Understanding Elopement and Wandering
Elopement, also referred to as wandering, bolting, or running away, is one of the most dangerous behaviors that BCBAs encounter in clinical practice. Elopement involves leaving a supervised area without permission or awareness of caregivers. For individuals with autism spectrum disorder and other developmental disabilities, elopement poses serious safety risks including exposure to traffic, bodies of water, getting lost, and encounters with dangerous situations. Research suggests that nearly half of children with autism engage in elopement behavior, making it one of the most common safety concerns reported by families.
The lethal potential of elopement places unique demands on BCBAs. Unlike many other challenging behaviors where the primary concern is injury to self or others in the immediate environment, elopement creates risks that extend beyond the treatment setting. A child who elopes from a classroom may end up in a parking lot within seconds. This urgency requires BCBAs to develop comprehensive, multi-component intervention plans that combine immediate safety measures with long-term behavior change.
Functional Assessment of Elopement
Like all behavior, elopement serves a function, and effective intervention requires understanding that function. Common functions of elopement include:
- Escape from demands or aversive situations: The individual leaves to terminate or avoid tasks, transitions, social interactions, or sensory experiences.
- Access to preferred locations, items, or activities: The individual runs toward something they want, such as a playground, a car, a body of water, or a specific room.
- Automatic reinforcement: Running itself may be inherently reinforcing due to the proprioceptive and vestibular stimulation it provides.
- Social attention: Elopement may be maintained by the pursuit behavior of caregivers and staff.
Assessment Challenges
Conducting functional analysis of elopement presents unique challenges because the behavior cannot be safely allowed to run its full course. Standard functional analysis procedures that involve arranging conditions and measuring the behavior may be impractical or unsafe because allowing elopement to occur, even briefly, creates unacceptable risk. Several modifications have been developed to address this challenge:
- Confined functional analysis: Conduct the analysis in a secure environment where elopement attempts can be safely observed without actual escape.
- Latency-based functional analysis: Measure the latency to the first attempt to elope rather than frequency, allowing the session to be terminated quickly.
- Precursor analysis: Identify and analyze behaviors that reliably precede elopement (e.g., moving toward the door, scanning the environment, removing shoes) and use these as proxy measures.
- Descriptive and indirect assessment: Use interviews, rating scales, and direct observation in natural settings to gather information about the conditions under which elopement occurs.
Antecedent Strategies
Because of the immediate safety risks associated with elopement, antecedent strategies that prevent the behavior from occurring are particularly important:
Environmental Modifications
- Physical barriers: Install locks, alarms, fences, and other barriers that prevent unsupervised exit. Door alarms that alert caregivers when doors are opened are especially useful.
- Visual boundaries: Use visual markers (colored tape, stop signs on floors) to define boundaries that the individual should not cross without permission.
- Supervised transitions: Ensure adequate staffing during transitions between locations, which are high-risk times for elopement.
- GPS tracking: Wearable GPS devices can provide an additional safety layer by allowing caregivers to locate the individual quickly if elopement does occur.
Function-Based Antecedent Interventions
Based on the results of functional assessment, antecedent interventions can address the motivating operation for elopement:
- For escape-maintained elopement: Modify demands to reduce aversiveness, provide advance warning of transitions, use visual schedules, offer choices about task order, and build in regular breaks.
- For access-maintained elopement: Provide scheduled access to the preferred location or activity, teach the individual to request access appropriately, and use first-then contingencies to make access contingent on appropriate behavior.
- For automatically reinforced elopement: Provide regular opportunities for movement and physical activity that offer similar sensory input in safe contexts.
Teaching Safety Skills
A critical component of elopement intervention is teaching the individual safety skills that reduce risk even if elopement occurs:
Pedestrian Safety Training
Teach the individual to stop at curbs, look for traffic, and cross streets safely. Use behavioral skills training (BST) with modeling, rehearsal, and feedback. Practice in simulated environments first, then generalize to real-world settings with close supervision. In-situ training, where the trainer tests the skill in the natural environment without the individual's awareness, can assess whether the skill transfers to real situations.
Boundary Training
Teach the individual to stay within designated boundaries. Define boundaries clearly using visual cues, practice staying within boundaries with reinforcement for compliance, and systematically fade prompts and increase the time and distance requirements. Reinforcement for boundary compliance should be rich enough to compete with the reinforcement available for elopement.
Help-Seeking Skills
Teach the individual what to do if they become lost: approach a safe person (such as a store employee or police officer), provide identifying information, and wait for help. Identification bracelets, shoe tags, or clothing labels with contact information provide a backup when the individual cannot provide this information verbally.
Function-Based Interventions
Functional Communication Training
Teach the individual to communicate the function that elopement serves. If elopement is escape-maintained, teach a request for a break. If it is access-maintained, teach a request for the preferred activity. Ensure that the communication response is efficient (easier than elopement), effective (consistently reinforced), and recognizable across settings and communication partners.
Differential Reinforcement
Reinforce staying in designated areas (DRA/DRO) on a schedule that is initially very dense and then gradually thinned as the behavior stabilizes. Use high-preference reinforcers that are powerful enough to compete with the reinforcement available through elopement.
Caregiver and Staff Training
No elopement intervention is effective without well-trained caregivers and staff. Training should cover consistent implementation of antecedent strategies and reinforcement schedules, appropriate responses if elopement occurs (pursue safely, do not chase in a way that reinforces the behavior), how to conduct practice trials for safety skills, data collection procedures, and emergency protocols for elopement incidents. Use behavioral skills training for caregiver instruction: explain, model, practice, and provide feedback until caregivers demonstrate fluency with all procedures.
BCBA Exam Connection
Elopement-related questions on the BCBA exam may test your ability to conduct functional assessments of dangerous behavior, select function-based interventions, implement safety procedures, and balance immediate safety needs with long-term behavior change goals. Understand that elopement requires multi-component interventions that address prevention, skill building, function-based treatment, and emergency protocols.