Elopement presents a major risk to your autistic child’s safety. Find out the causes for elopement, what prevention strategies to use, as well as how to plan for a possible elopement.

Autism Elopement Prevention & Safety

Elopement or wandering can be defined as when someone who may require supervision leaves a safe area or a responsible caregiver. When that person is an autistic child, the consequences can be tragic. Autistic children who elope often fall victim to harm through traffic accidents, drowning, falling, extreme weather, or even encounters with predators (human or otherwise).  

When faced with such a terrifying prospect, it is no wonder that parents of autistic children can be tempted to employ extreme measures to protect them without considering whether their interventions will be effective or not.  

The fact, however, is that nearly 50% of autistic children have eloped at some point in their lives, often with tragic consequences, and many parents are left in a constant state of anxiety.  

According to the Organisation for Autism Research (OAR) following their Safety Planning Cycle helps parents to constantly equip themselves and their children with the tools and skills to secure their child’s safety through prevention and planning. 

Why do autistic children elope? 

Firstly, it is important to understand why many autistic children elope. In their review of the assessment and treatment of elopement, Dr. Megan Boyle and Dr. Reesha Adamson of Missouri State University describe the four most common reasons for elopement as follows: 

1. To get away from a place, activity, or person (escape) 

2. To obtain access to an item, activity, or person 

3. To engage in an intrinsically pleasurable activity, such as running 

4. To gain attention 

Understanding your child’s triggers makes prevention and safety much easier to manage. If it is not immediately apparent why a child elopes, consider keeping a log of every elopement, to help you identify trends.

Here are a few questions to guide what to log: 

• What sequence of events preceded the elopement? 
• Who was present? 
• Can you remember any significant stimuli or obvious triggers? 
• Where was the child going?
• What happened after the elopement?   

Once there is a fairly good understanding of the reason for elopement, parents need to develop an elopement prevention plan that anticipates these triggers and mitigates the need for elopement as a response.  

The prevention plan may include some of the following interventions. 

The Safety Planning Cycle

There are five basic steps in the Safety Planning Cycle: 

1. Understand

What does your child need? What makes the child safe or unsafe in a particular situation?  

2. Prepare

What skills does your child need to practice in order to be safe? What resources do they need? What can be done to support your child?  

3. Practice 

Once you’ve created your plan and identified the various tools and skills, implement them and find effective ways to reinforce them. 

4. Share

This is a key step towards securing your wandering child. Share your plan, skills and tools with everyone entrusted with your child’s safety as well as those who form part of your support network. From school teachers to community safety personnel like police and firefighters and EMS, the more people who are aware of your needs, the safer your child is. 

5. Update

Work with your child to constantly assess the plan, tools and skills. See what works and what doesn’t then revise and update the plan accordingly.  

Behavior modification

Elopement prevention for children with autism should go beyond just locking the house down to create a gilded prison for your child. Remember that a child who feels safe, who feels that they have choice in their decisions, and who feels that all their physical and emotional needs are met, are far less likely to elope.  

Your prevention plan should therefore begin with behavioral interventions that reduce the need for your children to elope. These should also be supplemented with more practical interventions to inhibit them should they be overcome with the urge to run.  

A behavior intervention plan for preventing elopement should focus on addressing the triggers mentioned above. A key tool in this is to implement Functional Communication Training (FCT), a process of reinforcing alternative behaviors to elopement that meet the needs of the child as defined by the triggers. Here are a few FCT interventions that you can discuss with your professional support network to consider in your plan.  

Attention-seeking 

In the case of a child seeking attention, parents should use visual aids to teach the child how to get their attention without running away. Parents, who are often the preferred person, should be the ones using visual aids to reinforce the alternative behavior. It might also help to give increased fun and exciting attention in spaces where you want your child to stay.   

Parents should avoid overly angry responses in response to elopement as this will make it even more reinforcing for attention. Instead, provide positive reinforcement for all things you want your child to do, other than elopement.

 

Trying to escape

First, try to identify what would trigger a child’s need to escape a particular situation. This could be overstimulation, change in environment, or even just a chaotic or noisy environment.  

Parents need to teach their children how to ask for a break from whatever the trigger is rather than elope. If they run anyway, it is important to bring them back, safely and then review better strategies for escape in the future. 

