Greatest Hits - Escape Artist: Reining in a Runner

This summer, we're revisiting some of Hina and Marla's greatest hits from the first 10 seasons of The LowDOWN. On Season 8, Episode 3 of The LowDOWN: A Down Syndrome Podcast, Sara Peralta and Glen Hoos give us the lowdown on reining in a runner.

Transcript

Today on the Low Down, a down syndrome podcast Sara Peralta and Glenn Hoos gives us a lowdown on reining in the runner. Over to you, Hina and Marla. Thanks, Danielle. Hello and welcome to The Lowdown podcast. My name is Marla, and with me here is my co-host, Hina. Hey, Hina. Hi, Marla. Are you ready for another episode? Yes. It's going to be a good one. Yeah. Let's do it. Today we are talking about elopement. And definitely not the. We're going to Vegas to get married. Kind. Nope. No. Many families report to us that their child has either run away or wandered away. So we're talking about that kind of elopement today. This is this kind of thing is very critically stressful for families, obviously, and often very isolating. So the first thing we want to do is assure our listeners that this is not, in fact, uncommon at all. At our clinic, we receive this kind of news from a family about once per month with varying degrees of seriousness. So today we're going to be chatting with a parent who has experience with this and our staff, bcba, who can help guide us through what can be done to prevent this kind of incident. So we're joined by two of our very own colleagues today for this topic. We have our very own producer extraordinaire, Glenn Hoos, who has an eighteen year old daughter with down syndrome, Becca. And he will be providing us a parent's perspective. We're also excited to welcome back DSRF Board certified behavior analyst Sara Peralta, who will provide us with her expertise on how positive behavior support strategies can help with preventing those tricky episodes of running away. Welcome back to both of you, Glenn and Sara. Good to have you here. Thank you. We're excited. We're going to do secret questions even though you've been secret questioned question before the first two. I will ask you, Sara. Um, what is one wild but true fact about you? I was once, um, stung by a scorpion. Ooh, that is wild. Little. Yeah. I lived in Honduras. I grew up in Honduras. So, um, there's a lot of wild things that you don't find here in Canada. And, yeah, it was. It was a baby scorpion. I don't know, it was a scorpion. And I just moved it off my bed, and it stung me, and my whole hand got numb. Um, but I wasn't taken to the hospital or anything. It was fine. My family didn't. My worst. They weren't worried. But I do remember my hand getting numb, being really painful. Yeah, it was actively cringing. It wasn't painful. It was just numb. And yeah, I survived. Oh that's good. I'm really glad. We're very happy that you survived. Yeah. That was taking the word wild very literally. I like it. And my other question for you is where has been your best vacation destination? Oh, that's that's a hard one. Um, I think it you know what? I don't know if it's more about the destination, but who I've spent time with. Um, I just got back from the island, um, from Vancouver Island. And I think that we often create beautiful memories as a family. Um, so it's just me and my husband and my daughter, and we got to explore a lot of beaches, and I feel like, yeah, it's mostly about just the three of us spending time at the beach and and making memories in a place where he grew up as well. Right. So. Oh that's lovely. Yeah. That's beautiful. Okay, I'm going to take over. Glenn, over to you. What is your favorite band to see live? Hmm. Those of us that know Glenn well, I think know the answer, but, many people will not have heard of them. But they're called the Airborne Toxic Event. Okay. And I've seen them close to twenty five times now. Wow. Wow. Have you seen them since Covid? Yep. Okay. I saw them three times. Oh, wow. Okay. Earlier this year and last year. Definitely a fan. Um, okay. Question number four. Would you rather compete on Wheel of Fortune or Jeopardy? I think I'd do a lot better on Wheel of Fortune. Okay. Yeah, yeah. All right. I used to play along with that when I was a kid. Okay, perfect. Um, okay. And last question. Um, Sarah, you can chime in on this one, too, if you want to. Are you an ice cream person or a popsicle person? Well, now I'm a diabetes person, so I'm not really either. But if I had a choice, it would definitely be ice cream. Ice cream? Okay. Yeah. Same for you. Same for me? Yeah. Ice cream all the way for sure. Yeah. Yeah. I don't know. Okay. All right. Well, as Marla mentioned in our intro, our topic today is going to be elopement, something that we hear about and have actually seen at the DSF a few times, unfortunately, where some of our students will, um, you know, seek out some greater adventures outside of their home or the DSF building. But of course, it's a very stressful time for their caregivers and loved ones. So we're going to first kind of start to talk about this with Glenn and kind of get your parent perspective. Marla did mention your daughter, Becca. Um, can you tell us a little bit about Becca, for those of us or for those of our listeners who may not know her? Sure. So actually, by the time this episode is released, she'll be nineteen. Um, she has both down syndrome and autism, and she just graduated from high school this past year. So we're just moving into the adult stage. Um, I'm also going to go off script and introduce you to my son Sebastian, because, yeah, he's the one that's given us even more trouble in terms of running away. Sebastian, we adopted when he was two, and he has he doesn't have down syndrome, but he has other, uh, a couple of other, um, developmental disabilities, um, that have have caused similar issues to what