Autism and Safety: Recognition and Prevention

Universally parents worry about safety when it comes to their children. Those children on the autism spectrum are at a higher risk of being hurt, victimized or wandering off, to name a few concerns that are high on the list. Children and adults with autism seem to have a lower self-preservation ‘instinct’ built in, and their sensory processing does not work to protect them towards safety and crisis prevention.

Nonverbal children and teens are at higher risk of physical and sexual abuse because of their inability to talk back or protect themselves. The abuse rate for children with a developmental disability is 3.4 times the rate of typical children. Sexual predators very well recognize the opportunities for abuse with the nonverbal child who is many times more vulnerable. Predators know there is very little likelihood of their being caught as these victims either will not be able to communicate or they will not be believed. Therefore, the autistic person needs an adult who is present for a twenty-four hour support.

Parents have good cause to be concerned about the safety of their children on the spectrum – no matter their child’s age. It is imperative to get educated about what a parent can do besides worry. The following article is intent upon helping parents and caregivers with information on safety. Where there is light, darkness has no place.

Recognizing dangers and incidences

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Wandering defined

When a person, who requires some level of supervision to be safe, leaves a supervised, safe space and/or the care of a responsible person and is exposed to potential dangers such as traffic, open water-drowning, falling from a high place, weather-hypothermia, heat stroke, dehydration or unintended encounters with potentially predatory strangers. Wandering is also referred to as: Elopement; Bolting; Running.

  • Roughly half, or 49%, of children with an ASD attempt to elope from a safe environment, a rate nearly four times higher than their unaffected siblings.
  • In 2009, 2010, and 2011, accidental drowning accounted for 91% total deaths reported in children with an ASD ages 14 and younger subsequent to wandering/elopement.
  • More than one third of ASD children who wander/elope are never or rarely able to communicate their name, address, or phone number
  • Two in three parents of elopers reported their missing children had a “close call” with a traffic injury
  • 32% of parents reported a “close call” with a possible drowning
  • Wandering was ranked among the most stressful ASD behaviors by 58% of parents of elopers
  • Source: Interactive Autism Network Research Report: Elopement and Wandering (2011) Source: National Autism Association, Lethal Outcomes in ASD Wandering (2012)

Safety at home

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Safeguard Your Windows

  • If your child tends to climb out of windows, place locks on them. Hardware stores carry special locks for this purpose.
  • If he has a habit of beating down windows, replace the glass panes with Plexiglas, or also place wooden boards over windows to prevent injury or elopement.

Safeguard electrical points

  • Cover or remove electrical outlets and access to electrical appliances. Use plastic knob covers for doors, faucets, ovens and stove burners.
  • Lock the door to the rooms with the washer or dryer, appliances or power tools to limit access.
  • Persons on the autism spectrum often have a curious interest in how things work, but they are unaware of the potential dangers when it comes to electrical material.

Keep hazardous items out of reach

  • It is easy for an individual with autism to confuse a bottle of yellow cleaning fluid with fruit juice, based on appearance or to pour/spill liquids, which may be poisonous or toxic.
  • Medicine or pills that look like candy can easily be eaten by mistake. Keep such items out of reach or in cabinets with locks.
  • When the child is involved in cutting activities, use scissors that have blunted ends – child-safety scissors, and be sure to provide supervision.
  • Secure items that need to be limited like candy, video games, lighters, matches, TV, DVD player, toilet tank covers, with a lock or cord ties.

Label all important things

  • Use visual labels – symbols, photos, words, textures, on functional items, rooms, cabinets, drawers, bins, closets and anything that has relevance for the child.
  • Place the bins on shelves or in places the child can easily see and access. The better the organization, order and structure in the environment, the more likely it will reduce the frustration level of a child on the autism spectrum and the less likely she will be to engage in inappropriate behaviors.

Secure eating ware and sitting places

  • When using dining ware during mealtimes, consider tying utensils to nylon string and attaching them to the chair or leg of the table. This way if the child throws the utensils, they will remain attached to the string so as not to injure himself or other family members.
  • If the child throws or sweeps plates, bowls, and cups, secure them with adhesive Velcro and attach them to a secure place mat. Use plastic or rubber plates, bowls, and cups to prevent shattering of breakable items.

Make sure that bath items and toys are safe

  • Consider keeping bath toys in a bag or bin away from the tub and unavailable until bathing and hair washing are completed.
  • Keep bath items like soap, washcloth, shampoo, and sponges together in a plastic bin or rubber bag.
  • Replace open-top bottles with pump dispensers so the child will not empty or ingest the contents.

