Autism Health and Safety Issues
By Vincent Iannelli, M.D., About.com Guide
Updated August 01, 2012
Parents of children with autism have a lot of health and safety issues to think about when it comes to taking care of their child, from evaluating the latest biomed treatments (vitamins and special diets, etc.) to how to get him to keep his seat belt on.
Unfortunately, parents aren’t always prepared for many other health and safety problems, such as the tendency for kids with autism to elope or wander away from their home, to dart away in a crowd, or especially what to do when your child with autism becomes an adult.
Little formal research has been done on wandering, or the tendency for children with autism to leave a safe place and put themselves into dangerous or even life-threatening situations, even though it is thought to occur at a rate that is almost four to eight times higher than in other children.
Wandering sometimes just leads to a call to the police for help finding a lost child, or a close calls with traffic accidents or drowning, but it can be much worse, including recent tragedies like:
- the 11-year-old boy with autism in Stafford, Virginia who drowned in a retention pond near his home.
- the 5-year-old with autism in Bradenton, Florida who drowned in a retention pond behind her family’s home. She had wandered out of the home through a sliding glass door.
- the 10-year-old with autism in Riverview, Florida who drowned in a small neighborhood pond after wandering away from a birthday party.
- the 4-year-old boy with autism in Westborough, Massachusetts who drowned in the murky water of an apartment complex swimming pool after wandering away from his home by pushing out the screen of an open window. The pool was surrounded by a 6-foot-tall chain link fence with a locked gate, but the boy was able to go under the fence by pushing through a loose section of the fence.
- the autistic 13-year-old who was found after roaming the streets and subways of New York City for three days without food or water.
Why do kids with autism wander?
Although it is sometimes just because they like exploring, are heading for a favorite place, or to pursue a special interest, some kids with autism wander to get away from things. They may be trying to escape a stressful situation that is making them anxious or a loud noise.
The 13-year-old in NYC is thought to have wandered because he was trying to avoid a bully on the school bus.
You probably can’t stop kids with autism from wandering, but you might be able to decrease your child’s risk of wandering or getting hurt if he does wander by:
- using a layers of protection plan to keep your child safe, which means using more than type of child safety technique, barrier, or warning, as a protection against a specific hazard. That way, if one protective layer breaks down, then one or more of the other layers of protection will still be in place to keep your kids safe.
- childproofing your home so your child can’t easily get out or get out without being noticed, including a home security alarm that goes off when doors and windows are opened, window guards (even on the first floor), and a fence with self-closing and self-latching gates around your yard.
- making sure your pool is well childproofed and try to get nearby pools, ponds, and other bodies of water childproofed too
- if possible, teaching your child his name, address, and phone number, or at the very least, have that information on him at all times using a medical ID bracelet, necklace, tag on his clothes, or even a temporary tattoo
- having a designated watcher for your child at family gatherings, parties, or trips out of the house.
- considering the use of a personal locating GPS tracking system and/or an autism service dog
- eliminating wandering triggers
- educate local first responders about autism
Most importantly, have a plan to call 911 and check the places in and around your home that pose the greatest danger to your child, including pools, hot tubs, ponds, cars and car trunks, and streets with a lot of traffic. After checking these hazardous spots, you can then check other places your child might be likely to go. You could even compile a list of people in your area that you could call when your child is missing, with each searching a designated area.
Childproofing for Kids with Autism
Parents often underestimate the risk that children with autism have to be injured, despite the fact that research shows them to have five times the mortality rate from things like drowning, poisoning, and suffocation, than other children.
Children with autism are also two to three times more likely to need emergency medical attention from severe injuries than other children.
In addition to making sure your pool is well childproofed, help keep your child with autism safe from household poisons, poisonous plants, medications, and other poisons in and around your home by childproofing your home and keeping the number to poison control handy.
Also look to protect your child from many of the hidden dangers that parents don’t always think about, such as TV and furniture tip-overs, glass-topped tables, bunk beds, trampolines, lawn mowers, and home exercise equipment.
And while many parents let down their childproofing guard once their kids are in school, you should likely continue to childproof your home even as your child with autism gets older.
Safety Skill Training
While supervision and childproofing is an important way to keep your child with autism safe, it is also important to try and do as much as you can to teach your child to avoid danger himself, such as by teaching your child:
- his full name, phone number, and address
- to get an adult when someone rings the door bell, instead of simply opening the door
- to get an adult if they find a gun, cleaning chemicals, or other potentially hazardous things in or around their home
- how to seek help if he gets lost
- what to do if he is approached by a stranger
- to get out of the house if he hears a smoke detector go off and follow the family home fire escape plan
- how to safely cross the street
Of course, how much you can teach your child with autism is going to depend on how severely he is affected. The manner in which you teach him these safety skills, whether by using role-playing, computer programs, virtual environments, or another method, will also vary from child to child.
Teaching your child with autism to recognize and avoid common dangers will hopefully help him avoid many types of accidents and tragedies.
Puberty can be a difficult time for any child and their parents.
Issues of sexuality, sexual behaviors, personal hygiene, menstruation, nocturnal emissions, spontaneous erections, and masturbation are all things that parents of children with autism will likely have to address at some point, as all parents do.
Masturbating in public, inappropriately touching other people, and exposing themselves in public are some problematic behaviors that some parents and teachers begin to see as autistic children enter puberty.
Talk to your pediatrician, your child’s therapists, and other parents to get help preparing yourself and your child for puberty. While you might see some regression in your child’s behavior, you might also see some improvement. Either way, puberty is another stage of life that your child with autism will have to transition through and by being prepared, you can help make sure it goes as smoothly as possible.
As your child with autism approaches 18 years of age, but hopefully several years before he reaches the legal age that he will become emancipated and will be considered an adult, you should consider if you need to establish guardianship for your child.
With guardianship, you will still be able to talk to your child’s doctors and help him make health decisions, in addition to being able to:
- be involved in transition meetings at school
- help your child apply for local, state, and federal benefits
- protect your child from being cheated and entering into contracts that aren’t in his best interest
- help your child with financial decisions
Alternatives to full guardianship include a limited guardianship to make decisions in certain areas or a conservatorship to only manage their finances.
A local autism support group should be able to put you in touch with a lawyer and other resources if you think you need to apply for guardianship for your child with autism or if you need help with any of these other issues. Your pediatrician and other health care professionals that work with your child can likely be helpful too, especially once you understand that you should be asking and thinking about all of these things.
American Academy of Pediatrics. Management of Children With Autism Spectrum Disorders. Pediatrics Vol. 120 No. 5 November 1, 2007. pp. 1162 -1182.
Cavalari, Rachel. Supervision of children with an autism spectrum disorder in the context of unintentional injury. Research in Autism Spectrum Disorders 6 (2012) 618-627.
Kalyva, Efrosini. Teachers’ perspectives of the sexuality of children with autism spectrum disorders. Research in Autism Spectrum Disorders 4 (2010) 433-437.
McIlwain, Lori. National Autism Association. Lethal Outcomes In Autism Spectrum Disorders (ASD) Wandering/Elopement. January 20, 2012.
Summers, Jay. Teaching two household safety skills to children with autism. Research in Autism Spectrum Disorders 5 (2011) 629-632