many parents would face with a child with down syndrome. Um, he's now thirteen. Thirteen. Okay. So, yeah. So, like, let's talk a little bit about and you can use both Becca and Sebastian as an example, but can you describe for us an instance where either of them ran away or wandered away? And were you able to see a pattern of when and why they would? Sure. So we had many incidents, um, with both of them. But the scariest incident and the probably the scariest moment of my life was with Sebastian when he was maybe four or five. Um, my my brother, uh, came up with a brilliant idea that we should take our sons to the Washington State Fair. Oh. So away we went, the four of us. And, uh, we did have a good time for most of the day, but, uh, towards the, uh, early evening, uh, Sebastian and I decided to get some mini donuts. And Sebastian was the kind of child that you could not take your eye off for one second. And we stood in line for a long time, like, ten minutes. Everything was fine. We finally got to the front of the line, and I gave our order, and I turned to pay, and it couldn't have been more than about five seconds before. I looked back and I turned around and he was gone and I could not see him anywhere, and I immediately became very dizzy, like I felt like I was having an out of body experience, just kind of like turning around and calling him. And we were surrounded by people. I couldn't believe that no one would say, oh, hey, he just went over here. Yeah. And so I kind of did concentric circles getting larger and larger, and I just couldn't find him anywhere. And, um, this was a strange place that neither of us had been. It was outdoors, and there was no kind of, like, gate or anything. So he could have conceivably just walked right out of the fair into the anywhere parking lot in the middle of Washington state. And it was it was at least twenty minutes when I was just panicking, running around, looking for him everywhere. Um, and eventually some just another, uh, fair goer saw the look on my face and said, are you looking for a boy? And I'm like, yes. And he said, oh, a police officer just found him and took him to there's a lost children tent. Uh, of course there is at the fair. Oh my gosh. If I had been clear, this happens a lot, though it was probably a lost children tent. Would never have thought of it. Didn't even enter my mind. And I went there and he was playing happily like nothing had happened. And I like, had him on my lap for the next half hour. Like it took me that long to stop shaking. Yeah, I didn't call my wife at home until after I'd found him. It's probably a good move. Yeah, yeah, yeah. So that that one will stick with me forever. Yeah, yeah. And I think it's interesting how you said literally five seconds and and it was like from point A to point B, it just happened so quickly, right? Like you can't it's not even like you were away for a few minutes. No. Yeah. When they have it in their brain, they're like I'm out. Was he going toward something interesting? He just he just, um. It's interesting the first, I'd say the first three or four years after we adopted him, um, he had no impulse control and no fear like he did the craziest, most life threatening things without even thinking about it. And then almost overnight, uh, when he became, like, school aged, he went from that to almost too far the other way, just timid and not wanting to try anything. And it was like a switch had just flipped. But, uh, those first few years, it was. Yeah, it was crazy. Yeah. Um, what kind of tools and strategies did you kind of put in place after that really scary incident to prevent something like this from happening again? So a lot of it was preventative. Like, um, at home we installed locks, like towards the tops of the doors, um, so that he couldn't, uh, let himself out of the house, that kind of thing. Um. When we, we played, we did social stories. We played stop and Go with rewards for stopping when you're told to stop. And we would go on family walks and, um, you know, if we're walking down sidewalks and every block, there's a road to cross. He was allowed to run to the end of the sidewalk, but had to stop when the sidewalk ended and wait for us to cross the road with him. That kind of thing. Um, when we went somewhere super busy, like Disneyland, we just had to put safety first. Fifty first and you get a lot of dirty looks for this. But he had one of the backpacks that was like a stuffed dog with a tail that you could hold on to. Yeah. Oh yeah, I've seen those. A lot of people so practical like that. But it's if it's that or the alternative is horrible in Disneyland. Yeah, yeah, yeah, you do what you have to do. So I'm curious about, um, Becca's wandering or leaving as well. Was it similar, like an impulse situation or something different for her? Yeah, more. More impulsive. She just sort of didn't think of it. She. She was an extremely late walker. She didn't walk until she was almost four. So it wasn't until much later that it became an issue for her. Um, just sort of not paying attention. Um, like, for him, he was always looking to to run somewhere. Yeah. For her, it would be more just if she sort of saw something that caught her attention. Yeah. Um, that's very similar to my sister, who also has down syndrome. When she was younger, she did the same kind of thing. It was kind of one interesting thing to the next interesting thing further away to the next interesting thing further away, without looking back or checking to see if anybody's with you. And it just kind of more of wandering away as opposed to any goal directed. Yeah. I need to get out of here. Yeah. She never moved as quickly as he did. I think she had one incident where she really did get get away for a while. Um, but for the most part, she was she was easier to find than