Safety

Almost all of this page is one idea: decide the plan while everyone is calm. Nobody makes good decisions in the ten minutes after a door clicks shut.

Wandering, and the water

Wandering has a clinical name, elopement, and it means leaving a safe place without warning. It is common, it is not naughtiness, and it is not a sign that you are careless. It is often the opposite: the person is going toward something they love, usually water.

The figures worth knowing, because they set the priorities for everything below:

• The National Autism Association, citing the 2012 Pediatrics study by Anderson and colleagues, states that "roughly half, or 49%, of children with autism attempt to elope from a safe environment, a rate nearly four times higher than their unaffected siblings".
• The same source states that "nearly one-third of wandering incidents occurred from a school setting". It also reports that more than a third of children with autism who wander are never or rarely able to communicate their name, address, or phone number.
• In the National Autism Association's own six-year study of wandering deaths, "accidental drowning accounted for 71% of deaths".
• Citing a 2017 Columbia University study, NAA states that "children with autism are 160 times as likely to die from drowning as the general pediatric population".
• The CDC puts it in one line: "About half of children and youth with ASD were reported to wander." Of those children, the CDC says, "1 in 4 were missing long enough to cause concern and were most commonly in danger of drowning or traffic injury".

If the person you care for is missing right now, stop reading and open the first ten minutes. Come back to the rest afterwards.

Swimming lessons come before everything else

Every other measure on this page slows a person down. Swimming is the one that works when all of them have failed. NAA's own instruction is blunt: "Enroll your child in swimming lessons as early as possible." They add a detail most families never hear. Make sure "the final lesson is done with clothing and shoes on", because people do not fall in wearing swimsuits.

Ask for adapted or one-to-one lessons, not a busy group class, if noise and crowding are part of the problem. Call your local YMCA and ask two questions: do you run adapted lessons, and do you have financial assistance. Ask your parks department and your school district the same. NAA keeps a free Autism Swim Connect registry of instructors with experience teaching autistic children. Prices vary hugely by area, so this page will not name one.

NAA is honest about the limit, and so is this page: "Teaching your child how to swim can help lower risk, does not eliminate risk, so it's important to stay vigilant."

Locks, alarms and the fire question

The CDC's advice is to "secure your home (fences, door locks)". In practice:

• Door chimes on every exterior door. Battery-powered contact alarms cost a few dollars each and take two minutes to fit. They do not stop anyone. They tell you the door opened, which is the thing you actually need.
• A second bolt, mounted high. Out of sightline and out of reach is often enough by itself.
• Window stops. More on windows under the home.
• Visual prompts on the door. A stop sign or a red card at eye level. The National Autism Association's free Big Red Safety Box contains all of it. Inside: a Be REDy booklet, two wireless door/window alarms, a personalised bracelet or shoe tag, visual door and window prompts, a safety alert window cling, and a child ID kit. It is free to eligible families, one box per family, and they ask you to allow up to three weeks. nationalautismassociation.org/big-red-safety-box

Identification they will actually keep on

Choose more than one, because any single one comes off:

• A medical ID bracelet or necklace with a name, "autistic, may not respond to his name", and two phone numbers.
• Shoe tags. Laced on, out of reach, and shoes stay on when bracelets do not.
• Iron-on or stick-in clothing labels with your phone number, in every coat and every school jumper.
• Temporary tattoos with a phone number, applied on trip days, at fairs, at the beach, at any crowded place.
• A card in the pocket for a teenager or adult who will not wear a bracelet.

Here is the honest part. Some people will remove anything you put on them, and no amount of persistence changes that. If that is your person, stop fighting the bracelet. Put the effort into the two things that do not need their cooperation: something fitted to clothing or shoes, and a device or registry the police can use. Losing the argument about jewellery is not losing the safety plan.

Tracking devices, and the questions to ask

Three different kinds exist and they are not interchangeable.

• Radio-frequency bracelets tracked by public safety agencies. Project Lifesaver is the best known: it describes itself as a search-and-rescue programme "operated internationally by public-safety agencies", so you enrol through a local police or sheriff's department rather than through a shop. Their agency locator shows whether your area takes part.
• GPS devices sold to families with a monthly subscription. AngelSense is one, describing "a proactive monitoring & alerting system, an app for caregivers, and a wearable device", with school-bus monitoring and an SOS button. Its landing page advertises offers rather than a fixed price, so get the current cost from them before you commit.
• Consumer item-trackers and phone-based tracking. Cheap, easy, and only as good as the thing they are attached to.

