Autism Awareness for Law Enforcement & Court Personnel · •Lacks empathy •Unable to see another person’s perspective •Unrealistic fears (bugs, dogs, dentist, etc.) ... (burning

Autism Awareness

for Law Enforcement & Court Personnel

Why are we here?

To provide awareness of children and adults with an Autism Spectrum Disorder (ASD).

WHY is this important?

•To maintain officer and citizen safety and

•To avoid litigation

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You receive a “domestic disturbance” call from a shopping mall regarding a 32 year old male and

his caregiver.

• The man was pepper sprayed, handcuffed, ankles were flex cuffed, and then left face down on the pavement.

• He vomited and became unconscious.

• He was declared dead at the hospital.

• Court awarded 4.4 million dollars to the family

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Objectives

9.14.01 Identify the recognizable signs of a person who has Autism Spectrum Disorder (ASD).

9.14.02 Identify the procedures a law enforcement officer should follow to ensure the safety and cooperation of a person with Autism Spectrum Disorder (ASD).

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What is Autism or ASD?

• Autism Spectrum Disorder is a wide range of disorders including Autism, Aspberger Syndrome, Rhetts Syndrome and other lesser known diagnoses.

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Autism Defined

• Autism is a neurodevelopmental disability.

• What does neurodevelopmental mean?– It refers to the nervous system, including the brain

– Autism affects the normal brain development in the areas of social interaction, communication, repetitive behaviors and difficulty adjusting to change.

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Autism Facts

• IQs may range from 25 to >150

• It is NOT a mental or psychological disorder

• Cause is unknown

• NO CURE

• People with developmental disabilities are SEVEN TIMES more likely to come in contact with Police than the general public

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Incidence

• Autism/ASD is America’s fastest growing developmental disability

• National rate is 1 in 68 children

• MD rate is 1 in 80

• Autism is 4 times more common in males

• 25-40% of people with ASD have seizures, compared to .001% of the normal population

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Sensory Overload

• People with autism may react differently to what we perceive as normal levels of light, sound, touch, odor and taste (5 senses)

Why is this important?

• A person with autism may run from or toward lights, sirens, two-way radios, K-9 partners, aromas or a light touch on the body.

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What does “sensory overload” look like?

• People with autism can’t handle stimuli from more than 1 sense at a time.

• Overload results in self-stimulating “stimming” behavior (screaming, rocking, hand-flapping)

• The person will be so fixated on what he/she is doing that YOU CANNOT get his/her attention

• IF the person is sensitive to touch, he/she may pull away, run or scream when touched

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Be aware of and manage the sensory environment

• HOW?– Assess the scene for sensory influences. If

safe—turn off lights, sirens, remove K-9s and move person to a quiet area

– Calm creates calm!

– Use geographic containment and maintain a safe distance

– BE PATIENT! The person needs time to calm down

– Speak in simple “bullet point” language

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Recognizing a person with ASD

• The bad news: Autism may not be physically obvious. You cannot just look at someone and know that they have it.– Parents notice that their child with autism does

not respond when called by name

– They do not gesture or point to objects

– Most engage in repetitive behaviors such as

hand-flapping or finger flicking

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No one expects a police officer to diagnose Autism, but there are some common signs that you

may observe in a field situation.

Common signs: Social Interaction

• Avoid eye contact

• Prefer to be alone

• Does not notice other people

• Does not respond to name(may appear deaf, cover ears or look away)

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Common signs: Social Interaction

• Lacks empathy

• Unable to see another person’s perspective

• Unrealistic fears (bugs, dogs, dentist, etc.)

• Difficulty making transitions

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Common signs: Communication

• Be non-verbal (~50%), or have limited speech and vocabulary

• Have problem with speech volume (loud whispers) or sound monotone (computer-like)

• Echolaic

• Talk to themselves or no one in particular

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Common signs:Communication

• Doesn’t point to objects or use gestures AND doesn’t respond to other people’s words or gestures

• Laughs, giggles or other inappropriate response to questions (Says NO or Why to everything)

• Unable to process nonverbal cues like facial expression or body language

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Common signs: Behavior

• Unusual repetitive behaviors: rocking, spinning, hand-flapping, finger-flicking

• Tantrums: (screaming, hitting, biting, kicking, or hair pulling) if anything disrupts the daily routine or the obsessive behaviors

• Obsessed with need for order and routine

• Unusual reactions to pain (unresponsive or over-reacting)

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Common signs: Behavior

• Unusual responses to light, sound, or other senses

• No sense of fear or danger

• Avoid touch

• Unusual gait (may seem clumsy, pigeon-toed, use double footing on stairs, or runs with a “duck-waddle” motion

• VERY attracted to water, lights, reflections or shiny objects (your badge, gun, etc.)