than he was at this point, her mobility isn't very good, and she couldn't run away to save her life. But. Um, yeah. Very different. Yeah. Um, how have your family's needs changed over time as Becca and Sebastian have grown up because now Beck is nineteen, Sebastian is thirteen. So are you still able to go to places like Affair or Playland and not worry as much? Or how does that change? Um, like Sebastian, he wouldn't run away intentionally. Um, and he, he does tend to stick pretty close to us now in crowds. Uh, he's much more nervous than he used to be. Um, but we would still, um, keep a close eye on him. And usually it's a divide and conquer thing because he is still very fast, even if he's just walking normally. And Becca is very slow. Um, so it's hard for us all to stay together. So usually my wife would probably stay with Becca, and I would go with Sebastian, and we'd go ahead and then and then end up waiting for them to to catch up. Mhm. Yeah. Yeah. He's he's definitely more safety conscious. Becca. Still, she wouldn't often run away, but she's also not safety conscious whatsoever. Like, if you're in a parking lot, she'll just wander in front of the cars or cross the road without looking. And, um, so we always still have to be very aware of what's going on around her. Um, yeah. Front loading her with some of those things. Yeah. Yeah, that makes sense. One thing that a lot of our clinical families report is children leaving at night, that they wake up, and then they walk out at night to go to the playground or wherever. It might be fun. Um, has that ever been your experience that you've had to manage? Um, the one that happened at home that comes to mind wasn't at night, but it was early in the morning. Um, possibly before the rest of us were out of bed. Um, Sebastian, this was before we, um, put higher up locks on doors. In fact, this is probably what caused us to put higher up locks on doors because he walked out the front door and we were running around the neighborhood looking for him and, and, uh, then as we turned back towards home, he walked out of the next door neighbor's house. He had just presented himself at their breakfast table. And hello, what do you have? So he hadn't he hadn't gone far. But, uh, um, that's when we realized we needed some more, uh, internal home security. Um, and at this point, I don't think Sebastian would leave the house, um, on his own. He doesn't really like to leave the house for anything at this point, but Becca has been known to, um. She loves the mail. She loves going to the mailbox, and she loves putting things in the mailbox. Usually not mail or certainly not anything that's, you know, addressed and, and has a postage stamp on it. But, uh, she did try. Well, succeeded once in getting out of the house and going to the mailbox, which is not far, but, uh, yeah, it's something we have to be aware of for sure. Yeah, those out of home routines are interesting because when we have kids with us, they're watching everything that you're doing. And, you know, a lot of our, um, students with down syndrome, of course, they they have that sense of wanting to be independent and do things on their own. And I have so many stories of some of my clients here where parents have said, you know, like they watch me pump gas and one day they just kind of got out of the car and pumped gas themselves while I was inside paying. Right. So like, they're very watchful of what's happening around in their environment. And of course, they also want to be part of part of their routine. So sometimes something as simple as going to go check the mail you probably never think about, like, yeah, we're just going to go check the mail. But that is something that she's taking in and it's like, I'm going to try that the next time too, right? So the wandering and the running away is never to. And Sarah will be able to tell us more about this. But it's not always necessarily, you know, for like creating trouble or anything, but it's just like, oh, I've seen this person do this, so I'm going to go do this too. But yeah. Yeah. And we do have, uh, come to think of it, we do have a little playground in our complex. And Sebastian, uh, once escaped to go play on the playground. Playground? Yeah. Mhm. Mhm. Oh, yes. I feel like children often. All children like to think of themselves as small grownups. So, you know, they kind of overestimate their independent travel skills. It's a thing that can happen. Um, so I'm going to turn to you now with a little bit of a preamble here, because we want to be clear that there's not one blanket strategy that can prevent all kinds of eloping or wandering. and we really have to think about why this is happening from the child or teens perspective, just like we've been talking about with Glen, two kids who are leaving, but for different reasons and different motivations and ages, and the child's or teens perspective is really likely to be very different than our experience of someone leaving like that. Like Glen said, Sebastian was happy as a clam playing in the lost children's tent, much unlike poor Glen. Um, so let's talk through the reasons that a person might run away or wander. Yeah. So as a behavior analyst, um, the way that I would look at these things is, you know, just breaking things down. And usually behavior analysts will do something called a functional behavior assessment, um, which allows us to identify the reason, the function, um, why a person is engaging in these behaviors. Right. And I think, like you said in the beginning, all children engage in these types of behaviors. I think it's just the frequency, the intensity of these occurrences for people with Down's syndrome can, you know, can be scary for parents, of course. So, yeah. So going back to, you know why? Right. So from a behavior analytical