The Easton Police Department is among a growing list of police departments in the state to offer Autism Safety Alert Forms to aid interaction between police officers and autistic individuals.

The form is the brainchild of Naugatuck resident Jennifer Harding, a single mom whose son Derek has autism. Harding also founded Walk with Derek which is a walk to raise autism awareness.

When Derek was 11 years old, he was riding in the back seat when Harding got in a car accident. Thankfully neither were seriously injured, but the incident made Harding question what would have happened to Derek if something serious had happened to her. Derek is non-verbal and is also a runner.

“Derek just recently got an iPhone and understands how to type his name, town, and number into the notes app, but not all people with autism are capable of communicating important information like their name, town, and number,” Harding said. “The Autism Safety Alert Forms helps immensely.”

The form provides police dispatchers a child’s name, date of birth, nickname, emergency contact information, height, weight, address, eye, and hair color. The form also gives the child’s communication abilities, unique behaviors, likes, and ways to help comfort the child. The back of the form is specifically for favorites.

Easton Police Chief Richard Doyle said the forms are voluntary and kept confidential at the police station, and are only available only to police.

“They will assist first responders if an autistic individual goes missing or has a medical emergency at home,” Doyle said.

Harding said special needs parents are under pressure in a time of panic and can’t always remember what their child likes.

“Having the option to fill out this form gives parents time to think when they are not stressed out and include everything about their child,” she said.

 Harding’s goal is for every police department in Connecticut to offer the form. She is working with a state lawmaker and state troopers to get the form across the state. The Watertown, Oxford, Naugatuck, Meriden, Seymour and Ansonia PDs offer the form. Recently Norwalk, Orange, and New Britain added it. Oxford’s Board of Education is discussing sending the form home to children in the special education programs, she said.

“It would be fantastic to see the form grow further than the state of Connecticut,” Harding said, adding that she has spoken with officers in Colorado and Hawaii.

 Those interesting in filling out the form can pick one up in the police station lobby or download the form on the police department’s website at

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