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My 4-year-old sneaks out of the house, despite locks and alarms. What can I do?
Clinical Expert: Harold S. Koplewicz, MD
en EspañolI have a 4-year-old daughter who started sneaking out of the house every chance she got as soon as she could unlock and open a door. To my dismay, DHS even got involved once. I watch her like a hawk. We put chains on the tops of our doors and alarms on the windows. But recently she discovered she could get into the back yard of a neighbor who has a pool and I know she will continue to try to get down there. This is terrifying. She has no fear of water. Discipline does not seem to discourage this behavior. What can I do? I really don't think my pediatrician will listen and since we have Tricare for insurance, they more than likely won't recognize autism, if that is what she has, even if I could get a diagnosis.
The behavior you’re describing has been dubbed wandering, or eloping, and it is, indeed, associated with autism spectrum disorder, ADHD, and other psychiatric and developmental disorders. It’s very dangerous, as you know, and gets even harder to manage when a child starts school, and is in the care of other adults who have many children to supervise, and may not take the threat as seriously as you do. Children on the spectrum seem to wander either because they’re powerfully drawn by something (ie water), or because they’re fleeing something that makes them uncomfortable (loud noises, bright lights, conflict).
If your pediatrician won’t listen to your worries about your daughter’s behavior, you need a new pediatrician, as soon as possible. That pediatrician should refer you to a specialist—an experienced psychiatrist or psychologist—for diagnosis, because if your daughter is on the autism spectrum, early intervention can be crucial. A diagnosis opens doors to treatment, assistance with childcare, and a whole host of other benefits that could really help your daughter, if she needs them.
A diagnosis also opens doors to insurance coverage. As far as we can tell, Tricare generally provides some coverage for family members diagnosed with autism spectrum disorder. The military health insurance also appears to offer special programs that might be applicable in your case. These include the Exceptional Family Member Program; the Extended Care Health Option; and the Autism Services Demonstration.
But first you need, and deserve, a pediatrician who will take your concerns about behavior as seriously…
