Wandering Poses Serious Risks to Children With ASD

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Children with an autism spectrum disorder often have a different sensory profile than those without, and they may wander because of an overreaction to sensory stimulation such as noises or smells.
Children with an autism spectrum disorder often have a different sensory profile than those without, and they may wander because of an overreaction to sensory stimulation such as noises or smells.

Numerous deaths and serious injuries have been reported among children with autism spectrum disorders (ASDs) after they wandered away–or eloped–from caregivers. A study reported in PLoS One in February 2016 is the first to investigate the prevalence of elopement in a nationally representative sample of US children with ASD and other developmental conditions. Using data from a telephone survey conducted by the US Centers for Disease Control and Prevention (CDC), researchers from the Division of Developmental and Behavioral Pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York analyzed parents' responses regarding 3518 children with developmental disabilities. The children were divided into 3 groups: those with ASD, those with intellectual disability (ID) and/or developmental delay (DD), and those with ASD plus ID or DD.

Analysis of the findings revealed that 26.7% of the children had eloped during the preceding year, with most incidents occurring in public settings. Children in both ASD groups were more likely to wander than those in the ID/DD group. “I suspect the most likely reason is that children with ASD don't have the same degree of social connectedness or engagement,” study co-author Andrew Adesman, MD, chief of Development and Behavioral Pediatrics at the center, told Psychiatry Advisor. “They will be less likely to engage in social activities–perhaps instead watching alone from the perimeter– and their social isolation may predispose them to walk away from a parent, guardian, or other supervising adult if given the opportunity,” he explains. Because children with ASD often have a different sensory profile than non-ASD children, they may wander because of an overreaction to sensory stimulation such as noises or smells.

“Given these risks, parents and care providers need to take extra precautions, because tragedy can strike in the shortest of intervals, whether it be a motor vehicle accident or drowning,” says Dr Adesman. “Children with ASD can wander from the most familiar locations like a backyard or schoolyard, or from less routine locations like shopping malls or while on vacation,” he cautions.

He says clinicians can offer the following tips to parents and guardians to help minimize risks:

Secure the home with physical locks and alarm systems. “These are likely the least expensive and most effective interventions if used consistently,” he says.

  • Have the child wear an identification bracelet.
  • Use one of several commercially available global positioning system (GPS) tracking devices.
  • Add wandering precautions to the child's individualized education program (IEP).
  • Teach the child to swim. Drowning is the most common cause of death in children with ASD. “In 2009, 2010, and 2011, accidental drowning accounted for 91% of total US deaths reported in children with an ASD ages 14 and younger subsequent to wandering,” says Dr Adesman.
  • Notify neighbors to remain alert to an unsupervised child.

“Clinicians need to remember that fear of a child with ASD wandering represents a constant source of stress and anxiety for parents, and it can severely limit a family's ability to engage in social activities with friends, neighbors, or relatives,” Dr Adesman notes.

Reference

Kiely B, Migdal TR, Vettam S, Adesman A. Prevalence and correlates of elopement in a nationally representative sample of children with developmental disabilities in the United States. PLoS One. 2016;11(2):e0148337. 

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