This page does not recommend one. It gives you the questions that separate them: Does it work with no phone signal and no wifi? Who sees the location, and who else does the company share it with? What happens when the battery dies, and how do I know before it does? Can the person remove it? Is there a monthly charge, and what does it cost to stop? Does my local police department already run a programme that is free? Ask the last one first.

Tell the neighbours before anything happens

The single cheapest safety measure is a short letter with a photograph, hand delivered to every house that touches yours, plus anyone with a pool. You are not asking them to watch your family. You are telling them what to do in the four minutes that matter.

Words you can copy:

Hello. We live at number 12. Our son Sam is 9 and autistic. He does not speak much and he does not always answer to his name. He loves water. If you ever see him outside on his own, please do not wait to be sure: hold on to him if you safely can, and call me on 555-0148 or call 911. Please also check your pool first, before anything else. Thank you. Photo of Sam is on the back.

Give it to the people who are actually near: the two houses either side, the house behind, anyone with a pool, hot tub or pond in sight of your home, and the corner shop. Put a photo on it that looks like the person today, not the nicest photo you own.

Tell the police before anything happens too

Call the non-emergency line and ask for the officer who handles community programmes. Many departments keep a voluntary registry of residents with disabilities, though it varies entirely by place and some have nothing at all. Knoxville's is typical of the ones that exist. It is "a registry which allows family members and legal guardians to voluntarily register emergency contact information for individuals with cognitive and developmental disabilities". It holds "emergency contact information, detailed physical description, and a photo," and it is "a free service". Officers can search it before they even arrive.

If yours has no registry, do it yourself. Fill in the National Autism Association's free Personal Emergency Profile Sheet, keep a printed copy by the front door, and hand a copy to the responding officer instead of trying to explain everything while you are frightened. NAA also publishes a free Meet the Police toolkit for arranging a calm introduction in advance, which they describe as a way to "establish trusting relationships, reduce confusion and fear".

The school's plan, in writing

Nearly a third of wandering incidents happen at school. So the plan cannot live in your head.

• Ask for elopement to be named in the IEP, with the supports written in, not described verbally at a meeting. How to ask, and what to say.
• Ask who watches the door. Name the person and name the backup. Ask what happens at arrival, at dismissal, at recess, at fire drills, and on field trips.
• Ask what happens in the first five minutes if the person is not where they should be, and ask who calls you and when.
• Ask about water on or near the site. Retention basins behind school grounds are the ones people forget.

Self-injury and aggression, without anyone getting hurt

Head-banging, biting, hitting, scratching, hair-pulling, and violence toward you. These are frightening and they are also common, and both of those things stay true at once. What follows is about keeping everybody in one piece, not about stopping the behaviour by force.

Pain first, always

Before anything else, assume something hurts. A person who cannot describe a symptom reports it in the only currency they have. The American Academy of Pediatrics autism toolkit handout for families puts it plainly about gut problems. Constipation, diarrhoea, reflux, vomiting, belly pain and feeding problems "can add stress to the child and family and may cause behaviors such as aggression or self-injury".

Ask a doctor to check, by name, the things that are silent:

• Constipation. The most common and the most missed, especially with a narrow diet.
• Teeth. Abscesses and eruption pain. Head-banging on one side is worth a dental look.
• Ears. Infection and fluid.
• Reflux. Especially when the behaviour is worse lying down or after meals.
• Headache and migraine, and light or sound sensitivity that got suddenly worse.
• Sleep and seizures. New or changed behaviour that arrives out of nowhere deserves a clinical look, not a behaviour plan.

The words that get this taken seriously: This behaviour is new, or it has changed. Before we treat it as behaviour, I want the medical causes ruled out. Please check for constipation, teeth, ears and reflux.

The pattern log, which is more useful than it sounds

Keep it for two weeks. One line each time, on paper on the fridge or in your phone. Write down: the time, what was happening in the twenty minutes before, what happened after, and how long it lasted. Note hunger, noise, heat, a changed plan, a new person, a rushed transition, an unmet request.

