A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Spring, 2018 | Number 2, Volume 32

Intervention teaches children with ASD to respond correctly when lost in the community

Elopement, or wandering off without permission, is a significant danger for children with autism spectrum disorders (ASD). Nearly half of young children with ASD have eloped, and the vast majority of deaths of young children with ASD result from accidental drowning after a child has eloped. 

To address this problem, Kelly Carlile and colleagues developed an approach combining high-tech and low-tech help-seeking approaches with training that mimicked common community settings. They tested this approach on six male children with ASD, ranging from 3 years to 14 years of age. 

The researchers first showed the children videos, most filmed at local stores, showing the proper high-tech and low-tech responses to being lost. They then gave the children opportunities to practice these skills in a classroom designed to look like a local store, using several different store mock-ups. The mock store set-ups in the classroom included banners, bags, and baskets showing the store logos; pictures of store aisles along with actual store items placed in front of the aisle photos; and adults dressed in store uniforms and wearing store name tags. 

In the store setting, the adult escorting the child moved out of view so the child could not see him or her. If the child did not respond correctly, the researchers immediately stopped him, showed a video model of the step, and gave him an opportunity to try again. Manual guidance or verbal prompts were used if needed. 

The researchers taught the children different strategies depending on whether the children could identify “lost” versus “not lost” when shown videos: 

• The low-tech response taught to children who understood the concept of being lost involved identifying being lost (turning the head to look in different directions), scanning for a store employee, walking up to the employee, and saying, “Excuse me, I am lost;” handing over an identification card and remaining close to the employee. 

• The low-tech response taught to children who did not understand the concept of being lost involved remaining in a location until an employee approached; responding to the employee’s questions by handing the person a communication card stating that the child was lost, and remaining with the employee. 

• The high-tech response taught to the children who understood the concept of being lost involved using an iPhone preloaded with Phone and FaceTime. The children learned to recognize that they were lost, turn on the phone, tap the phone icon, tap the name/picture of the person who accompanied them to the store, wait for the person to answer, tell the person, “I’m lost. I’ll tell you where I am,” use the camera to show where they were, and then remain in that location. 

• The high-tech response taught to the children who did not understand the concept of being lost involved answering a FaceTime call on the iPhone, listening for directions to show their location, using the phone’s camera to show this location, and waiting at that location. 

The children were taken to real stores to assess baseline and post-training skills. The researchers report that accurate performance was near or at zero at baseline and increased to 100% after the intervention. In addition, correct responding remained high across maintenance and postintervention sessions. Moreover, two of the three children who initially could not understand the concept of “lost” were able to do this after the intervention. 

The researchers point out that their approach worked even with very young children. In addition, they note that teaching a low-tech response gave children a backup strategy in case they did not have a phone or their phone battery was discharged.


Citations

“Teaching help-seeking when lost to individuals with autism spectrum disorder,” Kelly A. Carlile, Ruth M. DeBar, Sharon A. Reeve, Kenneth F. Reeve, and Linda S. Meyer, Journal of Applied Behavior Analysis, Vol. 51, No. 2, April 2018, pp. 191-206. Address: Ruth M. DeBar, [email protected].