1.26 ELOPEMENT PATTERNS AND CAREGIVER STRATEGIES

Objectives: The goal of this session is to assess caregiver responses to elopement behavior among children and adolescents with ASD and cooccurring disorders such as intellectual disability, ADHD, and language disorder, as well as their perceived costs, effectiveness, and burden of use. Methods: An online survey of more than 1,000 parents of individuals with ASD was conducted via the Interactive Autism Network (IAN). Results: A third of parents reported current interventions to prevent elopement. Caregivers mobilize community resources, including neighbors, school personnel, and police, during elopement incidents. Caregivers were more than twice as likely to receive advice on managing elopement from an ASD advocacy organization (25 percent) as a physician (12 percent), and 43 percent received no advice or guidance from any source. Environmental interventions, such as locks, door alarms, and dead bolt locks, were rated as generally effective, affordable, and easy to use and were the most common interventions. The majority of parents using GPS tracking devices spent more than US$500 over the past 2 years, and only 41 percent reported them as effective or very effective. The most common co-occurring diagnoses in children who eloped were ADHD, language disorder, intellectual disability, and anxiety disorders. Medications most commonly prescribed to patients included stimulants, α agonists, antidepressants, and melatonin, but caregivers reported poor effectiveness and high rates of side effects. Conclusions: Clinicians should screen for elopement behavior in children with ASD and advise the use of inexpensive, easy to implement interventions, such as locks, door alarms, and dead bolt locks for children who elope. GPS-tracking devices may be effective in some patients, but they are more expensive and should be studied further. Further study of the effectiveness of off-label medication use for elopement is needed before their use can be recommended.