Patterns show up fast and they are usually not mysterious: always before lunch, always in the supermarket, always when a sibling is home, always on the third day of no sleep. A clinician or a school team can act on that. They cannot act on "he just goes off".

Protecting the head, and setting up the room

• Move the furniture, not the person. Slide the coffee table away, put a cushion between a head and a wall, and clear anything glass or hard. You are shaping the room, not pinning a body.
• Have one safe room ready before you need it. Soft floor, nothing heavy on shelves, nothing sharp, no lock. You stay in it or in the doorway. It is not a seclusion room, and the door does not shut on anyone.
• Reduce input. Lights down, the TV off, everybody else out, and your own voice down to almost nothing. Talking more usually makes it longer.
• Protect your own body. Long sleeves, hair up, glasses off, and stand to the side rather than in front. Getting bitten helps nobody.
• Ask the doctor about head protection if head-banging is causing real injury. That is a clinical decision made with them, not a purchase you make alone.

When to call the doctor, and when to call 911

Call the doctor within days if the behaviour is new, has suddenly got worse, or is causing injuries that need dressing. Call too if it is happening most days, or if you can no longer take the person out or leave them with anyone else.

Call 911 for a head injury with confusion, drowsiness or vomiting, or a wound that will not stop bleeding. Call for a suspected broken bone, a swallowed object or chemical, or when someone in the house is in danger you cannot get them out of. For a swallowed substance in the US, the Poison Help line is 1-800-222-1222, free, confidential and answered around the clock.

If you call 911 and it is about behaviour rather than injury, read the police section below first. What you say in the first sentence changes what arrives.

The restraint line

Restraint and seclusion injure and kill children, and they do not work. That is not this site's opinion. The U.S. Department of Education's Restraint and Seclusion: Resource Document says it in the Secretary's own letter. These practices "can have very serious consequences, including, most tragically, death". And there is "no evidence that using restraint or seclusion is effective in reducing the occurrence of the problem behaviors that frequently precipitate the use of such techniques."

The principle the whole document runs on: "restraint or seclusion should never be used except in situations where a child's behavior poses imminent danger of serious physical harm to self or others." Even then, it says, it "should be avoided to the greatest extent possible without endangering the safety of students and staff." Four more of its fifteen principles are worth carrying in your head:

• "Restraint or seclusion should never be used as punishment or discipline (e.g., placing in seclusion for out-of-seat behavior), as a means of coercion or retaliation, or as a convenience."
• "Restraint or seclusion should never be used in a manner that restricts a child's breathing or harms the child." The document is specific: "Prone (i.e., lying face down) restraints or other restraints that restrict breathing should never be used because they can cause serious injury or death."
• "Schools should never use mechanical restraints to restrict a child's freedom of movement," and never a drug to control behaviour except as authorised by a licensed clinician.
• "Parents should be notified as soon as possible following each instance in which restraint or seclusion is used with their child."

Ask your school these, and ask for the answers in writing:

• What is the district's written policy on restraint and seclusion, and may I have a copy today?
• Who is trained, when were they last trained, and in what method?
• Does this school have a seclusion room or a quiet room, and may I see it?
• Will you notify me the same day, every time, in writing?
• Has my child been restrained or secluded this year, and how many times?

The last question is worth asking even when you are sure the answer is no. State law varies widely, and the federal document is guidance rather than a ban.

At home, do the same thing. Block, do not hold. Move objects rather than bodies. Put a cushion between a head and the wall. Stand to the side, give more space rather than less, and let it run its course while you keep the room safe. Do not sit on anyone, do not hold anyone face down, and do not hold wrists or arms to make a point. If you have reached the stage where holding feels like the only option left, that is the signal to get help for the whole family, not to get better at holding.

Police, 911 and first responders

An officer arriving knows nothing. They see a large person not following instructions, not making eye contact, not answering, moving suddenly, maybe hitting themselves. Every one of those reads as a threat to someone with no other information. Your job in the first sentence is to give them the other information.

Say this, in this order: He is autistic. He does not speak. He is not being defiant, he cannot follow those instructions. Please turn the sirens off and give me space to help him.

