Home Safety Issues

How do I make my home safe for a child with autism?
Most parents and caregivers are familiar with basic home safety precautions for young children such as stairwell gates, electrical outlet covers and childproof locks on cupboards. Modifying your home environment may be even more necessary (sometimes well past the toddler stage) for children with ASDs. Many children with autism have serious behavioural problems which can put them and other family members at risk. Also, they may not be able to understand and remember the dangers of certain actions without consistent training and intervention. To make the home safer:

• Arrange the furniture to prevent throwing or sweeping objects off surfaces, climbing up onto high shelves or knocking over chairs and tables. Bookcases, dressers, china cabinets and free-standing shelves, laundry baskets and other taller furniture objects can be screwed directly to walls to prevent them from tipping over when the child does climb on them. Seat child in chair with arms or a wrap-around style desk when doing work or eating meals. Seat against the wall or in a corner to prevent continual escape from the table.
  
  
• Locks, gates and barriers can help prevent falling down steps, escaping from the house or climing out a window and can limit access to dangerous areas. Safety locks can be placed on interior doors and bathroom/kitchen cabinets. Before putting locks on windows or bedroom doors, families must find out if this is legal in their location. In some places it is against fire regulations. Contact your local fire department for a consultation on home safety for your child and recommendations on the kinds of locks to be used. Travel intruder alarms may be very helpful to alert caregivers to an escaping child or a child going into a room that is off limits.
  
  
• Some parents have tried using plexiglass in windows to protect children who pound on or push at glass but it should be noted that plexiglass can also break and become very sharp when shattered.
  
  
• Do not leave curtain and blind cords hanging. Keep cords out of your child's reach whether the blind is up or down. Cut the cords short. Do not put a crib, bed, high chair or playpen near a window or a patio door where a child can reach the curtain or blind cord and strangle. Sofas, chairs, tables, shelves or bookcases should not be near windows where children could climb up to reach the curtain or blind cord. The Public Health Agency of Canada provides a complete information sheet on window blind safety, see Resources.
  
  
• Secure all potentially dangerous items: Children with autism may be very curious and interested in how things work. Safety kiddie locks can be placed on every cabinet door in the house as well as on the stove, fridge, microwave, VCR, washer, dryer, and toilet (most baby sections of department stores and toddler catalogues sell these). Use safety covers for stove burners. Wiring for appliances and electronics should be hidden. Lock up household drugs and chemicals, lighters, matches, sharp knives and small items that might be swallowed. Use child safety scissors for crafts or projects with supervision. Pad all hard objects in a child's room with foam if he/she engages in any self-injurious actions. Never leave toiletries or glue bottles where they can be reached.
  
  
• Order and structure in the child's environment can reduce frustration levels. Some people put visual labels (symbols, photos, words, textures) on everyday items, rooms, cabinets, drawers, bins, closets. Child's things can be organized in see-through plastic bins with visual labels.
  
  
• Visual warning prompts can help to set boundaries. "STOP" signs or signs saying "No" or pieces of coloured tape can be used to help children understand what is off-limits.
  
  
• At mealtime, eating utensils may need to be tied to string and attached to the chair or table so that if thrown, they remain attached, preventing unintentional injuries. If the child regularly throws, plates and bowls can be attached to the table with adhesive Velcro on a placement secured to the table. Use plastic/rubber plates, bowls and cups to prevent breakage.
  
  
• In the bathroom: use an inflatable or foam cover on the faucet. Turn down the hot water tank to prevent accidental scalding. Use rubberized bath mats in the bath and remove soap and shampoo after washing so the child will not empty or ingest them. Water taps may have to be kept turned off under the sink to be safe. Keep sink plugs hidden so a child can not plug a sink and fill it to overflowing.
  
  
• Fire safety: Try to teach the child the rules to follow for fire safety. Have regular fire drills. Some parents use social stories (with photographs, pictures, words) about smoke detectors, fire drills, fire alarms, touching fire, etc.
  
  
• Car safety: a child may need to wear soft footwear so a shoe or boot will not hurt the driver if kicked off or thrown. Child locks may be installed on back doors and you may need to be creative about more involved seatbelts that can't be undone easily while driving. It may be necessary to talk to police and safety professionals in your region. Make certain the driver has hair up or secured so it can't be easily pulled while driving and a driver should not wear necklaces or other jewelry that can be pulled on. If an upset occurs while driving, it is often safest to pull over until calm is regained.

Wandering/Running Away

Children and adults who are at risk and who run away or wander off from parents and caregivers are a concern. Some children with ASDs just like to be outside and on the go and might head off at any opportunity. Others with autism may be very attracted to water such as ponds, rivers or swimming pools which can be very dangerous. If running away is an issue:

• Outside doors can be locked, but this presents safety issues in emergency situations. Contact your local fire department for a consultation on home safety as well as a professional locksmith or security company.
  
  
• Some parents find it helpful to use a velcro wrist strap and coiled cord to attach their child to them when out shopping or walking. This may prevent children from dashing into traffic, falling into water, running away at shopping malls, etc.
  
  
• Your child should always carry identification in case he/ she gets lost and is unable to ask for help. Some children wear a medical ID bracelet or necklace. If the child won't wear or carry ID and doesn't speak, some parents label clothing with iron-on labels.
  