perspective, we break it down into, um, you know, four different ways. So functions of behavior. So somebody can do things because they want to escape or avoid an aversive situation. Right. I know that something that I don't like is coming up. So I'm going to move away from this thing. I just don't like it. Um, and this is the kind of thing that we hear happening often in schools. This is running away. So leaving something that is not fun. And this would be running away from math class or that other thing that you don't like, or running away from transitioning to back inside from outside. Right. So trying to get out of doing something. Yeah, absolutely. Or avoiding it? Um, yeah. And then we sometimes, uh, you know, see that people engage in, uh, what sometimes we call attention seeking behavior. I think that we're moving towards calling that connection seeking behavior where you just want to connect with someone or you want, yes, you want someone's attention because it's fun to hang out with that person. You like the way that they, you know, engage with you. So you might engage in behaviors that get you that person's attention, that connection. Right. Which we all do. Um, it just looks different, right? Um, sometimes we engage. Oh, yeah. So that kind to paint a little bit of a picture there, that kind of wandering or running away schools again, sometimes families will describe to us as like the kid was running. And then there were five adults running after them, and everybody was shouting, come back. And, you know, it's like a miniature parade. And they often will say, if that's the story that they're telling us that like. Oh, and the child looked back and smiled like they were having the best time ever. And that is a signal to us that they wanted to have a relationship, connection or some attention from many adults, probably. Um, yeah. It's probably really fun to see Mom or dad running after you, right as you turn back and smile at them. Or laugh. Um, yeah, absolutely. And then we have things we have this other function called the tangible function. Right. And it's just a fancy way of saying that you want to have access to your preferred things. So, you know, maybe, um, you know, Glen's son was not interested in what was going on, but he maybe saw something that looked really fun on the other side. And I'm just going to go ahead and move towards that thing, right. So and that's like like my little sister. Right. Where it's like, oh that's a nice flower. Oh that's a nice you know. So it's point to point to point for things that are nice and attractive. More like wandering than Then running away from people or situations? Totally. Yeah. And then, you know, and then sometimes people engage in, um, what we call automatic reinforcement types of behaviors. And this just means that you do things because they feel good. So it might be that maybe you've been in the line for a really long time and you need to move. Your body is saying, hey, I need to move around. And I and I'm not thinking about everything else and who's going to be the consequences? Consequences. I just need to move. I need to stand up or right. Or sometimes it could be a combination of all of these things. Behavior is so tricky and it's so complex. Um, and it can, it can, uh, be different depending on where you are. Right. On settings with people. So it's not like sometimes it's just one thing. Sometimes it's a combination of multiple functions of behavior. And so that's why we do a functional behavior assessment to try and figure out what is the function. And based on the function of your behavior, what are the strategies that we're going to introduce so that we can prevent some of these things from happening. And your parents are not scared anymore? Yeah. Yeah. And I think we should point out, too, that the same like, let's take leaving the house for an example. They might somebody might leave the house multiple times and it might be at the same time every day even. But it might be for different reasons, even though it's the same point in the day. So some days it might be because, you know, there's going to be a parade coming after you, and other days it might be because you saw your favorite kind of truck go by. So you're going to go and look at that. And other days it might be because somebody said, do math homework and you're out of there, you know. So it somebody like Sarah really helpful to kind of dig into the multiple reasons and layers to these kind of very scary family things that can go on. Did you want to add more? Um, yeah. I would just, you know, encourage if anyone, um, needs support, um, you know, with, with this type of, um, challenging behavior because it can be super scary for parents, of course. Um, I would just encourage anyone to, to reach out to a behavior analyst so that they can they can get the support that they need. Um, because this is tricky. And I think that it's when you're in it. Um, as a parent, I think that it can be challenging to see the pattern of behavior, the function of the behavior, or, you know, the strategies that would be most appropriate to, to deal with, um, this challenge. Um, and yeah, so I would just encourage any parent to, to reach out to a behavior analyst for support and other professionals that work with their child as well. And somebody like Hannah and OT is also another great person to ask for some kinds of strategies. So we'll talk next about strategies and the kinds of things that can be used. And often, of course, it's going to depend on why things are happening. So that's your first step is to figure out why things are happening. Um, but once you know why things are happening, often there's more than one layer of prevention or protection to keep somebody safe and accounted for in their daily situations. So we're going to talk about a