A recent study by the American Journal of Public Health examined national mortality data and found that individuals with a diagnosis of autism died on average 35.8 years younger than individuals in the general population. Their research also found that the difference in deaths caused by injury was almost as striking.
Most parents place their children’s safety as a top priority as a rule. But for parents of children with autism, the reality is that it can be even more difficult to keep your children safe from themselves and others simply because of the nature of their disorder. However, parents of children with autism should not live in constant fear: there are tips parents and caregivers of kids with autism can follow to make sure they stay safe.
Characteristics of Autism
Image via Autism Society
People with ASDs (autism spectrum disorders) share some symptoms, such as difficulty with social interaction, and their brains process information differently than others Children with ASDs may exhibit a common set of characteristics that naturally make them more susceptible to danger. For instance, people with ASDs commonly have no real fear of dangers and an apparent insensitivity to pain. An inappropriate response—or no response at all—to sound is another common characteristic that could open the door to danger.
Scientists do not yet know the cause of ASDs. According to the CDC, ASDs occur in people of all racial, ethnic, and socioeconomic backgrounds. While it is estimated that 1 in 88 children have autism, boys are nearly five times more likely than girls to have autism; in fact, the number of boys with autism is 1 in 54, compared to 1 in 252 girls. And, Autism Speaks points out that the prevalence of autism is not just growing: it is “the fastest-growing serious developmental disability in the United States.”
Image via Autism Speaks
Keeping all children safe is important. But, keeping children with autism safe becomes even more of a priority because of their social, communication, and behavioral challenges.
5 Tips for Creating a Safety Plan
Autism Speaks recommends that parents of children with autism create safety plans, and there are some basic tips to keep in mind when creating those plans for your child with autism.
1) Include family and community members who come into daily contact with your child with autism. Keep in mind school personnel, daycare providers, neighbors, extended family, etc. Make sure you have contacted each person and discussed your most pressing concerns about your child’s safety.
2) Think about all of the places in which your child needs to be protected. This probably includes home, school, friends’ homes, community centers, etc. Then, be sure to evaluate them for safety and to put preventative measures into place in each area. It is especially important to remember to include safety skills in your child’s Individual Education Program (IEP) in your school district.
3) Consider the top safety risks for individuals with autism: wandering, pica (the tendency to eat or crave substances other than normal food), drowning, and household toxins. Take the necessary precautions for safeguarding your child against these safety risks and practice safety skills with your child other family members.
4) Give your child a form of identification with contact names and numbers listed. Make sure your child always wears or carries this identification, especially because wandering could be a concern. Or, purchase a child locator and clip it to your child’s shoe, belt, etc.
5) Contact your local communications center, police department, and/or 911 call center to communicate your concerns and safety plan with the appropriate officials. Remember, you are your child’s best safety advocate.
Image via GDS Infographics
Safety at Home
The home can be a very dangerous place for any young child, but it can be even more dangerous for your child with autism. The difference is that the safety measures and precautions most parents implement for very young children may need to be in place for a much longer period of time for children with autism. Consider this checklist to keep your child with autism safe at home
- Furniture – Secure especially top-heavy furniture to the wall with furniture brackets or safety straps. Don’t forget that some electronics also may be heavy or easily pulled over by your child, so use items such as TV safety straps.
- Cleaning products – All cleaning products should be locked in a safe location. You may want to put them in a locked area in the garage or basement, so they are not in the main living space of your home.
- Freezers – If you own a chest-style freezer, keep it locked at all times. Storing the key in a safe place where your child cannot access it is a good idea.
- Doors – Key locks may be enough for some children with autism, but you may want to use door alarms to prevent your child from leaving your home without your knowledge. Again, remember to keep your keys in a place out of your child’s reach. If your child has been known to wander (see the section on wandering below), you should use a child locator. There are several types available, especially online, but any you choose would help ease your mind about your wandering child.
- Visitors – As with any child, you should teach your child with autism the safety rules about opening the door to visitors, especially if he is home alone. The old safety rule of not opening the door to anyone when home alone is especially important for an child with autism who has a severe language or speech delay or who is completely nonverbal. One way to communicate this rule to your child with autism is to create a social storybook with pictures to help explain the rules.
- Hot water – Sometimes children with autism struggle with sensory challenges, so they may be more at risk for getting burned by hot water simply because they cannot feel hot and cold. One simple solution is to turn down the temperature on your hot water heater. If you have an older child with autism, you may want to practice turning on the hot water with the cold water. You may even put stickers on the hot water knob to remind your child that it is a potential danger to him. Don’t forget to do this in the shower as well as on your sink faucets.
- Fire – As with all children, practicing for a house fire is an important safety measure. Some children with autism may become frightened of the loud alarms in your home, so you may want to purchase a smoke detector that records your voice rather than a traditional one. Another fire safety tip is to take your child to your local fire department so he can become familiar with the firemen and the gear they wear when they enter your home because some children with autism handle stressful situations better when they have experience with them beforehand, in a calmer setting.
- Swimming Pools – If you own a pool, fence it in and make sure your gates are self-closing and latch above your child’s reach. Keep all pool toys and other interesting items out of the pool area when they are not being used. Ask your neighbors with swimming pools to follow these safety tips and make them aware of your child’s potential for wandering. Prior to the Danish study on the mortality rates of people who have an ASD, a California research team pointed to drowning as the cause of the elevated death rate of individuals diagnosed with an ASD, so swimming pool and water safety lessons are crucial for children with autism.
