Frontiers in pediatrics · 2026
Prevalence and risk factors of elopement behavior in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis.
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Ciai Lai, Guolin Huang, Xi Chen, Rongzhen Li, Xionghan Lian, Xin Li, Aiyuan Cai
Аннотация
OBJECTIVE: Wandering and elopement are common and potentially life-threatening behaviors in children and adolescents with autism spectrum disorder (ASD). Despite extensive research, debates persist regarding the chronic nature of these behaviors, their relationship with cognitive and linguistic functions, and the primary risk factors. This study aims to quantitatively assess the incidence of elopement in this population and systematically evaluate associated risk factors.
METHODS: Systematic searches were conducted in PubMed, Embase, Web of Science, and Cochrane Library databases to gather observational studies on the incidence and risk factors of elopement in individuals with ASD (≤18 years old) from the inception of the databases to August 2026. Data were pooled using random or fixed-effect models, and subgroup analyses were performed. This study is registered in PROSPERO (CRD420261456297).
RESULTS: Fourteen observational studies were included. Meta-analysis revealed that the pooled incidence of elopement among children with ASD was 46% (95% CI: 36%-56%). Subgroup analysis showed no significant difference between recent (43%) and lifetime incidence (51%) (P = 0.4954), highlighting the chronic nature of this behavior. Additionally, no significant differences were found in elopement risk across genders (40% in males vs. 31% in females, P = 0.4374) or cognitive/linguistic function levels (41% in severe/ID/non-verbal group vs. 45% in mild/without ID/verbal group, P = 0.8434). Risk factor analysis identified comorbid attention-deficit/hyperactivity disorder (ADHD, aOR = 3.00), lack of danger awareness (aOR = 2.20), and communication disorders (OR = 2.24) as highly correlated with elopement behavior.
CONCLUSION: Elopement is a prevalent and chronic behavior in children with ASD, unaffected by improvements in cognitive or linguistic abilities, challenging traditional clinical assumptions. In clinical practice, elopement prevention should be part of routine assessments, with interventions focusing on managing comorbidities like ADHD and enhancing safety skills training.
METHODS: Systematic searches were conducted in PubMed, Embase, Web of Science, and Cochrane Library databases to gather observational studies on the incidence and risk factors of elopement in individuals with ASD (≤18 years old) from the inception of the databases to August 2026. Data were pooled using random or fixed-effect models, and subgroup analyses were performed. This study is registered in PROSPERO (CRD420261456297).
RESULTS: Fourteen observational studies were included. Meta-analysis revealed that the pooled incidence of elopement among children with ASD was 46% (95% CI: 36%-56%). Subgroup analysis showed no significant difference between recent (43%) and lifetime incidence (51%) (P = 0.4954), highlighting the chronic nature of this behavior. Additionally, no significant differences were found in elopement risk across genders (40% in males vs. 31% in females, P = 0.4374) or cognitive/linguistic function levels (41% in severe/ID/non-verbal group vs. 45% in mild/without ID/verbal group, P = 0.8434). Risk factor analysis identified comorbid attention-deficit/hyperactivity disorder (ADHD, aOR = 3.00), lack of danger awareness (aOR = 2.20), and communication disorders (OR = 2.24) as highly correlated with elopement behavior.
CONCLUSION: Elopement is a prevalent and chronic behavior in children with ASD, unaffected by improvements in cognitive or linguistic abilities, challenging traditional clinical assumptions. In clinical practice, elopement prevention should be part of routine assessments, with interventions focusing on managing comorbidities like ADHD and enhancing safety skills training.