Autism and the Law Enforcement response

1. Autism and the Law Enforcement response Officer Seth Coleman 2019 CIT International Conference, Seattle, WA

2. Table of contents • Overview and ADA • Diagnosing Autism • Behaviors & Characteristics • Common Therapies • Autism Related Police Contacts • Restraint & Control • Care Giver Contacts

3. Course Objectives • Recognize the signs of Autism. • Identify safe methods for responding to individuals on the Autism spectrum. • Recall available therapies. • Recognize most common types of Police related contacts with subjects on the Autism spectrum.

4. If you’ve met one person with autism, then you’ve met one person with autism. • Autism is a neurologically based developmental disability that seriously affects a person’s ability to communicate, socialize and make judgments. • Autism can affect the person’s sensory responses to even normal level of lights, sounds, touches, odors and taste. • Autism is typically observed by age three and is more common in males than females. • Despite ongoing research, there is no known cause or cure. Overview

5. Autism is referred to as a spectrum disorder. It affects each person differently and ranges from mild to severe. It is an umbrella term. • Other terms for autism may include, Asperger’s Syndrome, High Functioning Autism or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Overview

6. Autism is a developmental disability, as stated by the Centers for Disease Control and Prevention (CDC). • A disability, per the (ADA), with respect to an individual • A physical or mental impairment that substantially limits one or more of the major life activities of such individual. • Self care, walking, seeing, hearing, speaking, breathing, learning. • Having a record of such impairment. • Being regarded as having such an impairment. American Disability Act

7. Diagnosing Autism

8. No one should expect a Police Officer or a Corrections Officer to diagnose an individual with autism or a related developmental disability. • Children as young as one year old have been diagnosed as being on the autism spectrum. Diagnosing Autism

9. Many children show signs of developmental delays at birth, although a percentage of children develop normally, hitting all developmental milestones until a major regression is observed. • Major regressions typically occur between the first and second year of life. • Major regressions can include the loss of motor skills as well as cognitive skills. Diagnosing Autism

10. Diagnosing autism is done through behavioral evaluations conducted by medical professionals with input from the parent or caregiver. • M-CHAT-R • Modified checklist for Autism in Toddlers revised • 16 to 30 months of age • No current blood tests, ultrasounds or CAT scans exist to diagnosis autism. Diagnosing Autism

11. Behaviors & characteristics

12. Non-verbal or limited speech. • Avoid eye contact. • Prefer to be alone. • Lack of fear or understanding danger. • Apparent insensitivity to pain or a high tolerance of pain. • Unusual responses to lights, sounds or other sensory input. • Seek sensory stimulation, including heavy pressure. Behaviors & Characteristics

13. Have difficulty interacting with others. • Avoidance of touch. • Sustained unusual repetitive actions. • Inappropriate laughing or giggling. • Inappropriate attachments to objects.. • Exhibit arm, finger or wrist flicking. • May have trouble with speech volume. Behaviors & Characteristics

14. Appears as if deaf. • Toe Walking. • Echo words and phrases. • Mimic body gestures and movements. • Fascination with shiny objects. • Rock back and forth.. Behaviors & Characteristics

15. Therapies for autism Therapy techniques are constantly evolving and vary on their therapeutic value from person to person.

16. Applied Behavioral Analysis (ABA) • Physical Therapy • Occupational Therapy • Speech Therapy • Social Groups • Diet GF/CF • Detoxification • Social Experiments • Horse Therapy (HIPPA) • Prescribed medication • Cognitive testing & family recording Therapies for Autism

17. The listed therapies are currently the most common and are not the only available ones. • Even with intense therapy, developmental improvements can be slow and must be constantly reinforced as regressions are common. Therapies for Autism

18. Autism related Police Contacts

19. Autistic individuals often won’t understand that their actions negatively impact others, or themselves. • Person displays unusual behavior in a community setting, store or restaurant. • Rearranging or making order out of store displays, may appear as shoplifting. Autism related Police Contacts

20. Parent or caregiver actions are misinterpreted as assaults or batteries. • Meltdown • A Meltdown might occur from a want or need not being met or the inability to adapt to a change in the environment or the persons schedule. • The complete loss of behavioral control can leave the most experienced parent stressed, frustrated and overwhelmed • An Officers involvement may cause additional stress to both the individual and caregiver.