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Visible Identification

• Medical-alert bracelet, shoe-tag

• Autism information card (name, address, phone, contact numbers for parent/caregivers and doctors)

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Vehicle Identification Stickers

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Responding to 911 Calls

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How should I respond to a potential Autism-related 911 call?

• Most autism-related calls for assistance fall into two categories:– Self-stimulating or aggressive behavior toward

others, or

– Running or wandering away

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Responding to Self-Stimulating or Aggressive Behavior calls:

• Stay calm and focused

• Use simple language and speak slowly

• Be patient--a person with autism has trouble sending & receiving messages.– He/she will respond inconsistently depending on

emotional state, familiarity with people involved in the situation and the sensory environment

• Behavior may escalate into Serious Injurious Behaviors (SIBs) due to the environment

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Serious Injurious Behaviors

• Serious Injurious Behaviors are behaviors that escalate to the point that the person can cause a serious injury to himself, other people or you

• What are some examples of escalated behavior that might trigger a call for service?– Screaming, pacing, kicking, biting, hair pulling or

head banging

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When responding to a call with no knowledge that an autistic

person is involved—what might each of the following 4 situations

be confused with?

Parent/caregiver actions are misunderstood

A parent refuses to buy his autistic son a toy at the mall and the child has a “melt down” by lying on his back on the floor kicking, screaming and crying.

•Bystanders call the police when the father quietly picks the boy up and carries him out of the store.

•What might this be confused with?– Assault or kidnapping

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A person is “acting weird” in a place where he/she is unknown

Police receive a call from a store clerk because a man is opening food/drink packages, eating without paying and acting suspicious.

•When you arrive—he ignores your orders to put the packages down. He gets belligerent and says that “These are MY chips” and seems aggressive and defensive.

•What might this be confused with?- Might be high on drugs or a threat to officers

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People with autism like to rearrange store displays

Police receive a call from a music store because a teenager is randomly picking up CDs and putting them back into the display in different places.

He keeps looking around the store, but never makes eye contact with the employees.

•What might this be confused with?• Shoplifting (but the person has an obsession with

putting things in order)

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Following a customer around a store

Police receive a cell phone call from a customer in a store because a suspicious person is following him/her around trying to be helpful. The person even peeks around the edges of the displays to keep the caller in sight.

What might this be confused with?-Stalking

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Responding to Running Away or Wandering Away calls

Call for Backup while you get information from the person that made the call.

•Most times this will be a parent or caregiver.– Many have the child’s information in a local 911

Call Center database

– Many have an Autism Emergency Contact Form with a photo and detailed information about their child’s characteristics, favorite places, and likes/dislikes including how to approach and de-escalate behaviors

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Is Project Lifesaver available?

• Radio frequency technology programs are now the standard for tracking vulnerable individuals.

• If available, these programs can assist you during the search and rescue operation using transmitters and receivers

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Search

• Check water sources (pools, lakes, fountains)➢ Drowning is a leading cause of death

➢ They may wander or run into traffic

➢ They may look in windows or try to enter homes/buildings

➢ They may hide in alleys or under things

➢ They may run naked in the neighborhood

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Keep in Mind

• A person with Autism does not know that he/she is lost and probably will not ask for help

• A person with Autism may not respond to you calling him/her by name

• He/she may hide from you because you are a stranger

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Field Encounters

During a field encounter, a person with Autism may:

• Approach inappropriately, invade your person space or stand too far away

• Be non-verbal

• Attempt to re-enter a dangerous environment (burning house, run into traffic, etc.)

• THEY ARE A “BOLT-RISK!”

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During a field encounter, a person with Autism may:

• Be upset about minor changes to daily routine

• Have problem recognizing police uniforms or vehicle

• Not understand command presence, body language or nonverbal communication

(eye rolling, shrugs, hand signals, etc.)