Fire Safety

  • It is important to keep lighters and matches out of reach or locked up. Place safety covers over gas stoves and oven knobs so a child cannot turn them on.
  • Always supervise children closely when there is an active fire in fireplaces or a gas stove with open flames.
  • Many community or civil defence and fire departments can provide stickers for children’s bedroom windows so that in the event of a fire, firefighters can locate a child’s bedroom quickly.

Provide Clear Identification options

  • It is important that your child have proper identification in the event she runs away or gets lost and is unable to communicate effectively. Some type of ID wear is essential for those with autism, especially if they are non-verbal.
  • Joggers shoe tags
  • ID information laminated card: on belt loops and belt, sewn into pants, sewn into jackets, hang from zippers, print screened into undergarments.
  • Bracelets, anklets, necklaces, shoe or jacket tags, ID cards, clothing labels or permanent ink ID on t-shirts or undergarments are all good options.

Bullying

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Bullying is unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems. 

  • 65% of parents reported that their children with Asperger’s syndrome had been victimized by peers in some way within the past year
  • 47% reported that their children had been hit by peers or siblings
  • 50% reported them to be scared by their peers
  • 9% were attacked by a gang and hurt in the private parts
  • 12% indicated their child had never been invited to a birthday party
  • 6% were almost always picked last for teams
  • 3% ate alone at lunch every day

Sexual Abuse

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Sexual abuse, also referred to as molestation, is usually undesired non-consensual sexual behavior by one person upon another. When force is immediate, of short duration, or infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or molester.

Approximately 1 in 6 boys and 1 in 4 girls suffer from sexual abuse before the age of 18, and every two minutes a person is sexually victimized and the numbers for individuals with disabilities are even higher. A child with any type of intellectual disability was four times more likely to be sexually abused than a child without disabilities.

How to Prevent Sexual Abuse

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Parents, caregivers and friends want to protect their loved ones from being victimized.  Here are some steps that parents and caregivers can take:

  • Teach children accuratenames of private body parts.
  • Keep in mind that someone they know and trust abuses most children.
  • Teach children about the difference between “good” and “bad” touches.
  • Let children know that they have the right to make decisions about their bodies.
  • Encourage them to say “no” when they do not want to be touched, even in non-sexual ways by politely refusing hugs and to say “no” to touching others.
  • Teach children to take care of their own private parts (bathing, wiping or washing after bathroom use) so they don’t have to rely on adults or older children for help.
  • It is never too late to talk to your child about sexual abuse. Do it NOW.

Warning Signs of Sexual Abuse

Parents, caregivers and friends can protect their loved ones by learning certain signs that may indicate victimization. The following steps outlines behaviors common in children who have been abused:

  • An increase in nightmares and/or other sleeping difficulties
  • Angry outbursts
  • Anxiety
  • Depression
  • Difficulty walking or sitting
  • Withdrawn behavior
  • Pregnancy or contraction of a venereal disease, especially if under age 14
  • Propensity to run away
  • Refusal to change for gym or to participate in physical activities
  • Regressive behaviors depending on their age (return to thumb-sucking or bed-wetting)
  • Reluctance to be left alone with a particular person or people
  • Sexual knowledge, language, and/or behaviors that are unusual and inappropriate for their age
  • Take it very seriously when a child reports sexual abuse by a parent or another adult caregiver.

Plan Your Checklist for an Autism Emergency

Model Autism Emergency Contact Handout

  • Name of child or adult
  • Current photograph and physical description including height, weight, eye and hair color, any scars or other identifying marks
  • Names, home, cell and pager phone numbers and addresses of parents, other caregivers and emergency contact persons
  • Sensory, medical, or dietary issues and requirements, if any
  • Inclination for elopement and any atypical behaviors or characteristics that may attract attention
  • Favorite attractions and locations where person may be found
  • Likes, dislikes–approach and de-escalation techniques
  • Method of communication, if non-verbal sign language, picture boards
  • ID wear jewelry, tags on clothes, printed, laminated handout card
  • Map and address guide to nearby properties with water sources and dangerous locations highlighted

 

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Keeping in mind that general safety, good judgment, competence and understanding of what is expected can be learnt and practiced; many of the environmental safeguards can be eased out over time. Introducing the home modifications and intervention techniques mentioned above will not only help keep your child and your family out of harm’s way, they will also help ensure your child is ready and able to learn and, be able to reach her full potential.

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