How do I leave my autistic child with a babysitter?

What should I put on a sitter sheet?

Write down the routine, communication supports, allergies, foods to offer or avoid, and the support your child prefers when distressed. Show the sitter how to understand your child's words, signs or device; keep that communication available. Include the home address, your contact details, where you'll be and when you'll return, emergency contacts, your child's doctor and, in the US, Poison Help (1-800-222-1222).

Go through the sheet and the home together. Discuss exits, water hazards, safe sleeping and any individualized medical or emergency plan. Ask the sitter to explain the plan back and show that they can use the needed supports. A sheet helps share information; it doesn't replace suitable training or supervision. Use the AAP checklist to identify further questions for your family.

How do I make the first few times easier?

Arrange a paid introductory visit while you remain available at home. Watch how the sitter responds to your child's communication and needs before deciding whether they're a good fit. If you later choose a short outing, agree on contact and return arrangements, and make sure the sitter has the support they need.

Explain your departure using communication your child understands. A picture schedule may be useful if they already use one; don't assume pictures work better for every child or promise an exact return time you can't keep. Agree with the sitter how to respond if distress increases or doesn't settle. Don't assume it will pass within a set number of minutes. If the child or sitter cannot manage safely, return or arrange appropriate help. There is no required practice schedule or guarantee that repeated departures will make it easier.

What safety basics does the sitter need to know?

Go over your child's safety and medical plans together before you leave. If your child may need medicine while you're out, leave written instructions that match the prescription label and your child's care plan: the medicine's name, how much, when and how to give it. Keep the medicine in its original labeled packaging, out of your child's reach. If anything is unclear, the sitter calls you or your child's clinician before giving it. A sitter never guesses at a dose and gives no medicine you haven't asked them to give. If a medicine or task needs training, ask your child's clinician how the sitter should learn it. The AAP's medication safety tips advise keeping medicines in their original packages, reading the label and checking with a doctor or pharmacist when unsure about a dose; its sitter checklist says a sitter gives medicine only as the parents instruct.

Water needs an adult's full attention. Agree how closely the sitter watches your child in a bath, pool or anywhere near water, based on your child's age, swimming ability and care plan; for young children, the AAP advises staying within arm's length and keeping off the phone. Barriers help between swims: if there's a pool, the AAP recommends a fence at least 4 feet high on all four sides with a self-closing, self-latching gate. Keep bathroom and outside doors closed or latched where your child could get through, and empty buckets and wading pools after use. No single step prevents every drowning, so barriers and alarms work alongside watching, not instead of it (AAP water safety).

If wandering is a concern, plan adult supervision and secure exits without obstructing emergency escape. Discuss nearby water and traffic hazards. Locks don't replace supervision; agree on who watches the child when doors open. Ask the care team about an individualized wandering plan. Anderson and colleagues' parent survey documents wandering risk, but it doesn't test this sitter checklist or prove a particular lock will prevent harm.

If your child is missing, the sitter calls emergency services right away (911 in the US; your local emergency number elsewhere), then calls you, and follows the dispatcher's instructions and any local procedures. The National Center for Missing & Exploited Children advises calling 911 immediately and searching the surrounding area, especially water, because time matters. For any other immediate danger or medical emergency, the sitter follows your child's emergency plan and calls emergency services without waiting for you to answer.

Is it normal to feel guilty about leaving?

You can want a break and still feel worried about handing over care. You don't have to dismiss those feelings or treat them as proof that the arrangement is safe or unsafe. Review what worries you, what the sitter can demonstrate and what your child communicates. You can change the plan.

A 2013 survey by Harper and colleagues found an association between more respite hours and lower reported parental stress in 101 mother-father pairs raising autistic children. It wasn't an experiment, didn't establish that respite caused the difference, and didn't measure a guaranteed improvement in parenting patience or the child's outcomes. A suitable break is an option to explore, not an obligation or a promised treatment.