Wandering (Elopement)

Wandering and children with disabilities

Wandering, also called elopement, typically includes situations where the person may be injured or harmed as a result.1 Wandering goes beyond the brief time that a typical toddler might run off from a caregiver. Some children and youth with disabilities, such as those with autism spectrum disorder (ASD) or intellectual disability (ID), have challenges understanding safety issues and communicating with others. For example, such a child might run off from home to play in the pond down the street—and be unable to respond to their name or say where they live. This can happen quickly, even under constant supervision. The parents are left searching desperately for their child.

The primary reasons for wandering included

• Enjoyment of running or exploring
• To get to a place the child enjoys (such as a pond)
• To get out of a situation that causes stress (for example, being asked to do something at school or getting away from a loud noise)
• To go see something interesting (for example, running to the road to see a road sign)

Although many examples of dangerous wandering have focused on children with ASD, we know that challenges with communication, social interaction, attention, and learning can put many children and youth with developmental disabilities at risk for becoming lost or injured due to wandering.

What can we do to keep children safe who might wander?

Parents, teachers, and other caregivers

Plan

• Watch the child's behaviors
• Have an emergency plan to respond
• Keep information about the child up-to-date (picture, description)
• Secure your home (fences, door locks)
• Keep identification on the child (ID bracelet or information card)

Prevent

• Notice signs that the child may wander off before it happens (for example, child makes a certain sound or looks towards the door)
• Be alert about the child's location
• Provide a safe location
• Inform neighbors and school workers
• Alert first responders

Teach safety skills

• Responding to safety commands ("stop")
• Stating name and phone number (or showing ID)
• Swimming, crossing the street

First responders

First responders are vital for maintaining the health and safety of members of our communities. They are likely to be called upon in the event of a missing child or youth. It is important for first responders to be prepared by knowing which children in the community might wander, having family contact information, and having a plan to respond.

Healthcare providers and other professionals

Healthcare and other professionals need to be aware of wandering as a safety issue. Their role includes discussing safety issues and helping caregivers come up with prevention and response plans.

The ICD-10-CM code Z91.83 (wandering in diseases classified elsewhere) helps document wandering and to prompt important discussions about safety among caregivers, individuals, and providers. This code is not linked to a specific diagnosis, nor is it part of the diagnostic codes used for ASD or intellectual disabilities. Wandering should be coded if documented in the medical record by the healthcare provider.