AUTISM AND WANDERING

Reported by Lirio Sobrevinas-Covey, Ph.D.

Wandering or “elopement” from their habitual and safe settings is a behavior commonly seen among children with autism spectrum disorder (ASD). These behaviors are often a form of communication — the person’s means of expressing a need, a want, or a state of anxiety. Accidental drowning, traffic injuries, falls, encounters with strangers, heat stroke, dehydration, are some of the dangers associated with wandering.

Most children with ASD who are wanderers outgrow this behavior; however, wandering also occurs in autistics older than 16 years. Wandering sometimes occurs in group homes for autistic adults, requiring these settings to install preventive procedures such as door alarms.

Here are some facts about elopement listed by Dr. Patty Huang, M.D. from a survey of parents of more than 1,200 kids with ASD and her suggestions on how to reduce the risk of wandering.

• Nearly half of 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 three fourths 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.

• The first step in managing and reducing the risk of wandering 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.

• 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.

Source: Patty Huang, M.D. Newsletter of the The Children’s Hospital of Philadelphia, Center for Injury Research and Prevention.