Optimizing safety toolkits for elopement: secondary data-analysis of a treatment study

Emory University received a $156,500 Project Grant from the National Institute of Child Health and Human Development (NICHD) under the Child Health and Human Development Extramural Research program (CFDA 93.865) for the period September 1, 2025, through August 31, 2027. The project, titled "Optimizing Safety Toolkits for Elopement: Secondary Data-Analysis of a Treatment Study," will conduct secondary data analysis of a randomized clinical trial to develop optimized safety resources for families of children with Autism Spectrum Disorder (ASD) who engage in elopement behavior.

The primary deliverable is a modified and improved safety toolkit informed by detailed analysis of parent narratives and participant data from the parent clinical trial. Through systematic analysis of caregiver accounts of their children's elopement episodes, the research team will develop elopement subcategories to guide toolkit redesign, addressing barriers to parental implementation identified in the original trial. The toolkit modifications aim to improve usability and accessibility, particularly for underserved populations in rural and minority communities with limited access to behavioral intervention services. The output will provide evidence-based resources that can be immediately distributed to families at no cost, reducing the burden on children with ASD and their caregivers through enhanced prevention, response, and harm-reduction strategies.

Abstract

Elopement is an incredibly dangerous and prevalent behavior among individuals with autism spectrum disorder (ASD). While behavioral interventions are often effective at reducing elopement attempts, access to these services are limited, especially in areas with primarily rural or minority populations. An important resource for families, especially those with limited access to behavioral interventions, are safety toolkits. These are resources available online for parents and clinicians that include several strategies that may prevent some instances of elopement (e.g., locks on doors), improve the speed of finding a child who has eloped (e.g., identifying search teams), and reduce the potential harm following an elopement episode (e.g., teaching traffic safety). Safety toolkits have several advantages, primarily in their availability as a free resource that can be immediately provided to parents. However, results from a randomized clinical trial that incorporated safety toolkits for elopement suggest that parents of autistic children who elope may not consistently implement recommendations from these toolkits without clinician follow-up and support. Given this, IT is important to modify and optimize these toolkits to improve ease of use. This project aims to use secondary data from a randomized clinical trial of a behavioral treatment of elopement to guide the development of a modified toolkit. Specifically, caregivers in the parent study completed detailed parent target problem narratives of their child's elopement. We aim to use these narratives, along with additional participant information, to develop subcategories of elopement following analyses akin to past studies that have subtyped other topographies of challenging behavior (e.g., aggression). All caregivers in the parent study were also provided with safety toolkits, but groups differed in the amount of follow-up support provided by clinicians to complete the toolkit strategies. Thus, we aim to conduct additional analyses to determine which items from the toolkits were most likely to be implemented by parents on their own versus which were only implemented with the assistance of a clinician. These secondary analyses will be summarized and provided to a group of expert clinicians, researchers, and stakeholders (e.g., caregivers of autistic youth, autistic individuals, autism agency representatives) who will use the information to guide development of a modified toolkit that tailors recommendations to the type of elopement and service-delivery model. The end deliverable will include a modified toolkit that provides more tailored recommendations with the aim of improving usability.