21. What is the most common cause of Death for individuals on the Autism Spectrum?

22. Elopement and drowning are the leading causes of death for individuals with ASD. • In 2009, 2010 and 2011 accidental drowning accounted for 91% of deaths for ASD under the age of 14. • Most individuals with an ASD who wander or elope are unable to communicate their name, phone number or address. • Nearly half of all children with ASD will attempt to elope from a safe environment. • How do we respond? Autism related Police and Fire contacts

23. Police response tips

24. Make sure the person is unarmed and maintain a safe distance, as they may suddenly invade your personal space. • Subject may be nude. • Talk calmly and softly. • Repeat or rephrase questions. • Speak in direct, short phrases. • Avoid using slang terms. • Allow for delayed responses, 10 to 15 seconds or more Police response tips

25. Consider using pictures or written words. • Model the behavior you want the person to display. • May answer with seemingly meaningless answers / it is an attempt to communicate. • They are under no obligation to make sense to you. Police response tips

26. The person may inappropriately run towards officers. • May flail / fight against medical procedures. • May be Non-verbal. • May not recognize your uniform or vehicle as authority. Police response tips

27. Look for medical alert tags. • If available, use time and distance to your advantage. • No one would expect a person who is deaf to be interviewed without an interpreter, use all available resources and document it. • Don’t force eye contact. Police response tips

28. Move them away from the scene, or move the scene away from them. • Even if your subject is nonverbal they probably can hear and understand some or all of their primary language. • Only one Officer should do the talking, use the contact cover model. • Subjects with autism will act out, if they have no other means of telling you what’s wrong. Police response tips

29. Break down tasks into simple steps. • Prepare the person for what comes next, avoid the surprise. • Bribe techniques. • Listen to nonsensical statements for key words • Continue to answer repetitive questions. Police response tips

30. Restraint and control Despite your best efforts, you may have to restrain the person and take them into custody or transport for medical attention. These are high risk situations for Police Officers and individuals with Autism / Safety First

31. The subject may have an altered sense of pain. • Pain compliance may not work reliably. • Biting is a common defensive behavior. • Up to 40% of this population has some form of seizures. • Most subjects have hypotonia, meaning poor or low muscle tone / Think asphyxiation. Restraint and control

32. Asthma and heart conditions are also common for individuals with autism. • The person may not recognize the futility of resistance and continue to struggle. • Avoid standing too close or behind the person, as they may suddenly lurch backwards. • Roll medical, once the person is safely restrained. Or stage prior to contact. Restraint and control

33. OC Spray, Pepper spray, CS Gas. • If your subject has an altered sense of pain, aerosols will most likely fail as a means of control. Remember that the subject is most likely hypotonic in tone and has respiratory problems already. You will then be going hands on with a mentally unstable individual in a medical crisis / prepare to be covered in OC. • Post incident care? Restraint and control

34. Taser, Electronic weapon. • An initial Taser probe deployment will likely create momentary incapacitation that could enable officers to quickly move in and stabilize and restrain the subject (cuff under power). One must presume that pain compliance resulting from a drive stun with or without the use of a cartridge will most likely be unsuccessful. • Post incident care? Restraint and control

35. ASP baton, PR24 • A baton strike may be useful as a means of disarming or creating a distraction, depending on the circumstances. Be prepared to cause damage and injury to the subject without an appropriate pain response or mental response to the actions. • Post incident care? Restraint and control

36. Post incident care. Care Giver Contacts

37. Communicate with the family about what comes next, Arrests, legal hold, medical transport. Keep them informed. • Offer to contact family members for support, or refer to support groups. • Communicate with loved ones to ensure their mental stability. • Inform them of their rights as parents and care givers. • Make attempts to spend extra time on scene. Care Giver Contacts

38. Attempt to recognize sign of depressions and document. • Difficulty concentrating. • Feelings of guilt • Feelings of hopelessness and helplessness. • Insomnia. • Lost of interest in activities. • Overeating or appetite loss • Headaches • Thoughts of suicide or attempts at suicide. • Thoughts of violence toward loved ones. • Fatigue. • Isolation Care Giver Contacts

39. Economic costs • It is estimated to cost $17,000 more per year for care of a child with an ASD compared to child without ASD • Intensive behavioral interventions for children with ASD cost $40,000 to $60,000 per child, per year. • Victims of snake oil Care Giver Contacts

40. Jillian and London McCabe

41. On November 3rd, 2014, at approximately 6pm, Jillian McCabe threw London McCabe off of the Yaquina Bay Bridge near the Oregon coast. • Jillian then called 911 and informed a dispatcher of the event saying “he is in the water and gone”. Oregon Mother throws son off bridge

42. Jillian’s husband Matt had recently been battling multiple sclerosis and a mass on his Brian stem making work impossible. • Jillian posted a video on Youtube expressing that she was alone and overwhelmed. • Jillian had created an account on Youcaring.com to raise money for care for her husband and son. • Jillian claimed to begin hearing voices in her head. • Relatives reported that Jillian attempted to self admit into an inpatient and outpatient facility but never received treatment, as beds were not available. Oregon Mother throws son off bridge

43. Our most vulnerable citizens • Police Officers will often be the last and best hope a subject with special needs may use to help them endure a community that can be actively hostile and neglectful towards their very basic needs and concerns. Caring for them kindly, humanely and with respect is one of the highest callings of our profession. CLOSING