Preventing elopement in children with autism spectrum disorder.
Most kids with autism elope and the least verbal are in the most danger—so lock doors first, then teach a function-based plan.
01Research in Context
What this study did
Pizzighello et al. (2019) asked families of children with autism one big question: does your child elope?
They sent a survey to parents. They also asked what locks, alarms, or ID tools the families use.
The team wanted to know who elopes most and what, if anything, families do to stop it.
What they found
Two out of three kids with autism had slipped away at least once.
Children who speak only a few words were twice as likely to elope.
Only half of families used simple door locks. Richer families and kids with extra diagnoses used more safety tools.
How this fits with other research
Scheithauer et al. (2025) picked up where this survey left off. They gave parents a 12-week class that teaches why the child runs and what to do instead. Elopement dropped 50%. The survey showed the need; the RCT showed the fix works.
Nevill et al. (2025) did the same thing in a hospital. They built function-based plans for 14 kids. Thirteen kids cut elopement by 80% or more. Again, the survey cried out for plans; the case series proved they work.
Lang et al. (2009) already said function-based plans are best. The 2019 numbers simply showed most families still do not get them. No clash—just a gap between what works and what parents receive.
Why it matters
You now have hard numbers to show parents why a plan is needed: their minimally verbal child is twice as likely to bolt. Start with a free fix—check every door lock today—then write a quick functional plan. The later studies prove you can cut risk in half within weeks.
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02At a glance
03Original abstract
Reports of missing children with autism spectrum disorder (ASD) are common in the media, and elopement can lead to dire consequences. This study quantified the use of preventive measures that target elopement, plus identified child/family characteristics associated with elopement and the use of preventive measures. This cross-sectional study included 394 caregivers of children ages 2-17 years with ASD followed in an academic medical center's Developmental-Behavioral Pediatrics clinic. Details about elopement, preventive measure use, and sociodemographic characteristics were assessed via an investigator-designed, parent advocate-approved questionnaire, while pertinent clinical factors were extracted from patients' electronic health records. Two hundred and sixty-seven caregivers (68%) reported elopement by their child. Elopement risk was not associated with sociodemographic characteristics, nor with any specific comorbidity or neurobehavioral medication. Children with limited communication skills were more likely to have a history of elopement (OR 2.24, 95% CI 1.30-3.84; P = 0.004). The most common preventive measure used was lock(s) at top of doors (51%), while less than a quarter of families were using handicap permits, signs/visual markers, or tracking devices. Implementation of certain modifications was statistically associated with socioeconomic status and comorbidities of interest. In addition to supporting previous literature about the increased elopement risk in children with limited communication skills, this study is the first to reveal that caregiver use of numerous preventive measures varies widely. The associations noted with use of specific preventive measures can help guide recommendations for this dangerous comorbid symptom, and provide information needed for future studies to assess the efficacy of various preventive measures. Autism Res 2019, 12: 1139-1146. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Elopement, defined as leaving an area without permission and placing oneself in a potentially dangerous situation, is a behavior exhibited by many children with autism. There is little information about the use of various modifications that target elopement in the pediatric population. This study identifies child/family characteristics that were related to elopement and the use of modifications, and stresses the importance of counseling families of children with autism about elopement.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2114