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Saturday, 27 April 2024

What is Elopement in the Child With Autism?

It can happen in the blink of an eye. One moment your child is close, the next, they’re nowhere in sight. For the parents of a child with autism, wandering away — commonly called “elopement” — is a real and present worry. Plan and prepare for elopement, says Tisa Johnson-Hooper, M.D., medical director at the Center for Autism and Developmental Disabilities at Henry Ford Health.

In children with autism under the age of 7, 50% will have some type of elopement behavior. During each visit, Dr. Johnson-Hooper helps parents create a plan to prevent their child from wandering off or escaping.

Tips for preventing elopement

Think ahead to your child’s next developmental stage. Your 2-year-old may not be able to use a key in a lock placed high on a door. Eventually, they will have the fine motor skills to unlock a door or window — and be able to climb, too.

Alarms that alert parents and caregivers when doors and windows are opened can add another layer of protection, says Sarah Peterson, manager and lead board certified behavior analyst (BCBA) with Henry Ford Health’s Center for Autism and Developmental Disabilities.

“An alarm can be very helpful because parents can grab their child before they get too far away,” Peterson says.

If your child is in ABA therapy, talk to your BCBA. Together, you can tailor an appropriate prevention plan for your child’s developmental stage. Peterson shares an example of a child who typically wandered away during trips to the grocery store.

“What I had the family do was take more trips to the grocery store, but for shorter periods of time,” she explains. She recommends starting at just two minutes a visit.

“They could leave on a good note of their child staying with them, and then they’d get some sort of reward afterward for staying close to the parent. And then slowly increase the time,” she says. “I encourage parents to start small.”

Some families discover that their family dog steps into the role of protector, sleeping at the door outside the child’s room at night and guarding the front door during the day.

“There are dog trainers who many work specifically to train a family dog for this purpose,” says Dr. Johnson-Hooper. “I do love that when you are thinking about therapies or interventions, if the family can identify ones that are just natural. It’s natural to have pets, and if you can just simply train your dog, that’s a great thing.”

More ways to keep your child close

Other tips to prevent elopement during trips in the community include:

  • Holding hands, especially in parking lots.
  • If your child doesn’t want to hold your hand, they can hold onto the cart, your purse, or dad’s backpack instead. This can be helpful when you need to use your hands for other tasks, like picking out produce at the store.
  • Put young children in the shopping cart. Save walking around for a place where you can focus on keeping them close.
  • Make the case for a disability parking placard from your child’s doctor — or see if this is available through your ABA therapy clinic. “In my mind, the closer you can get to the door, the less chance your child can get away from you in a potentially dangerous environment,” says Dr. Johnson-Hooper. “It’s not an ambulatory issue, it’s a safety issue for older children who are bigger, faster, and stronger.” When she authorizes a parking placard, as the reason needed, she writes in “Autism. Significant risk of eloping.”

It feels easier to leave your child at home, but resist this temptation, says Dr. Johnson-Hooper.

“I understand that as a parent, you just want to get through that activity in peace. But how will a child ever learn if they don’t have the experience and exposure? That’s part of preventing this outcome of eloping. When they practice and don’t elope, reward them for safe behavior. Be consistent and persistent” she says.

Ways to prepare for the best outcome if your child with autism elopes

If your child does elope, how do you find them quickly? Labels in your child’s clothing and an ID bracelet are a good start. Additionally, you can put a GPS or cellular tracking device in their pocket. You can also work with your child’s BCBA to help them learn to share identifying details and a phone number.

You can also make sure everyone in your neighborhood knows who your child is and can name them on sight. Dr. Johnson-Hooper did this when her own kids were young.

“And for a child with autism, you should take them to your neighbor and say, ‘Hey, this is my little kiddo, he’s 5, he loves being outside, but he’s likely to wander. This is his name. He’ll respond to this if you see him. This is my contact information.’”

Don’t be surprised if your neighbors become your extra eyes and ears — something you’ll welcome when you need it.

Is your child running away from something — or toward something?

When your child elopes, they’re often escaping something, such as noises, crowds, or lights. Or, they are seeking something favored, like trees or dogs. Your child’s BCBA can also help you determine what can trigger elopement, says Peterson.

“It’s individualized. However, if parents have children who elope, what they can start to do is look at the situations around when eloping occurs and that will help them get a better understanding,” she says. “If a certain noise happens or a situation happens, the likelihood my child is going to elope is pretty high, so they could hold their hand or be in closer proximity to them. There usually are some signs if you look closely at the situation of the person eloping.”

On elopement: two critically important situations to bear in mind

1. Swimming pools, lakes, bodies of water

Water is one thing children with autism often seek when they elope. Drowning is the No.1 cause of death in children with autism.

“I recommend swim lessons as soon as possible because a lot of the times, they get to a body of water and they don’t know what to do,” Peterson says. Find your nearest YMCA or ask at any of the new swimming schools in southeast Michigan.

2. Law enforcement

One thing to be aware of is when a teenage boy or young man leaves home and encounters the police. This situation can escalate. Keep an eye out for this. If it happens, it is crucial to handle it carefully.

“Many of my families who have young men who elope, especially those of color, fear that their child will not be given the grace and that space to not be responsive to law enforcement,” says Dr. Johnson-Hooper.

The way to preempt possible conflict, she says, is to get to know law enforcement in your community and make sure they know your child. Introduce your child to all law enforcement officers in the area. Share his picture with them. Explain the steps you are taking to prevent him from wandering off. Then tell them what they need to do if they see him.

“You need to alert law enforcement that your child has autism, lives in the community, and is at risk of eloping. Sometimes you may even need to explain what autism is and that he’s not going to respond to his name,” she says.

Take the time to educate others about your child and where you live. And, says Dr. Johnson-Hooper, give people grace. They may not understand how autism increases the risk of elopement, or that you are doing everything you can to prevent it.

Expertise from the Center for Autism and Developmental Disabilities at Henry Ford Health. Learn more at henryford.com/services/autism.



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