Once back, parents should adjust the task or change the environment to reduce the stress on the child by introducing breaks or moving to a quieter room. This should then be followed by positive reinforcement of getting back to the task. Again, meeting elopement with anger will trigger further elopement or in this circumstance, turn it into a game.  

Doing something pleasurable

Sometimes referred to as “automatic reinforcement or maintained behavior,” autistic children often elope simply to engage in something they enjoy doing, like running or the feeling of the breeze outside.  

In cases where automatic reinforcement is the trigger, parents need to provide more regular access to that activity in a controlled environment. This will reduce the impulse to elope to access it. For example, a child who loves running should have additional access to a gym or track with supervision.  

Desire to access an item, person, or area

Where the trigger is a desire to gain access to an item, person, area, or activity, parents need to teach their children how to ask for it or access it in a safer way. It is also important to establish a routine for access and explain when they will get access and reinforce this by making absolutely sure that they get it on schedule. A break in routine will definitely encourage elopement.  

Teach your child essential skills

Here are some situational elopement strategies on how to prevent autistic children from wandering off, as well as ways to protect them should they succeed.  

Swimming

Swimming lessons for children with special needs can be difficult to find. The YMCA in many locations across the country offers this specialized service at affordable rates. 

How to navigate traffic

Teach your child basic traffic navigation skills like what traffic lights mean, when and where to cross the road, and how to avoid moving vehicles.  

Stay with you in public spaces

Teach your child to understand the difference between walking and running. Reinforce holding hands or to walk within 6-12 inches of an accompanying adult as well as words like “go, walk, stop”. Reinforce things like staying by the cart in a grocery store, or keeping a hand on the cart in a parking lot.   

How to communicate contact information

Verbal children can be taught to memorize parents’ phone numbers, addresses, and other critical information and should be taught how to provide the answers. This may be difficult or impossible for non-verbal children so alternative means may be necessary in the form of an ID bracelet or card. Even in verbal children, this is a useful tool.  

Practical interventions

Behavioral interventions will only go so far towards mitigating the underlying reasons for elopement while skills are usually employed once in distress. Even if you have a high-functioning autistic child, there may still be a risk of elopement, which requires parents to take very practical steps towards preventing a child from wandering off and to be in a state of readiness should the child elope.  

Create an emergency plan

There are many resources available with templates for an emergency plan in the case of elopement. This plan should include emergency contact information and a step-by-step guide on what to do should your child wander off.  

Your emergency plan should include things like a Google map of the area, a 911 emergency call script, highlights of dangerous areas like bodies of water and high-traffic zones, possible points of interest for your child, etc.  

You should have multiple copies of the plan stored in your home, car, office, school, etc. Be sure to share the plan with key people in your safety network like neighbors, schools, EMS, and others, especially if your child has a history of elopement in the past.  

Secure the home 

In instances where your child routinely wanders, you may need to consider securing your home with locks for your doors and windows, home alarms, printed STOP signs around the house, and even fencing off your yard. It would be a great idea to discuss these options with your local emergency responders to determine what is most appropriate, but also safe.  

Explore a tracking device 

There are numerous wearable tracking devices that use different methods. Some use radio frequencies and triangulation while others use GPS. Consider the right wearable for your child. Some may prove irritating and be removed.  Many devices double up act as elopement prevention devices by alerting parents when a child leaves a predetermined radius or location.  

ID bracelets

Traditional medical ID bracelets will include your name, telephone number, and other important information. They may also state that your child has autism and is non-verbal, if applicable. If your child will not wear a bracelet or necklace, consider other means of ensuring that critical information is located on your child.  

Establish a safety network 

Informing those around you and your child of your child’s vulnerabilities will go a long way to preventing wandering into extremely dangerous situations.  

Introduce your child to your neighbors 

Creating a safety network starts with those in closest proximity. Introduce your child to the neighbors and try to establish a rapport where possible. Provide them with a picture of your child so they will recognize them.  

Introduce your child to first responders

Providing first responders with key information before an incident occurs may improve response. Informational handouts should include all pertinent information and be copied and carried with caregivers at all times. Circulate the handout to family, neighbors, friends, co-workers, and first responders. See the tool kits below for resources to use to alert them. 

