Antecedents and Characteristics of Missing Incidents and Recoveries

Background:  Children with autism spectrum disorders (CwASD) are at increased risk for missing incidents and the associated dangers. There is little guidance as to how to prevent or address these behaviors, and as such, caregivers report additional caregiving stress, sleep problems and/or isolation. 

Objectives:  The purpose of this study was to better understand the antecedents of missing incidents, the circumstances under which a missing incident occurred, the characteristics of how children are found and to determine any predictors of a missing child not surviving the incident. 

Methods:  The study was a retrospective review of media reports of missing CwASD.  Seventy-five analyzable cases were retrieved using a systematic search strategy.  Inclusion criteria included: specific indication the child was diagnosed with ASD, aged 3-17 years, reported in an official news media, and have adequate data to be able to understand the circumstances of the event.

Results:  Missing incidents occurred across the age span with a higher ratio of males, from all living settings and throughout the U.S.  Most children left on foot, but a few utilized wheeled or public transportation.  In a third of the cases, there was notation of a previous missing incident. The most common care provider at the time of the incident was a parent who was generally in close proximity to the child.  In 10% of the cases, the child was intentionally left alone, usually to and from the school/bus setting.  The children went missing from both the home and community settings which included: playgrounds and recreation areas and visiting friends/relatives. Most children were observed just minutes before a missing incident by the care provider.  Sometimes the children were left intentionally unsupervised while the parent was in a different area, i.e. playing in the yard while the parent was inside.  Sometimes the care provider was distracted and there was an unintentional gap in supervision.  The strongest predictor of not surviving a missing incident was age with younger children having 22 times greater risk of death.

Conclusions:  Missing incidents in CwASD are ubiquitous in terms of location and circumstance as incidents occurred throughout the normal set of activities for a child. Few predictors could be identified – agitation and an extended stay in a different location seemed to associated with some incidents.  Some children were able to leave a safe situation even during times that care providers were intending direct supervision; other times children left in circumstances they previously negotiated independently.  Further research is critical to understanding mechanisms of prevention and rapid location, particularly of young children.