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Safety & Communication Tips

• Approach in a quiet, non-threatening manner

• Make sure the person is unarmed-maintain a safe distance

• Model calming body language (slow breathing and keep hands down low)

• Use low gestures and keep hands down low at waist level

• Avoid rapid movements like pointing/waving

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• Talk calmly-being loud does not help understanding

• Talk in short, direct phrases (like bullet points)– Stand up now, Go to the car, Sit down please

• Allow 10-15 seconds for delayed responses to questions or commands

• Avoid literal expressions like “That’s the way the cookie crumbles”, “Are you waiving your rights?”, “Shake a leg”, or “Move it Move it”.

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• Use a communication board with Yes/No, alphabet, simple phrases, or pictures

• Avoid positional asphyxia! Turn person on side often if restrained.

• Person may have seizures if senses are overloaded

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De-escalating Behavior

• Emergency situations require an immediate response.

• If you determine that the person is unarmed and not in immediate danger—allow time, space and management of the environment to help the person de-escalate without your intervention.

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• Do not interpret the person’s failure to respond to your orders or questions as a lack of cooperation or a reason to use increased force

• Ask a parent/caregiver how to communicate with the person

• Speak calmly-model body language you want him/her to use

• Watch for seizures

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• If the person is fixated on an object, let him/her hold it if officer safety is not compromised

• Avoid stopping repetitive behavior unless safety is an issue

• Be patient. After 30 minutes the behavior may improve

• Watch for sudden outbursts or impulsive acts

• Evaluate for injury—person may have high pain tolerance

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Restraining a Person with Autism

• Avoid positional asphyxia. Many have under-developed trunk muscles and may be unable to support his/her airway

• After takedown, turn the person on side often

• Monitor the person’s condition frequently

• 40% may have seizure disorder. Asthma and heart conditions are also common.

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Restraining a Person with Autism

• He/she won’t recognize the futility of resistance and will continue to struggle.– Use communication, de-escalation and calming

response techniques

– Do not stand too near or behind the person as he/she may suddenly lurch backward

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Custody and Arrest

• Document Autism in your initial report

• Consider a medical evaluation

• Alert detention facility and suggest a segregation placement

• Contact parents/caregiver for information regarding care and communication with the person

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Interviewing a Person with Autism

Remember :

➢Autism includes a social interaction deficit.-That means many of the things individuals with Autism do appear to be rude or disrespectful.

➢When you add a communication deficit, interviewing a person with Autism can be a challenge

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Interview Techniques

• Ask permission to videotape the session

• Avoid uniforms or authority clothing

• Use casual conversation to assess the person’s ability to communicate before an interview

• Develop rapport—use the person’s first name

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• Use calm voice with simple, direct questions

• Allow for delayed responses

• May need to repeat and rephrase questions

• Be sure your words and his/hers mean the same thing to both of you

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• Explain you might have to ask questions more than once

• Tell him/her it’s OK to say “No” to questions

• Do not interpret limited eye contact as deceit or disrespect

• Be alert for nonverbal clues that he/she does not understand, is confused or does not agree with your statement

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• With a short attention span—you may need to do several short interviews

• Avoid asking “What time did it happen”?– Instead learn the person’s schedule and

determine events from that context

• Be alert to a spontaneous disclosure of evidence

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It is very hard for a person with Autism to look directly at someone and understand

what he/she is saying.

Example: one young man with Autism said “I keep telling you—I am looking at you. I’m looking at you. I don’t understand a word

you are saying, but I AM looking at you. It’s your choice. You can have me look at you or you can have me understand what you are

saying, but I can’t do both!”

Autism and Law EnforcementRoll Call Briefing Video

• Talking about Autism is important—but seeing real people with autism in police-related situations will reinforce what we discussed.

• After the video, we will debrief this activity by asking questions about what you saw and how officers handled calls for service.

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1. What are some of the autistic behaviors you saw in the video?

Brandy:

•No fear or sense of danger

•Attracted to swimming pool

•Running naked in neighborhood

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Christina:

•Avoided eye contact

•Non-verbal

•Used picture board to communicate

•Had unusual gait

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Red haired Teenager:

•Giggles during interview

•When asked her name—gave name, address and phone number all jumbled together in one string

•Did not understand “waiving her rights”

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OTHER:

•Unusual response to sound (little blonde haired boy covered ears with hands

•Unusual sensitivity to pain (little boy putting plate in trash can)

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2. Example of sensory overload

• Brandy: When leaving the house, she was dressed. The stress and anxiety of being out with her history of sensitivity to touch, led her to shed her clothes and search out a pool.

