Moments of Crisis and the Safety Plan

In this chapter, we'll look at why it matters to put a safety plan in place ahead of time for unpredictable crisis situations (wandering off, a serious behavioral crisis, a medical emergency).

Preparing for the Risk of Wandering

The risk of bolting or wandering (elopement) that we covered in Chapter 32 is one of the most worrying issues for families. A plan prepared in advance reduces panic in the moment and speeds up your response:

• Keep a current photo of your child on your phone
• Consider using a bracelet, necklace, or a tag sewn into clothing that includes your child's identifying details and your contact number
• Let your close neighbors, the neighborhood watch, and if possible the local authorities know in advance
• Identify the places that might be "draws" for your child (pools of water, main streets, specific interests) ahead of time; in the event they go missing, this information saves search teams critical time

A Plan for Serious Behavioral Crises

It's helpful to prepare a written crisis plan in case the meltdowns we covered in Chapter 43 very rarely reach a level that seriously threatens your child's safety or that of others. This plan should include who to call (doctor, behavior specialist, and if needed emergency services), which calming strategies to try, and the information that needs to be shared with the school or caregiver.

Good to Know — Prepare a Written "Emergency Card"

Prepare a short card with your child's diagnosis, level of communication (verbal/nonverbal), known triggers, effective calming strategies, the medications they take, and who to call in an emergency — and keep it in your wallet, in your child's bag, and at school. When you're not there, this card gives quick access to critical information for a teacher, a medical worker, or a neighbor.

Preparing for Medical Emergencies

A child who is nonverbal or has limited speech may not be able to express their pain when they're injured or ill (see Chapter 8, on a high threshold for pain). When you need to go to the emergency room, letting medical staff know in advance about your child's ASD diagnosis, level of communication, and sensory sensitivities (bright light, touch, noise) makes things easier for both your child and the team. Some hospitals are now developing special "sensory-friendly" emergency room protocols for patients with ASD; it can be worth finding out ahead of time whether hospitals in your area have anything like this.

Tip / Practical Suggestion

Always keep a soothing object your child loves (a toy, headphones, a blanket) in an easy-to-reach "emergency bag"; this bag should be right at hand during an unexpected wait or a crisis.

Caution / When to Seek Advice

The safety planning covered in this chapter is preparation for situations that are possible but rare; our aim isn't to create anxiety, but to give you the confidence that comes from being prepared. If you find yourself in constant, intense worry about these things, it may help to talk about that worry with a mental health professional (see Chapter 40).