Work with your child’s school

Ensure that your child’s school has a crisis plan in place in anticipation of possible wandering and elopement of autistic children.  

What to do if your child elopes

Should your child manage to elope, follow these steps to reduce the possibility of harm and ensure a speedy recovery.  

• Call 911. 
• Locate your emergency plan and follow the action steps.  
• Alert first responders in your area and request an amber alert.  
• Explain to first responders that your child has autism and, if applicable, that their cognitive impairment makes them unaware of danger. Explain how they should interact with your child and what may trigger a flight response or paralysis. Give them suggestions of what to do and what not to do specific to your child’s needs.
• Request that your child’s information be immediately entered into the National Crime Information Center (NCIC) Missing Person File.  
• Alert neighbors and enlist them to help search for your child.  
• Distribute prepared materials with the following details: child’s name, communication level, how to calm your child if they are distressed, a recent picture of your child, caregiver’s contact information, and places your child is likely to go to. Distribute this information to individuals in your search party as well as public authorities. 

Lighthouse Autistic Center

The Lighthouse Autism Center is the Midwest’s leading autism therapy institution, which also provides world-class autism resources and is the proprietor of their unique, ground-breaking Lighthouse Fusion ABA Therapy program, which fuses the best practices of ABA and speech therapy into a one-of-a-kind clinical model to deliver better outcomes for autistic children. 

We look at the best ways to navigate your autistic child’s school refusal. Find out how to work with the school and how to aid your child.

Navigating Autistic Child’s Refusal To Go to School

School can be a frightening and overwhelming place for many kids, especially autistic children. This can cause a child to refuse to go to school. With all of our knowledge and autism resources, we will navigate the reasons and how to address autistic children’s school refusal in a positive and proactive way. 

What is school refusal?

School refusal can occur when children become distressed thinking about going to school. Although allistic (non-autistic) children may also struggle with this problem, it may be more pronounced in autistic children. Autism and school can lead to a tough environment as factors such as sensory challenges, difficulties with reading and verbal comprehension, and executive functioning fine and gross motor skills all play a part.  

School refusal can go from being reluctant to go to school to not being able to leave home or go to school at all. This will result in the child missing some or even all of their school days.  

What are the signs and symptoms?

The signs of school refusal are similar between autistic and allistic children. Knowing what to do when your child refuses to go to school can be difficult as you try to navigate the reasons. Let’s take a look at some of the signs and symptoms of school refusal:  

• Your child begs and pleads not to go 
• Trouble sleeping the night before school 
• Increase in complaining of being sick and feeling unwell before a school day 
• An increase in anxiety  
• More meltdowns and avoidance behaviors 
• Difficulties following morning routines 

When it comes to learning how to help a child with anxiety about school, it is important to understand the reasons behind these heightened feelings. Here we will look at the reasons behind school refusal. 

The reasons behind autistic children’s school refusal

Some children may find it difficult to cope with the demands that the school environment can place on them. It is very important for the parents to get to the root cause of the problem. It’s very important to act quickly on these signs that suggest your child’s school refusal. School refusal will not go away on its own. Let’s take a look at some of the added pressures of the school environment and what your child could be experiencing. 

• Your child may lack social skills, which could cause them to struggle to make and keep friends, or they might experience some form of bullying. 
• The school curriculum could be a bit difficult for them to cope with. Autism support in schools may not exist. 
• They might struggle to cope with the school timetable. 
• The sensory differences in the school environment could be overwhelming, such as noises, lighting, and smell. 
• They might get into trouble with their teachers for unintentionally being inappropriate or not respecting authority. 
• Sudden changes in their routine could be difficult. 

How to strategize with the school

Autism  support in schools is needed to ensure that autistic children can thrive in the school environment. You can use your understanding of your child to identify coping strategies that can be used in schools. Here are some ways to strategize with the school: 

• Make sure to utilize your child’s IEP (individualized education plan) to get the supports needed.  
• Request the school to make some reasonable adjustments at the start and end of your child’s school day. A staff member your child feels comfortable with could meet them at the school entrance. 
• Ask the school if extra breaks could be allowed for your child throughout the school day. This will allow your child to redirect their attention and energy to different activities. 
• Ask the school if they are willing to reward your child for some small improvements in achievement. 
• Find out if autism support in the school for staff is an option. More autism awareness will ensure that your child’s needs are met. 
• Be sure to set up a regular meeting with your primary contact at the school. This is often the teacher of record on his/her IEP, but could be the home-room teacher, principal, counselor, or student support group. 