• Little blonde haired boy: crying and covering his ears with hands

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3. List 5 things that Sgt. England did when responding to a call involving a person with Autism

• Talk in short direct phrases

• Wait for delayed response

• Use pictures or have person write it down

• Use low gestures when talking to the person

• Look for emergency ID on the person

• Model behavior you want the person to use

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4. If restraining or arresting an individual with Autism, what are 3 things to remember?• Watch the airway (positional asphyxia)


• Document Autism in the initial report and recommend segregation

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Independent Practice Scenarios

• In all cases follow your department’s procedures as you work through the problem

• You will work in teams.

• Team responses will be compared.

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Closure

• Law enforcement officers can enhance public and officer safety and potentially reduce their own exposure to liability when they:– Recognize behavior/signs of autism disorders

– Practice tolerance and communication skills

– Follow procedures to ensure the safety and cooperation of a person with autism

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By adopting a proactive approach to working with our citizens that are

developmentally disabled, Maryland law enforcement has the opportunity

to prevent a serious or fatal encounter from occurring in our state.

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Debriefing the Lesson

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1. What is Autism and how common is it?

➢Autism is a neurodevelopmental disability that affects social interaction, communication, and repetitive behaviors.

➢1 in 88 children (U.S.)

➢1 in 80 children (MD)

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2. What is sensory overload and what steps can you take to manage the environment?• Too much sensory input coming into the brain

at the same time which may result in “Stimming” or Self-stimulating behaviors

• Manage the Environment– Assess scene (turn off lights/sirens, etc.)

– Move to quiet area (geographic containment)

– Talk calmly and be patient

– Reassure the person

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3. Two common social interaction signs that indicate Autism

• Avoid eye contact

• Does not respond to name

• Difficulty making transitions

• Covers eyes or ears

• Lacks empathy

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4. Two common communication signs that indicate Autism

• Non-verbal

• Limited vocabulary

• Speech volume (loud whisper) or Monotone

• Echolaic speech

• Don’t use gestures or respond to other person’s gestures

• May giggle/laugh or use unacceptable responses

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5. Two common behavior signs that indicate Autism

• Rocking, hand-flapping or finger-flicking

• Tantrums if daily routine is changed

• Obsessed with order and routine

• Unusual response to pain, light, sound

• Attracted to shiny objects, water, lights

• No sense of danger

• Unusual gait

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6. Two common types of Autism-related 911 calls for service

• Self-stimulating or Aggressive behavior

• Running or Wandering Away behavior

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7. Steps to follow when responding to a call involving the behavior of a person with Autism

• Stay calm. Focus. What is going on?

• Assess the scene for sensory stimuli

• Is a “stimming” behavior present?

• Manage the environment

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8. Steps to follow when responding to a “run away” call for a person with Autism

• Call for backup at the scene

• Gather information from person making call

• Is Project Lifesaver an option?

• Begin area search

• Approach in a quiet non-threatening way

• Model calming body language

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8. Steps to follow when responding to a “run away” call for a person with Autism

• Avoid rapid pointing or waving

• Talk in short, direct phrases

• Allow delayed responses

• Use communication board if available

• Ask parent/caregiver to communicate with the person

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9. De-escalation techniques

• Stay calm. Model body language

• Assess scene

• Manage environment

• Speak calmly with short phrases

• Allow delayed response

• Be patient (at least 30 minutes)

• Do not use force because the person didn’t respond to you

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9. De-escalation techniques

• If person is fixated on an object, let him hold it

• Don’t stop repetitive behaviors

• Seek assistance from parent/caregiver

• Watch for sudden outbursts/impulsive acts


• Evaluate for injury

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10. Interview Techniques

• Seek permission to videotape the interview

• Avoid uniforms/authority clothes

• Use casual conversation to assess ability

• Develop rapport

• Speak in a calm voice with short phrases

• Make sure words mean the same to both of you

• Allow delayed response time

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10. Interview Techniques

• Watch nonverbal cues for confusion or him not agreeing with what you asked

• May need to repeat and rephrase questions

• May need to ask a question more than once

• OK to say “No” to a question

• Short attention span may require several interviews

• Spontaneous disclosure of evidence

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Documents

Autism Awareness for Law Enforcement & Court Personnel · •Lacks empathy •Unable to see another person’s perspective •Unrealistic fears (bugs, dogs, dentist, etc.) ... (burning