  
• Contact local police, fire and ambulance services and ask your local 911 call centre to keep identifying information about your child on record. Dispatchers can alert officers about your concerns.
  
  
• Get to know your neighbours and let those neighbours you trust know in advance that your child with an ASD might wander off. Explain any unusual behaviours or characteristics that might be confusing. Neighbours can be given a handout with a photo of your child and emergency contact information for you.  
  
  
• Some municipalities will reduce the speed limit on a street where a child with autism is living if they are prone to dashing out into the street without looking. There are signs available to warn drivers of deaf children and blind children but not yet children with autism, so reducing speed may be a useful option.
  

Safety With Others

There are many intervention techniques available to teach personal safety, at home and for when your child goes out into the community. All children must learn to be street-smart and safe from abuse by other people as well as how to act appropriately in different situations. Effective treatment programs will include life-skills building to deal with these issues using interventions such as:

• social stories
• visual signs/charts 
• peer and adult role modeling 
• positive reinforcement for safe and appropriate behaviour
• consistent consequences for unsafe or inappropriate behaviour 

Life at School

What school issues should I be watching for?
Meeting with the child's classmates and/or parents can be helpful in encouraging other students to understand and interact positively with your child. A student's education program should include a plan to create an environment where typical children can interact in positive ways with the child with ASDs. Recess can be a valuable time for teachers to encourage play with other children and time can be set aside in school for formal "play time" between children with ASDs and volunteer peers. Parents and caregivers can encourage friendships by inviting other children over to play and by encouraging focus on shared interests, such as computers, hobbies, school groups, etc.

As public education and awareness of ASD as a disability increases, teasing and bullying become more and more socially unacceptable.

Children and youths with autism conditions experience more teasing and bullying than others. They may be targeted at school as being "strange" or "weird", etc. This can cause a child to be very isolated, resulting in depression and despair. Having friends to rely on can help to offset bullying. While some children with ASDs may seem to prefer to be alone, the development of friendships is very important to many children and youths with ASD. Youths with AS in particular may be acutely aware of their differences and difficulties making friends. Developing the necessary communication and social skills may take a long time and may require constant reinforcement but if work on these skills starts early, many people with ASD can develop friendships. More information on Approaches to Treatment and Education.

Fostering Unique Abilities

How do I help my child develop his/her special talents?
Many people with ASDs have unique talents and special skills. People with AS frequently have incredible memories and may have acquired a tremendous amount of knowledge about their particular interests. Some are very creative or have particular skill with spatial perception, music, art or mathematics. The traits of ASD may be challenging in some areas of life but they can also lead to great achievement. Like all people, children and youths with ASDs need your encouragement and opportunities to flourish.

We will be providing more content for this section (as resources allow) during 2005. Please check back with us again to view new information as it becomes available.

Siblings

What about my other children - will they feel left out?

Meeting the daily needs of a child with a disabling autism condition requires a tremendous amount of dedication on the part of parents and other caregivers. This will of course put added strain on the family as a whole and usually means less time and energy for other children in the family.

Inevitably there will be special demands placed on siblings of children with ASDs. Siblings can often cope very well and frequently become more sensitive and resilient adults. Parents play a key role in helping their other children develop good coping skills and understand ASDs. Parents must make a special effort to make sure each child feels secure that there is enough love and attention to go around. Things to do:

• Discuss autism and ASDs frequently as your child grows up. Explanations should use terms and words appropriate to their age and understanding. Questions will depend on the developmental stage of the child - for example, a young child's concerns might be about frightening behaviours while an older child's questions may have more to do with how to explain autism to friends.
  
  
• Train your child to teach. It can be frustrating for young child who loves to play to develop a satisfying relationship with a brother or sister who has an ASD. Invitations to play may be misunderstood or ignored. Aggressive behaviours or tantrums may be frightening and unpredictable. Siblings can be taught to use focusing techniques, praise and simple instructions and other teaching skills to help the child with ASD take part in activities. In fact, siblings can use play to reinforce many of the skills and tools used in treatment and education plans.
  
  
• Siblings may benefit from connecting with other siblings of children with autism in order to prevent feelings of isolation which many siblings report. Check with your nearest Provincial or Territorial Autism Society to find out if peer support groups or sibling courses may be available in your area.
  
  
• It will be important to find even small amounts of regular time for your children who do not have an ASD. You may not be able to give your child without autism the same amount of your attention but each child will need to feel that there is equal love in the home and that everyone is equally special. Also, there will be times when an event or situation for a sibling will take priority and may require not including the child with autism.
  
  
• Older siblings of children with ASDs may have questions about genetic factors and their own plans to start a family. They may also feel a deep sense of responsibility for their brother or sister with an ASD that can cause them to worry about leaving home and beginning their independent lives. Parents need to discuss any concerns or expectations regarding future care of the loved-one with autism and offer reassurance regarding moving away and beginning their adult lives.
   
• The role of adult siblings. When an adult family member with autism will clearly need continuing care and parents are aging, children and parents must openly discuss options for supervised living arrangements, future guardianship and financial planning.

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