variety of tools and supports that might be worth trying. And we'll bring in Hina as well because she's very valuable resource for families. Um, so I have a big long list here, and I'm going to kind of bring them off, and then maybe you can give some notes about it or shadow you as well. And Glenn, you too, if you've tried it and found that those kind of things are helpful. So the first one I'll say is a GPS tracking device. Sometimes their radio frequency tracking or Bluetooth tracking, but the same kind of concept there. Can you tell us a bit about what it is? Hina yeah for sure. So I think the fact that there's so much on the market in terms of child tracking devices kind of goes to show you that it is a universal issue, right? It's not only within the disability community. There's a lot of parents all over the world that are struggling with this kind of thing. So, um, but in terms of tracking, we often have families ask and we'll recommend one or two. But of course, you know, because there's so many out there, um, it's hard for families to pinpoint which one to start off with. So one of the ones that's the most, um, the, the biggest one on the market is called Angel sense, which is a GPS tracker. So of course, for those of you that are not familiar with how GPS technology works, basically using satellites all over the world to pinpoint and triangulate where your child is. So the angel sense system is really great because you have an app. Everything has an app these days. And, you know, I've had a few parents use it, and it's been a big game changer because they can keep track of where their kid is. It gives them alerts. You can talk to them. Um, so, you know, of course all of these things are going to cost something. So that's a consideration as well. Um, the radio frequency trackers are kind of using radio frequency towers to To triangulate. So, um, they have a different range and a different set of, um, considerations when you're thinking about it. So Project Lifesaver is, uh, universal, but there's a BC version of it. So, um, that particular product can help with tracking as well. They keep track of everything. The great thing about the Project Lifesaver is that they actually also involve your local police department with it, so they can actually help you if that situation arises. And then for a situation like, um, Glen was talking about like going to a fair or, um, you know, going to a busy mall or anywhere where, you know, you're somewhat in an enclosed space, but still it's quite big. Um, I've recommended families get those Apple AirTags and you can actually get wearable Apple AirTag lockets or watches. And the great thing with the Apple AirTag technology is that it uses Bluetooth. So it's using almost everyone else's iPhones and pinging off of that to give you information. So, you know, we use AirTags to manage our luggage, but it's actually really a great tool for smaller environments to use for our kids and teens. So those are three of the different kinds of tracking technologies that are out there. And I've heard families say that the the Bluetooth tracking ones are really helpful for things like school field trips where your child is going out with a big group of people and, you know, they're kind of expected to tag along and stick with the group, but maybe they're not always interested in what the rest of the group is doing. So have a higher likelihood of kind of leaving. Yeah. And just kind of keep track of where you can, like, allow them to maybe even wander a little bit like within a set frame of guidelines like, okay, sure, you can go look at that, but at least you have that peace of mind that you can track them. And the Apple AirTags, out of the three that I've mentioned, is probably the most affordable because AirTags are ten dollars. So a little bit easier to to start off with. But yeah, and Project Lifesaver I think has to be initiated with the police. Like you need to go to your police station. Those are really robust, um, Units. They're waterproof. They're everything proof, um, and are really useful if you live in a more remote location where you would have concerns about being in the forest or somewhere where there's not Bluetooth. Um, so that's there as well. And you can talk to your local police department if that's something that you feel like you need. We actually did use the Project Lifesaver for my sister because we lived very remotely, and she had one for, I think, several years. Um, and it was monitored and sort of the maintenance of it was kept up by the police. Um, but it gave everybody a lot of peace of mind because of the sort of spaces between things and the likelihood of getting lost in the wilderness. Um, so, yeah, very possible. And it's been around for many years now. Yeah. And I was also going to add that a lot of families are also opting to get ID tags for their kids. So it's always kind of a, you know, a good thing to have to have their name and phone number so that if you know whether they're stressed or not, non-verbal or for whatever reason, they may not be able to identify themselves or their phone number or whatever. So, um, like road ID is a great website that you can go and order a variety of different kinds of, um, ID bracelets or like a medical alert bracelet, kind of like a medical alert bracelet. But yeah, so that's another option. Um, and I've heard some really clever things. A family I work with said, oh, we were camping and we just wrote our campsite number on our kid's bike helmet. I'm like, yeah, that'll that'll do it. That'll identify them to their location for sure. Yeah. Temporary tattoos are so much out there now. Yeah. Um, okay. Let's talk about another sort of set of strategies. And this has to do with the door. So having door chimes or door bells. Can you talk about why that would be