A Randomized Clinical Trial of a Structured Function-Based Elopement Treatment Program
Elopement, or wandering, is a common and dangerous behavior in autism. Case reports suggest the benefits of tailoring interventions to what’s driving the elopement. For example, is the child trying to escape an unpleasant situation or trying to reach an attraction (such as water, roadways, etc.)? Yet we lack peer-reviewed, published findings from randomized clinical trials (RCTs) to confirm the benefit of this approach. This type of rigorous testing is necessary before such approaches can be recommended for widespread use.
In an earlier federally funded pilot RCT with 24 participants (R03-HD082436), we showed that a structured, function-based elopement intervention is feasible and acceptable to participating families, with preliminary suggestions of effectiveness.
We propose a more-definitive RCT comparing a 16-week behavioral intervention to a psychoeducation program in autism. We will enroll 76 participants, ages 4 to 12. Our study will include individuals with cognitive impairment, use valid outcomes and focus on the co-occurring behavior of elopement.
The primary outcome will be improvements on the Aberrant Behavior Checklist-Hyperactivity subscale. The key secondary outcome will be improvements on the Clinical Global Impression scale, as rated by a blinded evaluator based on caregiver report on elopement. Participants will be randomized to the behavioral intervention or psychoeducation program with assessments conducted prior to, midway through (week 8) and immediately post (week 16) intervention, as well as at follow up (week 28).
We hypothesize that the behavioral intervention will be superior to psychoeducation on primary and key secondary outcomes. Results will guide clinical practice and future effectiveness trials.
Grant Term:3 years