Kids with Autism Wandering Away from Home
A recent study funded by Autism Speaks, through its support of the Interactive Autism Network (IAN), an online project bringing together families affected by autism, and published in the journal Pediatrics shows that children with ASDs wander away from home, stores, and school more often than unaffected children. Through the use of parent surveys, researchers found that nearly half of children with autism attempt to wander or run from a safe, supervised place, and more than half of these wandering children go missing long enough to cause worry. Of the children who caused worry, 65% of the incidents involved a close call with traffic, and 32% involved near drowning.
Overall, the occurrences of wandering increased with the severity of the ASD, and the children who wandered most commonly left their own homes or ones they were visiting. Most parents listed the main reason for their child’s wandering as being their enjoyment of running and exploring, but other reasons included visiting a favorite place or escaping a stressful situation or an uncomfortable sensory stimuli. The study highlighted the need for parents to develop safety plans with their families, teachers, police, and other community members to protect children with autism who wander and to be able to locate them.
6 Tips to Help Prevent Wandering
1) Determine which type of wandering best describes your child (is he directed by goals, is he a sudden runner, etc.).
2) Recognize what triggers the wandering incidents.
~If it is a goal, allow the child to explore the goal in a safe and supervised manner (for example, if the child’s goal is to get used to water, schedule a time for water play each day).
~If it is to escape something, address the issue (for example, there may be too much noise at a certain time of day that the child is trying to get away from).
3) Develop and implement strategies to help your child deal with his triggers in a way that helps him to cope with the trigger rather than running away.
4) Include known triggers in your child’s IEP so that he may work on calming techniques with the appropriate school personnel.
5) Acquire appropriate social stories and review them with your child.
6) Share your child’s goal, fascination, or need to escape with all people who are involved in your child’s daily routine to aid them in preventing your child from wandering.
Moreover, the Autism Wandering Awareness Alerts Response and Education (AWAARE) Collaboration is working toward reducing autism-related wandering incidents and deaths. Some of the tips they specifically recommend for parents of wandering children with autism include the following:
~ Contact a professional locksmith, security company, or home improvement professional to promote safety and prevention in your home.
~ Have your child wear an ID bracelet or necklace that includes your name, telephone number, and other important information. If your child with autism will not wear a bracelet or necklace, consider a temporary tattoo.
~ Teach your child to swim, but remember that teaching a child to swim does not mean he is safe in or near water.
~ Introduce your neighbors to your child with autism and provide a photograph with your name, address, and phone number so they can call you immediately if they see your child outside of your home.
~ Provide first responders with key information on handouts (you should distribute these to your family, neighbors, friends, and coworkers as well): include the name, age, and physical description of your child with autism as well as his favorite song, toy, or character so the first responders are able to communicate with and calm your child more easily.
Safety at School
Because children spend such a large amount of time in school, it is just as important to know how to keep them safe in the classroom as it is at home. The following six tips should help to keep your child with autism safe in their home-away-from-home.
Image via Masters in Special Education
- Visit your child’s school and classroom prior to the start of the school year. Evaluate the building in the same way that you evaluated your home. Are there doors and windows that lock? Can your child reach the locks? Is there any water nearby? Are there any sensory triggers that could result in your child running away? Are there times when your child will be transitioning from one place to another without supervision?
- Take your child to school prior to the start of the school year. Show him his classroom and the restroom facilities and introduce him to faculty and staff.
- Schedule a meeting with all of the faculty and staff who will be in contact with your child. Give them copies of the key information handouts and share your concerns with them.
- Schedule an IEP meeting before school begins and a follow-up meeting once the school year is underway. Be an active participant and advocate for social skills, safety training, and learning goals to be included and evaluated as part of the IEP process.
- Meet with the principal about the school’s policy on bullying. A study published in Archives of Pediatrics & Adolescent Medicine found that about 46% of children with autism in middle and high school reported to their parents they had been victimized at school within the previous year, compared to just over 10% of non-autistic children.
- Also, ask the principal about the school’s use of restraint and techniques for calming students with autism. An ABC News investigation found that in recent years, thousands of children have been injured and dozens killed after being restrained at school.
Safety in Public
Because of the unpredictable nature of going on an outing, one of the most important things you can do is prepare your child with autism before going to a public place. Telling your child where you are going and why may ease his anxiety about changing the routine of his day and may prevent a meltdown. Health Central recommends a few things that may make the preparation for the outing easier for your child and yourself.
- Use pictures so the child can become familiar with the new place. This will also give you an opportunity to discuss some safety measures you may take with your child, such as holding hands when you cross the street, watching for the appropriate signal before crossing the street, etc.
- Tell social stories to describe the public place and the relevant skills that will be needed to have an enjoyable outing. Remember to emphasize something that an individual does well, so that your child will have a better understanding of what he should do in the public place you are going to visit.
- Explain what will happen when you go on the outing. There is no way that you can anticipate everything that will occur, but you can highlight key points and reassure your child that he will enjoy himself. And, if something unexpected happens, remain calm so that your child does not pick up on your level of anxiety.
- Create a schedule and plan activities that your child enjoys. You should be prepared to keep your outing short and your expectations reasonable.
- Practice traffic safety rules and role-play public outing scenarios. For example, when you cross a street, verbalize the rules and then have your child recite them as you cross the street. Follow this routine each time you cross a street. This behavioral skills training is critical to a child with autism’s understanding of public safety rules and has even better effects when a parent or teacher trains the child in more realistic situations.
Whether your child with autism is home, at school, or in a public space, make sure you have equipped him with the materials, skills, and knowledge necessary to stay safe. Remember, you are his best safety advocate.
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