Two behaviors change a family's life more than any other: aggression toward people, and elopement, the clinical word for running or wandering off. Both are common in children with autism and other developmental conditions, both are dangerous, and both respond to treatment. This primer covers what to do today and what a plan looks like.
Safety first, before any plan
You do not have to wait for an assessment to make the house safer. Start with these:
For elopement
- Door and window alarms, and if needed a lock placed high or a keyed deadbolt. Chimes on exterior doors are cheap and effective.
- A recent photo on your phone, and a written card in your child's pocket or shoes with your number.
- Introduce your child to nearby neighbors and, if your child is drawn to water, tell them. Drowning is the leading cause of death in children with autism who elope, and Miami-Dade has water everywhere: pools, canals, lakes.
- Enroll in swim lessons that teach floating and getting to the edge, even before other skills.
- Tell your child's school and any after-school program about the history, in writing, so supervision plans reflect it.
For aggression
- Notice the pattern before the hit: most children have a build-up (pacing, louder voice, refusing) that gives a few seconds of warning.
- Keep siblings' safety concrete: a room they can go to, a phrase that means "go now."
- Remove or secure objects that get thrown. Do not try to reason during the episode.
- Avoid physical restraint except to prevent immediate injury, and never as a consequence.
Why the behavior is happening
Aggression and elopement almost always have a function. Elopement is often escape (leaving an overwhelming place), access (getting to something interesting: water, a playground, a favorite store) or, sometimes, the chase itself, which is attention. Aggression is often escape from a demand, access to something denied, or frustration when the child cannot communicate what they want.
Identifying the function is the job of a Functional Behavior Assessment, and it is what makes the plan work. Two children who both run out of the classroom may need opposite interventions.
What the behavior plan does
A plan written by a BCBA for these behaviors typically includes:
- Prevention. Visual schedules so transitions are predictable; warnings before demands; scheduled access to the things the child runs toward (a planned walk, pool time with supervision); noise-reduction in overwhelming settings.
- Replacement skills. Teaching your child to ask for a break, to ask to go outside, to say or sign "help," and reinforcing those requests immediately and generously so they become faster than running or hitting.
- Consequence strategies. What every adult does when the behavior occurs so that it stops paying off: calm, minimal attention, no access to the thing the behavior was aimed at, and a return to the replacement skill as soon as possible.
- Teaching safety skills directly. Stopping at "stop," staying within a boundary, holding a hand in parking lots, responding to name from a distance. These are practiced in sessions, first indoors and then outside, with data on each step.
- Crisis procedures. A short written protocol for what to do if the behavior escalates, including when to call for help, so no one has to improvise.
Working with the school
Both behaviors usually show up at school too. We coordinate with the IEP or 504 team so that the same strategies and the same data definitions are used in both places. A child who is taught to request breaks at home but is punished for leaving his seat at school gets mixed signals; consistency is half the treatment.
When to call
If your child has run off even once, or if aggression is injuring someone or happening most days, call now rather than waiting for a scheduled evaluation. A bilingual BCBA from Beaton Care Services can observe at home in Miami-Dade, help with immediate safety, and start the assessment so a written plan exists within weeks.