in the home, or consider security cameras. Consider placing bells or motion detectors on all doors. Talk to neighbors and explain that you have a child who wanders, and may not respond to their name or to questions. Make sure close neighbors have your contact information and a photo of your child, so if your child ever wanders into their yard they can call you immediately. If there are many people in the home (such as for a party) have at least 2 people keeping an eye on the child. Write and post house rules, and one of the rules should be that the child cannot go outside without permission. Teach the child to respond to their name, and provide praise when they respond. Practice going into another room and calling the child, and provide reinforcement when they come find you.

Antecedent Interventions- This would involve changing the triggers that precede the child eloping. Start determining the triggers for the child attempting to elope. Many children display wandering behavior in the middle of the night if they can’t sleep. Other children wander away from home if they see something interesting outside, such as the ice cream truck driving by. Once you have identified the triggers, teach your child replacement behaviors. If they wander in the middle of the night teach them to stay in bed when they can’t sleep. If they wander outside to explore interesting items teach them that they need permission first. If the child can communicate they can request permission to go outside, e.g. an “Outside” picture card. When the child brings you the picture card, they are allowed to go outside (with supervision). Put the picture card away or cover it up at night, to signify that going outside at night is not an option.

Consequence Interventions- This would involve changing the way you react to your child wandering away, or attempting to wander away. When you see the child bolt, and you catch up with them, what is your reaction? Do you yell, become angry, cry, give a lecture? If the behavior is happening regularly, your reaction may be feeding the behavior. If you yell at your child every time they begin to wander away, then that child is wandering to get your attention. Try reducing the attention you provide for elopement, and give MORE attention for when the child is near you and within your sight. Use specific praise such as “Awesome playing on the front porch”. If the child steps off the porch, or tries to bolt into the street, get them back safely with minimal eye contact or language and place them on the front porch. Practice appropriate behaviors for being outside and staying near an adult using praise and reinforcement.

Resources-

Below is a list of resources and safety tools that can be used with individuals who elope or are at risk to elope.

http://www.autismsafety.org/wandering.php 12 Ways to Prevent & Respond to ASD Wandering

http://www.projectlifesaver.org Wrist bands with transmitters

http://www.americanmedical-id.com Identification bracelets

http://www.radioshack.com/home/index.jsp Purchase surveillance cameras

http://www.homesecuritystore.com Fingerprint detection locks

http://policeandautism.cjb.net/avoiding.html  How to alert police that you are raising a child who elopes (article written by a police officer)

http://www.awaare.org/docs/FWEP.pdf  Sample of a Family Wandering Emergency Plan

https://www.safetynetbylojack.com   Safety Net by Lo-Jack

http://www.amberalertgps.com  Amber Alert GPS

http://www.specialtyalarms.com  Child Specialty Alarms

**Quick Tip: Teaching a child to respond to their name typically means they look at you when they hear their name.  If you want the child to come back to you when their name is called, you have to specifically teach that. For children who run towards the street, you can use a simple statement such as "Stop" or "Freeze". If you yell out the child's name because they are running away from you, they may not understand they are supposed to STOP.