Working on school refusal strategies at home

Of course, there are some practical strategies that you can implement at home!  

• Acknowledge their feelings: show your child that you understand their feelings and anxiety about going to school. 
• Make it clear and reassure them that things will be okay at home if their biggest fear is leaving home. 
• Regularly remind your child about activities that can help them feel calm, such as using a fidget toy or practicing deep breathing. 
• Set up a routine for the morning to set your child up for success for the day 
• Set a plan for reinforcement right when your child gets home to make a successful day a big deal 

Lighthouse Autism Center is here to help

At Lighthouse Autism Center, we provide the highest quality therapy! Compassionate care meets clinical excellence in a beautiful play-based environment. Contact us and find out about all our services, such as Lighthouse Fusion ABA therapy and so much more! 

Children with autism may struggle with sensory issues that lead to sensory seeking or sensory avoiding behavior. We explore these two types of behavior, their causes, the problems they may create and how they can both lead to sensory overload.

Sensory Seeking vs Sensory Avoiding in Autistic Children

Many autistic children have a variety of sensory processing issues that can affect their behavior, of which the main two types are sensory seeking and sensory avoiding. Join us as we explore the difference between these two categories of sensory processing issues in autistic kids and how you can help them understand their sensory experience better.

Understanding autistic children who are sensory seeking

If your child prefers to get a lot of stimulation from their environment, they are likely sensory seeking. Autistic children who are sensory seeking are considered “hypo-responsive” and tend to exhibit the following sensory seeking symptoms or characteristics:

• Prefers to be moving
• Likes to smell things
• Enjoys being touched, tickled or massaged
• Has a habit of fidgeting with things
• Standing very close to people when talking to them
• Likes to jump, hop, spin, rock and other repetitive motions
• Will slam or thrust their body into things
• Enjoys touching objects and people
• Likes loud noises and enjoys making them
• Likes to put non-food items in their mouth and chew on things
• Enjoys engaging in risky behavior
• Prefers to go barefoot

What causes sensory seeking behavior?

As with autism, exactly what causes sensory seeking behavior is not yet known. We only know that some autistic children are under-responsive to sensory input, others are hyper-responsive and yet others are a mix of the two. Because of how their bodies experience and process sensory input, they will then engage in behavior that will help them meet their sensory needs.

The problems affecting those who are sensory seeking

If you have a sensory seeking child, it may have a negative impact on their life, especially if they do not learn how to manage their sensory needs in appropriate ways. Here are three examples of how a child may struggle if they are sensory seeking.

Might cause themselves physical harm

Firstly, a child may unknowingly engage in dangerous behavior to meet their sensory needs. For example, they may jump from dangerous heights or come up with their own risky stunts to stimulate themselves. 

Might be ostracized by others

Secondly, certain behaviors might provoke negative reactions from those around them. For example, if an autistic child randomly touches other children and adults without their consent, these people may choose to avoid the child.

Might struggle in learning spaces

Finally, they may struggle to pay attention due to the fact that they are constantly seeking out higher levels of stimulation. This could negatively impact learning and academic performance in a learning environment.

How to help those who are sensory seeking

Your first port of call when it comes to helping an autistic child who is sensory seeking is a professional, such as an occupational therapist, who will be able to directly assist your child with their sensory seeking behavior. 

There are also activities that you can engage in at home to help your child meet and manage their sensory needs. Some examples of these activities include:

• Jumping on a trampoline
• Bouncing on an exercise ball
• Climbing on a jungle gym
• Have a pillow fight
• Using a weighted vest
• Letting them play with specifically designed sensory toys, such as weighted toys, scented play-doh and sensory bins
• Practicing respecting personal boundaries
• Practicing asking and waiting for explicit consent before touching anyone

Understanding autistic children who are sensory avoiding

If your child prefers to avoid being stimulated by their environment, they are likely sensory avoiding. Autistic children who are sensory avoiding are considered “hyper-responsive” and tend to exhibit the following:

• Has a greater sensitivity for smells
• Easily startled by unexpected sounds or bright lights
• Avoids crowded areas in favor of quieter environments
• Filters out fewer sounds compared to neurotypical children, which means they “hear more”
• Likes to wear headphones or earplugs to block out unwanted sounds
• Incredibly sensitive to pain
• Doesn’t like clothes with certain textures or clothes that are too tight
• Finds seams or tags in clothes incredibly annoying
• Is very picky about what they like to eat
• Doesn’t like being touched, even if it’s affectionately or playfully
• Dislikes being barefoot

What causes sensory avoiding behavior?

