Insights and advice from a developmental-behavioral pediatrician in the Autism Speaks Autism Treatment Network
“We keep reading news reports about both children and adults wandering or running onto highways and getting hit by cars. Is there something about highways that attracts them? We’ve noticed that our teenager likes to stand by the side of the road when cars whoosh by. How can we keep him safe?”
Editor’s note: The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.
Today’s “Got Questions?” response is from developmental-behavioral pediatrician Peter Chung, of the Center for Autism & Neurodevelopmental Disorders at the University of California, Irvine. The center is one of 14 sites in the Autism Speaks Autism Treatment Network (ATN).
Thank you for your question. You are correct that wandering into dangerous situations is a common problem among both children and adults affected by autism.
First and most importantly, I recommend that you discuss your concerns with your son’s healthcare providers and therapists so they can help support you in developing a plan to increase his safety.
No matter why your son tends to wander close to roads, we know it’s dangerous because of the potential for injury from falls, vehicle accidents, drowning, abduction and dehydration.
Yet in developing a safety plan, it’s important to understand the reason behind his behavior. Is he wandering towards the road because he’s fascinated by cars? Or is he trying to get away from something he finds stressful?
Both tendencies are common among those with autism. Some have a tendency to wander toward objects of interest, sometimes heedless of associated dangers. Others tend to wander or bolt to get away from something they want to avoid.
Like your son, many individuals with autism appear to be particularly drawn to roadways and moving cars. Some appear to enjoy the visual stimulation provided by the spinning wheels or the many different colors, shapes and sizes of vehicles. Others seem to be drawn to the sounds and sensations of cars rushing by. Still others have a fascination with street lights or even highway signs.
An important detective game
If your teenager is non-verbal, you may need to play detective to figure out what exactly is attracting him. Look for patterns in the way he behaves. Is there any pattern to when or under what situations he gravitates to the roadside? In essence, you’re looking for possible triggers for the behavior.
Over time, a record of these observations may help you identify underlying similarities in the situations that occur before your son wanders dangerously close to a road. We call this the “antecedent” for the behavior.
Antecedents can be immediate and specific events like spotting something he likes – say, a particular kind of vehicle such as a big truck.
Alternately, you might notice that your son tends to wander toward the road at a certain time of day or just before or after an activity. For example, I’ve had patients who tend to wander when they’re bored or frustrated – for example, after their parents take away Minecraft and Angry Birds.
I encourage you to likewise consider whether your son’s tendency to wander close to the road is worse when he’s under stress or wanting to avoid an activity or stimulus he doesn’t like. If this may be the case, your detective work should focus on identifying the “negative” situation or stimulus that’s driving him.
If you don’t see an obvious pattern, a behavioral therapist or other autism specialist might be able to help you identify the triggers. Once identified, you can work together to remove the stimulus or otherwise help ease your son’s anxiety around it.
Encouraging safe behavior
Once you’ve figured out the motivation for the behavior, the next step would be to modify your son’s environment to foster safety. I suggest placing a visual reminder of safe behaviors on doors. For example, the Big Red Safety Toolkit has printable “STOP” signs you can tape to doors and windows.
Another option is to reinforce the visual STOP sign message with audible door and window alarms. These don’t have to be the harsh alarms that prove so distressing for many of those who have with sensory issues. The National Autism Alliance, for example, has alarms that trigger a door chime.
Visual supports and social stories
I likewise recommend using visual supports to write, illustrate and share a social story about practicing safe behaviors near roadways and cars. You can customize the social story with your own pictures using templates from AWAARE which can be found here.
Exploring safer alternatives
In addition, I suggest exploring whether you can find some safer “replacement behaviors” for your son’s roadside fascination.
For example, if his attraction involves looking at cars, you can create enjoyable opportunities to share this interest with him. These activities might include watching videos of cars, reading about cars or playing with toy cars.
If your son’s highway fascination is driven by the sensory experience, an occupational therapist trained in sensory integration techniques can help identify activities that replicate the sensations he likes in a safer environment. For example, if he likes listening to car sounds and feeling the whoosh of cars rushing by, he might enjoy sitting in a sensory swing while listening to a recording of highway sounds.
If you haven’t already, I urge you to alert your neighbors to your son’s tendencies and make clear that you appreciate their alerting you if they see your son by the road unsupervised. You might also consider one of the growing number of wearable global positioning satellite (GPS) and radio frequency (RF) locating devices. In addition to pocket-sized models, options include small devices that can be fitted into accessories like wristwatches or shoes. A neighbor alert form can be found below.
Autism Speaks has recently provided a grant to Project Lifesaver to protect individuals with autism prone to wandering through a multi-faceted approach involving technology, training and education. Also see the following resources from Autism Speaks:
Preventing Wandering: Resources for Parents and First Responders
Neighbor Alert Letter
Safety Log to Record Wandering Incidents and Attempts
Autism Elopement Alert Form: Person-Specific Information for First Responders
I hope these insights and suggestions are useful. Please let us know how you and your son are doing with a comment below or by emailing us again at GotQuestions@AutismSpeaks.org.
Editor’s note: The above information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.