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Autistic children face a higher risk of drowning; an expert offers safety advice

 Underwater view of a pool. Blue lines are on the floor of the pool.
Creative Commons
One of every six child drownings involve a child with autism, according to data from the Florida Department of Children & Families.

Families with ASD children need to pay close attention near water. Drowning is the No. 1 cause of death for autistic kids due to a behavior known as "elopement," according to the National Library of Medicine.

In February, a 5-year-old boy with autism managed to get out of his family's Seminole County home without them noticing and wandered over to the pool. He was later found unresponsive and pronounced dead, according to a report from the Florida Department of Children & Families.

The tragic event is just one instance indicating the dangers bodies of water pose to children. Drowning is the No. 1 cause of death in children in general for ages 1 to 4, according to the Centers for Disease Control and Prevention.

However, drowning is also the No. 1 cause of death for children of all ages with autism spectrum disorder. (ASD).

Kids with autism face a higher risk of drowning due to the behavior known as "elopement" or a tendency to wander off, according to data from the National Library of Medicine.

The reason for the elopement is because of an attraction to the way light shines off the water, said Katie Pabst Williams, a director of clinical operations at the Florida Autism Center’s Northwest Florida Division.

Pie chart in entirely one color: all 36 child fatalities in Florida this year are caused by drowning, side-by-side with a bar graph that shows children 3 and under are 64% of those deaths.
Florida Department of Children & Families
There have been 36 reported drownings involving children in Florida. Six of them were reported to have autism. Five of the six were reported to have had wandered off unnoticed.

There have been 36 reported drownings involving children in Florida. Six of them were reported to have autism. Five of the six were reported to have wandered off unnoticed.

“A child can drown in as little time as it takes to go inside and get a towel. Or, put a load of laundry in the washer," Pabst Williams said. "So, having someone designated constantly to supervise any children near the water or in the water is extremely important.”

Reports indicate between 2000 and 2017, "wandering" was the most common activity that led to the drowning of an autistic child — listed at 73.9%.

So far this year, DCF has reported 36 deaths associated with drowning for children up to 18 years old in Florida. Six deaths included children with autism. Five out of the six incidents reported the child had wandered off undetected.

The most recent occurrence was at the end of April in Hernando County involving an 8-year-old autistic boy who died in a horse trough.

Part of the problem is children may not recognize the danger the water holds, Pabst Williams said.

“They may not recognize that they don't know how to swim, especially if they've been in flotation devices every time they've been in the water around their parents," she said.

As the weather heats up, more families are headed to the water to cool off and experts are warning families and lifeguards to pay close attention.

Pabst Williams said supervision is key to a child's survival, but there are other strategies parents can use including investing in barriers such as self-latching gates, fences around pools and child locks on door knobs.

"Another example is pool alarms," she said. "If we're talking about swimming pools, there's a device that can sit on the edge of the pool that can detect when anyone at or, you know, a body enters the water, and the alarm will sound."

Alarm systems are valued between $50 and $250, according to the Florida Department of Health.

Pool covers can also be greatly effective, not only acting as a barrier, but also removing the shimmering reflection that may attract a child. However, the health department listed this as one of the more expensive solutions at over $1,000.

 Graphic showing "The Physical Barriers" that can be installed around a pool to keep children safe, and their relative costs broken down by $. Pool Safety Fences and Safety Covers cost more than $1001, Self-Closing and Self-Latching Gates cost $501-1000, Latches on Doors to Pools and Pool Alarms cost $50-250, and Childproof Locks and Door/Window Alarms cost $0-49.
Florida Department of Health

Visual cues are another good option since many autistic children don't necessarily respond well to verbal commands. Pictures indicating the water safety rules, or red cards depicting when a child should not enter are both effective ways of communication.

Pabst Williams also advised lifeguards at public pools to be on the lookout for autistic children. If they encounter a child breaking the rules, an autistic patron may not respond well to loud, verbal commands. Instead, be patient and try to point out signs at the pool that may indicate what rule they're breaking.

Ultimately, Pabst Williams said there’s no alternative to swim lessons — the best option to guarantee a child's safety. Pabst Williams said theFlorida Autism Center creates individualized plans that evaluate any negative effects the child is experiencing while swimming, and then modify their environment accordingly.

"If they're enrolling in swim lessons and going to be experiencing that for the first time. A booklet of pretty simple pictures that an adult can kind of talk them through what that looks like," Pabst Williams said.

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