As with autism, we don’t know what causes sensory avoiding behaviors. What we do know is that some autistic children are overstimulated by certain activities or situations, which they then try to avoid so as not to overwhelm themselves.

The problems affecting those who are sensory avoiding

Sensory avoiding behaviors can affect your child negatively, most especially if they do not learn healthy coping mechanisms to meet their sensory needs. Here are a few ways sensory avoiding behavior can impact your child’s life.

May avoid activities and environments to their detriment

A sensory avoidant child may develop anxiety around activities and environments that make them uncomfortable, even if these things would benefit them, such as playing games with their peers or exercising on a playground.

May struggle to make social connections

Connected to the point above, if an activity or space is uncomfortable for your child with autism, they are likely to avoid it, which could, in turn, cause them to withdraw from social situations. For example, if they don’t take part in school games during breaks or are anxious about attending birthday parties, they may struggle to make social connections with other children.

Another example is that while other children may enjoy playing on a bouncing castle and all the rough and tumble that comes with it, a sensory avoidant child may not. Consequently, they may have to deal with feelings of loneliness, frustration, anger, sadness or being “left out” when they are the odd person out in such situations.

How to help those who are sensory avoiding

Again, as with sensory seeking children, you should seek out specialists who can help your sensory avoidant child learn to manage their sensory challenges. An occupational therapist or other health professionals can help you address your child’s needs.

There are also various precautions you can take to help your sensory avoiding child not feel overwhelmed. Some examples of these include:

• Decluttering an environment
• Keeping a pair of noise-canceling headphones nearby
• Making sure their clothes are not too snug and are made from materials that they are comfortable wearing
• Trimming the labels off their clothes
• Considering a weighted vest or blanket to help them feel more comfortable when overstimulated
• Preparing a quiet, calming space for them at home so that they have an area to retreat to if needed

Autistic children can have both sensory seeking and sensory avoidant traits

While we’ve split sensory seeking and sensory avoiding into two sections, it’s important to note that some autistic children can have characteristics of both categories.

What about sensory overload?

Regardless of whether your child is sensory seeking or sensory avoidant, they can still experience sensory overload. Sensory overload is when your brain is overloaded by the sensory information it is receiving. The amount or type of sensory information that causes sensory overload differs from person to person.

Sensory overload symptoms

Here are some of the signs of sensory overload:

• Anxiety, irritability, stress, fear or panic
• Overexcitement or restlessness
• Physical discomfort
• Need to limit source of overload by covering ears or closing eyes
• Need to leave area or space where the cause of the sensory overload is
• Tantrums or “meltdowns”

How to help with sensory overload

Here are some tips for managing and coping with sensory overload:

• Take preemptive steps to avoid triggers that cause sensory overload for your child, such as asking for lights or sounds to be turned down. 
• Ensure you are able to easily leave the location so that your child has the space to recover from sensory overload. 
• Be prepared by making sure your child has enough rest the night before and is properly hydrated. 
• Have a sensory toolkit filled with items that can help your child calm down, such as noise canceling headphones, sunglasses, fidget spinners and other objects that can help your child relax. 
• Talk to a health professional about medications that might be useful in avoiding or minimizing the consequences of sensory overload. 
• If possible, make sure those around your child are aware that they might become overwhelmed by specific triggers and explain to them what those triggers are. 
• Most importantly: help your child identify and understand their own sensory needs and triggers as far as possible – this could go a long way in helping them learn to manage their sensory issues in healthy ways. 

Discover how Lighthouse Autism Centers can help your child

At Lighthouse Autism Center, we offer our unique Lighthouse Fusion® ABA therapy program which combines the best aspects of ABA and speech therapy. This program, as well as our autism resources, are vital in helping your child unlock their full potential.