Calling 911 yourself, lead with it: I need help with my autistic son. This is a disability crisis, not a crime. He is not armed. He may run. He does not respond to shouted commands. Please send someone trained in crisis intervention if you have one. Ask the dispatcher to add the word autistic to the call notes so it reaches the responding car.

Before any of that is needed:

• Register, if your area has a registry. Free, voluntary, and it means the photo and description are already in the car. See telling the police first.
• A window decal by the front door and on the car saying someone autistic lives or travels here. NAA's free Big Red Safety Box includes a safety alert window cling.
• A card you can hand over instead of explaining. Keep one in the glove box, one in the wallet, one by the door.
• Meet them first, if you can. A calm ten minutes in a station car park is worth more than any document.

If police are involved right now, open the police card.

The home

• Chemicals up and locked. Cleaners, detergent pods, laundry liquid, bleach, vape liquid, alcohol, essential oils, batteries. High is not enough on its own once someone climbs.
• Medicines in a locked box, including your own. Not the bathroom cabinet, and not a handbag on a chair. Keep the Poison Help number where you can read it without looking for it: 1-800-222-1222, free and confidential, around the clock.
• Pica, which is eating things that are not food. It is genuinely more common in autism. The CDC's Study to Explore Early Development found the prevalence of pica was "around 28% in children who had both ASD and co-occurring ID, around 14% in children who had ASD without ID". In the general population, "less than 4% of children" had pica. If this is your person, treat small objects, coins, batteries and paint chips as you would treat poison, tell the dentist and the doctor, and ask about testing for lead and for low iron or zinc.
• The stove and the oven. Knob covers, a stove guard, and the habit of cooking on the back burners. Ask your utility company whether they supply a gas shut-off you can use.
• Windows above the ground floor. Insect screens are the trap here. As Nationwide Children's puts it, "window screens are not designed to stop a child from falling. A normal window screen is NOT enough to keep children safe." Use window stops "to prevent windows from opening more than 4 inches". Fit guards with a quick-release for emergency escape on upper floors. And "move all furniture away from windows", because a bed under a window is a ladder.
• The car. Child locks stay on for teenagers and adults too, if leaving a moving car is even a remote possibility. Keep car keys out of reach and lock the car on the driveway. State highway-safety offices running the national heatstroke campaign report that "in more than 29 percent of cases, a child got into the vehicle on their own". They add that "on an 80 degree day, temperatures inside a vehicle can reach deadly levels in just 10 minutes". If seatbelt escapes are a problem, ask an occupational therapist or your state's child-passenger-safety technician about approved solutions. Do not improvise a restraint in a vehicle.

Online safety, for teenagers and adults

The risk online is rarely the one families brace for. It is being liked. An autistic teenager or adult who has been lonely at school for ten years may be very literal about promises, very quick to trust warmth, and very slow to accept that someone kind is lying. That is not a deficit to fix. It is a target that people hunt, and it means the protection has to be a rule that works without judging the person on the other end. The US Federal Trade Commission's warning signs are useful because they need no social reading. Scammers pretend to be an organisation you know, say there is a problem or a prize, "pressure you to act immediately," and tell you to pay in a specific way. Their line is worth taping to a laptop: "Honest businesses will give you time to make a decision. Anyone who pressures you to pay or give them your personal information is a scammer." Gift cards, wire transfers, payment apps and cryptocurrency, demanded urgently, mean stop.

So teach one rule, in the same words every time, and practise it when nothing is happening. Money and photos: I do not send either one until I have talked to you. Nobody real needs it in the next five minutes. Say out loud that they will never be in trouble for telling you, because the shame is what keeps people trapped and paying. If someone already has images and is threatening to share them, that is a crime committed against your person, not something they did wrong. In the US, report it to the National Center for Missing & Exploited Children's CyberTipline, which takes reports of online enticement and child sexual abuse material: report.cybertip.org or 1-800-843-5678. For images of someone under 18, use Take It Down. Report scams and fraud at reportfraud.ftc.gov.

Verified September 2026 against the National Autism Association's safety and water-safety pages, the CDC on wandering and on pica, the U.S. Department of Education's Restraint and Seclusion: Resource Document, Poison Help, the 988 Suicide & Crisis Lifeline, the FTC and NCMEC. Sources on the sources page. Background for a caregiver, not medical, legal or financial advice.