useful. Yeah. So I think Glenn had mentioned this earlier and how you found this useful. You had to adjust it obviously as the kids get older and taller. Um, but yeah, there's a variety on the market, uh, of different door locks, um, locks that can go on the handle so your child isn't able to turn a handle. Um, and a few family. You just have to kind of be careful because some families will opt for to doing like the key code one, but that's to get into a door, not to get out of a door. So, um, so you just have to be careful with what you purchase. But there's plenty on Amazon that I would always recommend having something that makes noise when the front door opens. So there's door chimes, um, the door locks that go at the top and things for the door handle. So it makes it just that one extra step, um, that they would have to take to open the door and then they can't. Um, so those are some good options for doors. There's also the low cost option of Jingle Bells on your door, like we did for several years, just to have a way to know if doors were being opened. Um, and then, you know, your child might be forty steps ahead of you, but at least, you know, they went out. Um, so that's helpful. And you can even, um, a lot of our families are now opting to get because there's so much more affordable and accessible now. Little like mini security cameras that you can just put on top of the front door or outside the front door. So at least you kind of see, you know, that they've left the because a lot of the times you don't know where they're at. So even if you have one in the room, you can monitor where they're at, even if you have to leave the room. Um, so those things can also be really helpful because they're, you know, playback. There's live sound that you can talk to them, all those kind of things. So technology. Yeah. Go, Franklin. The other thing we did, which is more a teaching tool rather than preventing them from leaving, was just the stop signs on the doors. Um, I don't know if you were going to cover that somewhere else, but, um, that actually did help Becca quite a bit. Um, she would see that and sort of remember that she wasn't supposed to go through that door by herself. Yeah, yeah. And there, that's a really good one. And the stop sign just of note should be at the child's eye level. Um, so it's right in front of them right before they're going to be reaching for an exit. Um, another thing that I work with families on, from an SLP perspective, is a little bit of a verbal routine around leaving. So we practice going to the door, stopping, turning, saying, mom, are you ready? And then that's not enough, though, because you can say that and mom's not looking. So then you wait for mom to look at you and say yes. And then we all then we're ready to leave and go out the door. Um, and it's teaching a little bit of impulse control with a bit of a routine. And we know that routines are a real area of strength for people with Down's syndrome and learners with Down's syndrome. So it can work. But it takes takes legwork, takes practice, like all of these kind of things do. Much like the stop sign, it's not going to work the first time. You have to have to teach the purpose of the stop sign. Yeah, exactly. Um, did you want to make any more notes about the stop signs? No, I mean, I and I think it's so great because it is a visual cue. And since our loved ones are Down's syndrome are visual learners, so it kind of gives them that, you know, like second to be like, oh, hold on, there's something on here. What does that mean? And when it's taught properly then they'll I use it in my sessions all the time when I don't want kids running out of my office. So it works really, really well. Yeah. So that's a great suggestion. So now that we've spoken a bit about the kind of range of tools that are pretty common in this area and the reasons why someone might be wandering or leaving unexpectedly, let's talk to you a little bit more about how we kind of assign strategies to a given function of this challenge. Sure. Yeah. I mean, I think that a lot of what what was just discussed focused on environmental strategies, right? So setting up an environment where we can prevent these things from happening or be alerted that these things are happening, which which is great, right. But again, that's just one part of this whole this whole thing. Um, so as a behavior analyst, what I would do next is look into those visual cues, those other types of preventative strategies that we can do. Um, so what we we call that antecedent strategies. Right. So we might do things like social stories. We might do things like visual schedules, um, putting stop signs on the door to remind everyone of what they're supposed to be doing. Um, for sure. Depending on the function of the behavior, there might be different types of antecedent strategies that we might use, right? So for example, if it's something like I don't like brushing my teeth and I know that that's coming and it's getting close to bedtime. So I'm gonna try to move away from this environment. Right. So one of the strategies that we might use is using preferences, right. So how can we make this routine a little bit less aversive for you so that the chances of you wanting to run away from the situation go down. Right. So that would be one example. Um, if it means, you know, I want, um, I want to connect with you. Um, and, you know, I know that if I run away from this situation right now, um, I'm gonna get your your attention, then how can we create a routine where that quality time, that child time, is being presented so that we again decrease the chances of that child running away. Right. So that would be those would be some of the examples. Um, this would also all depend on the child, on the family's time and energy. You know, um, the