The picture exchange communication system, or PECS, is a teaching system that can help an autistic child or another individual with speech difficulties improve their communication skills. We take a look at PECS’ role in ABA therapy and unpack how it works.

Picture Exchange Communication System and its use in ABA Therapy

Many autistic children have difficulties communicating verbally. PECS is one of the many tools we use in ABA therapy to help them increase their independence and improve their outcomes. Join us as we further unpack PECS, how it works, the benefits it offers, and more.

What is PECS?

The picture exchange communication system, or PECS, is a communication system that was developed in the USA in 1985 by Andy Bondy, Ph.D., and Lori Frost, M.S., CCC-SLP, the founders of Pyramid Educational Consultants, Inc. It is based on the book “Verbal Behavior” by B. F. Skinner. 

This augmentative or alternative communication system was first used to assist autistic preschool students who were part of the Delaware Autism Program. It is now also used to help people of all ages with communication difficulties that are caused by many conditions. 

How PECS works

One of the downsides to other programs and methods designed to help those with communication issues, such as sign language and picture point systems, is that they rely on the teacher to initiate communication with a student. This creates a situation where the student learns to only respond in communication and to never initiate it themselves. The main goal of PECS is to help address this by teaching students to communicate more spontaneously using specific prompting and reinforcement strategies and avoiding verbal prompts, as well as improving their functional communication skills. 

Implementing PECS

Regardless of whether you are using the PECS program for autism or other causes of communication-related challenges, it has a specific process that you need to follow.

Complete reinforcer sampling

Before the PECS protocol is implemented, it’s important to first complete “reinforcer sampling.” Reinforcer sampling simply refers to the creation of an inventory of activities, toys, or other items that the student likes so that these items can be used as motivators during PECS. 

This inventory is created using an assessment process that can be completed in numerous ways, such as asking caregivers, observing the student and what they choose most and least often, and presenting the learner with pairs of options to see what they like the most. The reinforcers that are chosen will need to be consistently appealing to the learner in order to assist with PECS.

The six phases of PECS

Phase 1: How to communicate

In phase one, the student learns to initiate communication by exchanging pictures for things they really want or activities they want to take part in with a second trainer, who is the student’s communicative partner. (These desirable items and activities were identified during the complete reinforcer sampling stage.)

Phase 2: Distance and persistence

During phase two, the student learns to use this skill of exchanging a picture to get something they want in different places. They learn to do this by seeking out their communicative partner. They are also taught to initiate communication with other communicative partners using the same system. This is accomplished using different desirable items and activities. 

Phase 3: Picture discrimination

During phase three, the student is now tasked with asking for two or more of their favorite things, using multiple pictures. These images are stored in a PECS Communication Book, which allows for easy removal and return of images used by the student.

Phase 4: Sentence structure

In phase four, the student learns to complete basic sentences using what are known as Sentence Strips. These strips begin with an “I want” picture, with the student adding the picture of the item they desire to the strip from the PECS Communication Book. Once the student has demonstrated the ability to make this request, additional detail is added to these statements using descriptors, including the number, color, shape, or size of the object that they want.

Phase 5: Responsive requesting

Phase five asks the student to engage with the question “What do you want?” and to respond using the skills and tools they learned in phase four. When asked this question, the student must use the Sentence Strips and pictures from their PECS Communication Book to provide an answer.

Phase 6: Commenting

In the final phase of PECS, the student learns to answer other questions such as “What do you see?”, “What do you hear?” and “What do you smell?”. This is done by teaching them to use additional phrases such as “I see,” “I hear,” and “I smell” on their sentence strips, expanding their requests beyond “I want.”

The benefit of PECS

There are many benefits to teaching using PECS. Here are some of the advantages that it offers to autistic children:

• Helps make communication a more understandable process
• Improves the initiation of communication
• Can decrease problem or negative behaviors
• Can help improve social skills and allow students to build relationships
• Easy to learn for a student’s partner
• Increases the use of speech in some learners

Find out more about Lighthouse Autism Centers and how we use PECS

At Lighthouse Autism Center, we provide PECS for autism treatment and to help our students achieve better outcomes. We also provide autism resources so that you can better navigate this spectrum disorder and more insight into our Lighthouse Fusion® ABA therapy program and how it can help your child.