capacity that a parent might have to implement all of these strategies, um, as well, um, we would also look into teaching strategies, of course. Right. So, um, sort of like what Glenn, um, was mentioning earlier, you know, a stop go game. Um, checking in. I think that this is super important. Checking in to see if we are allowed to go. Is it time? Is it? Is it an okay time? Um. You know, is it, uh, sometimes we do what I've done in the past. Um, uh, we call this, um, discrimination training, right? Where we teach that a certain thing means yes, and a certain thing means no. Right? So maybe a go sign and a stop sign on the door, which means that. Yes, right now we're able to go into the backyard or, you know, a stop sign is there right now is not a good time. And maybe we need to check in with with, um, with my grown up. Um, so, yeah, it would be, you know, just like how Hannah was saying as well, allowing also to practice and to teach. Oh, I can take a few steps away from mom and dad, and I can still check in to see if things are okay. And this all takes time and energy and effort on everyone's part so that another another set of strategies, teaching strategies. And then we have things that I think that sometimes we forget about which is consequence strategy. So making sure that we reinforce the appropriate behavior. I think that sometimes we we because it is scary, we tend to focus a lot on, um, on the things that have happened. And our reaction or reaction is valid, right? Like, oh my gosh, you ran away, right? And we might feel scared and anxious and all of these things. And sometimes I feel like we don't provide enough reinforcement for when a child does engage in appropriate behavior. Right. So also making sure that if a child is following a routine is checking in with mom and dad, they're also being praised and rewarded, um, as we're establishing these behaviors. Right. So it's not just about, um, consequence strategies, as in, you know, reacting to when these things happen, but also providing positive reinforcement for hey, you waited for me by the door. Thanks so much. High five or something like that. And sometimes that, you know, the the behavior might need to be reinforced in a more, um, in a more obvious way. Right? So, hey, you waited by the door. Thanks so much. Here's, you know, a sticker for for waiting for me. Or here's your favorite toy. Thanks. Thanks so much for waiting for me. Um, so, yeah, it would be a combination of a whole bunch of different strategies that target the function of the behavior. Right? And that would just depend on so many different things. I think a functional behavior, um, plan. Um, sorry. Assessment. Sorry. A behavior support plan would look different depending on the function of, of the child. Right. You could have several different behavior support plans depending on what function um, we're targeting. So tons to think about. But parents are not alone. This is why we're here to support parents in putting together a behavior support plan that, um, that suits their family and the child needs and function, um, of the behavior. Yeah. I think I just want to make a note about being extremely explicit when you're teaching some of these skills, like using very clear language. We as adults all know what checking in with a parent is. That doesn't make sense to a child. You have to explain all of the steps like you need to look at their face. You need to see that their face is looking back at your face, you know, and you have to wait for them to say something like, yes. And, you know, because a lot of times kids are taught like, look for mom and dad before you go. So they look and they're like, oh, yeah, mom's over there in the kitchen doing something completely different. But I did see her. So now I'm going, right. So we have to really, really break down the steps required for all of these things. And that is where having a team to help you is really useful. Did you have more notes that you wanted to? No. I think that's a really good point. And I think sometimes it's easy to do these kind of strategies within like a routine. Right. So anytime you're gonna I say this to a lot of, um, school teams that, you know, like if you're going to go out into the playground on lunch, like create a routine around that, that includes those strategies for staying close to the E or, you know, checking in and everything. Because obviously, as you know, families have a lot on their plate. They have a lot going on. And if you're packing up a whole family of six people to go to the fair, the last thing you're thinking about is like, oh, I got to employ all these strategies. But I think if you build them into your routine and everybody is part of that routine, then it gets easier also. So it's not just like a you don't want it to be like a random, just like grab the strategy and grab this strategy. But if we can make it into a structured routine and like Marla mentioned, people with down syndrome really thrive on structure and routines. So let's use that to help them understand. So a lot of our families that have had success with decreasing the levels of elopement is because they're like, okay, so we have a visual at the door that has a picture of checking in with mom. So we do that, we point to it, we pick up our shoes and whatever. So they have an established routine that works for them, and then it just helps solidify that strategy in the child's head as well. And I think it's it definitely can be that a family relies more on environmental strategies, locking that door up, you know, charms, alarms, GPS, all of those things until they get to a point in daily life, which is very hard to do where there is space to work on teaching some of these skills. And there might need to be a waiting period for some maturation and some impulse control and some executive functioning skills that maybe aren't fully developed yet. Right. There's there are better and worse times to try and teach some of these skills. Yeah, for sure. Depending on where you are in the process, you might rely more on one thing or another thing, um, depending on what everyone's needs are. Yeah, absolutely. I definitely wouldn't recommend trying to teach this at the same time that your child's, like starting high school or having a surgery or doing some other major life transition. That's not the moment. Um, so use the environmental strategies to prevent things and work on addressing the real cause of the behavior, um, when there's space in life to do that. I was also going to say as well that maybe. Yeah, just like you were saying, Marla, we we rely on the environmental strategies, and then maybe we add one antecedent strategy and we get really good at that, and then maybe we start teaching a little bit. Right? And then we get really good at that and then add another thing. Right. Um, it doesn't have to be this super, um, daunting task of having to implement all of these strategies all at once, because that's just not realistic for anybody. No, it's yeah, it's not very practical. Um, And of course, we're keeping keeping half an eyeball on the longer term goal, which is that we would have a person who doesn't need these environmental strategies because they just know how to, you know, when it's safe and how it's safe to leave the house or leave the situation. Um, so that's what we're aiming for. Um, so we probably don't want to have to use the GPS and things forever, and that's why we would put effort into teaching some of the other skills, especially as they get older and more mature. You can start shifting your focus more towards some of those other higher level strategies. And Marlo brought up a good point earlier that that level of impulsivity, you know, it takes time for that to kind of dwindle as you get older because, I mean, all young kids, no matter what diagnosis they have, have an impulsivity thing, right? Like kids will jump to play with something and they're learning their own boundaries. They're learning to figure out what's safe and what's not. And I think even, um, helping them understand the word safe and not safe or unsafe, right. Like having them understand that because that can help them in so many situations, even if you're out with them to know what is safe and what's not, and then that can kind of help. And Glenn described it really well earlier when he said, you know, with his son Sebastian, the impulsivity was really, really, really high for a long time. And then kind of all of a sudden it clicks in like, oh, impulse control. Oh, alerting around leaving the house like, oh, I see why that is dangerous. So we can't always predict why and when somebody would develop more of that. Executive functioning and safety skills basically is what it comes down to. Yeah, yeah yeah, yeah. It's funny because he I mean, to this day he still has very poor impulse control generally and like emotional regulation. But in terms of like physical safety. Yeah. Just that one area like of traffic and those kinds of things just. Yeah. Not wanting to be away from us a lot more separation anxiety than he had when he was younger. Yeah. There is another angle on consequences that we should at least talk about a little bit, because it's every parent's impulse for sure. Um, and that is punishing your child for leaving unexpectedly or running away. Um, and I think parents have this impulse to do this because it is so scary, and they just want it to never, ever, ever happen again. Um, so what are your thoughts or what could you share with us around sort of punishing your child or yelling at them, or trying to make sure that that will never happen again through that strategy? Yeah. Punishment procedures are usually not effective, um, in these types of scenarios. Um, as a behavior analyst, you know, we, we, we go for procedures that, um, focus on positive reinforcement. I think one of the reasons why punishment procedures are not effective is because it doesn't teach the child what they're supposed to be doing, right. They just get, um, perhaps an aversive, um, thing presented to them in the moment. And yeah, it might be, you know, scary to see Mom or Dad respond that way. It might also be funny to see Mom and Dad respond that way. Parents really do not like that. Um, yeah. Yeah. But it doesn't address the fact that you're not teaching what they're supposed to be doing. Right. And so, um, at the end of the day, it doesn't become, um, uh, an effective strategy that, um, that replaces appropriate, more adaptive behavior. Right. So, um, I know that, you know, every parent, I think any parent would respond, um, in a way that, you know, would would, um, perhaps might not be the best in that moment. Right? And it's out of and rightfully so stressful. So scary, so scary. Yeah, but I think that, uh, you know, if this is something that, um, maybe you notice that you do, um, again. Right? Just connect with people who might be able to support you so that you can come up with a plan that would, uh, focus more on on those, um, proactive strategies, um, to support your child. Um, there is a handout that we created with some of some of, like the, the trackers that I talked about and a few additional strategies that include some of the behavioral strategies Sarah talked about. And Glenn. Um, so, yeah, so we'll put that up on our episode page for families to access if needed. Um, well, thanks to both of you for coming. This is a very, very common experience. So I hope if you were listening, you at least felt like, oh, it's not just me. Okay. Um, and that there is support available for this kind of extreme stress and situation. Yeah. Yeah. Great. Thank you.