Law Enforcement and Autism

It started out as a Peeping Tom call in progress. Two units respond, the suspect is sitting on the porch. As officers approach a teenage boy seems indifferent, like he is in his own little world. Suddenly he reaches for one of the officer’s shiny badges. The cops go hands on and suddenly all hell breaks loose. Back up arrives code three which only makes matters worse. The light bars are flashing, sirens wailing, everyone is screaming. The suspect is more than resistant, appears completely oblivious to pain, and is attempting to flee. A responding medic notices a medical bracelet on the suspect’s risk…he is autistic. Calls related to an autistic individual can be challenging at best. Recognizing autism, understanding the risks, and learning methods of interaction is critical for a successful crisis resolution.

Autism is a complex developmental disability; a neurological disorder that affects the functioning of the brain. Autism, sometimes called “classical autism”, is the most common condition in a group of developmental disorders known as the autism spectrum disorders. Persons with autism are estimated to have up to seven times more contacts with law enforcement agencies during their lifetimes. Yet, only 20% of patrol responses related to autistic individuals are related to criminal activity. Interacting with a child or adult who has an autism spectrum disorder will challenge your experience, training and patience.

Autism interferes with the normal development of the brain in the areas of social interaction and communication skills. It typically appears during the first three years of life. The disorder makes it hard difficult to communicate with others and relate to the outside world. Autism affects each individual differently, many function well in society; they may have regular employment in a supervised or unsupervised workplace. They may live in traditional, assisted living homes, or have a caregiver with them at all times. There are degrees of autism which are usually described as low or high functioning.

Autism is the fastest-growing American developmental disability, with an annual growth rate of between 10-17%. The prevalence is estimated at 1 in 88 births, and is 4X more prevalent in boys than in girls. By way of comparison, this is more children than are affected by diabetes, AIDS, cancer, cerebral palsy, cystic fibrosis, muscular dystrophy or Down syndrome, combined. This disorder knows no racial, ethnic, income, educational, life-style or social boundaries. As a law enforcement officer you will probably handle many calls related to autistic individuals.

It is crucial to remember that autism is not a mental illness; however, individuals with autism can develop mental illness just as anyone in the population can.

Types of Calls for Service

Contact with an autistic individual may occur anywhere in the community. The initial call for assistance to law enforcement may first appear as a domestic disturbance, or child abuse, as a caregiver is forcing the individual into a home or a car. There will be calls to assist the FD for medical assistance; approximately 25% of individuals with autism will have seizures by the age of 21. Other calls may involve reports of a suspicious person related to strange behavior or trespassing. There are prowler calls, as an autistic individual enters another person’s home, car or business. They may peer into windows. Of course there will be the welfare checks, as they may run into oncoming traffic. There will be calls for a missing person at risk; children and adults with autism are prone to escape when left unattended or when care providers turn their backs. Tragically, these so-called runners are often attracted to water sources such as pools, ponds, and lakes. Without a fear of real danger and in spite of not knowing how to swim, they jump in.

Recognizing Persons with Autism

Law enforcement responders may unexpectedly encounter a person with autism. Individuals with autism look like any other person; however, behavioral clues do exist that an observant officer can use to help indicate they are dealing with an autistic individual. Subtle cues on scene generally depend on the functionality level of the autistic person. Recognition of the behavioral symptoms of autism and the techniques of approach can reduce risk factors to both the individual and the first responders. In most cases, the person will have difficulties following your verbal commands and reading your body language. They may attempt to flee or resist medical treatment. Autistic individuals often have a high level of pain tolerance.

50% of people with autism communicate non-verbally. They may not respond to your verbal commands, and may cover their ears, look away, or run away when approached.
They may toe walk, have a pigeon-toed gait or a running style.
They may appear psychotic, or under the influence of alcohol/drugs.
Their responses reflect changes in their sensory perception: lights, sirens, canine partners, odors will escalate repetitive behaviors (pacing, hand flapping, twirling hands, self-hitting, screaming).
Some will attempt to present an autism information card or wear medical alert identification
They may not recognize police vehicle, badge or uniform or have any inkling of what is expected of them if they do.
They frequently appear argumentative, belligerent, or stubborn. They may consistently ask “Why?” or respond "No" to all questions.
They may parrot (repeat exactly) what the officer says.
They will have difficulty interpreting your body language.
They are generally poor listeners.
They may have a passive monotone voice, and pronounce words unusually.
They may have difficulty judging personal space; standing too close or too far away from you.
They frequently perseverate on a favorite topic when they feel uncomfortable; rambling about favorite sports teams, train, bus or plane schedules, city names, foods, etc.
They are consistently very honest, (sometimes too honest), they do not lie, are blunt, but not very tactful.

Tips for Law Enforcement Responders

No matter what, responding officers must always consider their own personal safety, as in any call.

Typically, persons with autism do not understand the implications or consequences of their behavior; especially aggressive actions. An autistic person may flee when approached by an officer, and fail to respond to an order to stop. Others may react by dropping to the ground and rocking back and forth. They will avoid eye contact with the officer. Officers should not interpret these actions, in and of themselves, as a reason for increased force. Be aware that autistic individuals react to their environment: bright lights, sirens, K-9s, different smells, loud voices, or touching may cause an individual with autism to react in a fight or flight manner.

You may learn the person has autism from your dispatcher, someone at the scene, or the person themselves.

Make sure the person is unarmed and maintain a safe distance; they may suddenly invade your personal space.
Evaluate for injury, remember pain tolerance is high.
Assess for seizure symptoms or injury, request a paramedic response as appropriate.
Talk calmly and softly in direct, short phrases: “Stand up now.” or “Get in the car.”
Your uniform, gun, handcuffs, etc may frighten him/her; reassure him/her that no harm is intended.
Indicate a willingness to understand and help.
Avoid quick motions or gestures.
Avoid slang expressions.
Allow for delayed responses to your questions or commands. Repeat or rephrase as needed. Understand that a rational discussion may not take place.
Consider use of pictures, written phrases and commands, and/or sign language.
Avoid pointing or waving.
Check for medical alert tags or an autism handout card.
Model calm body language and behaviors.
Get information from caregivers at the scene about how to best communicate with and de-escalate the person’s behavior.
Do not stop repetitive behaviors; unless there is risk of injury to yourself or others.
If possible, decrease sensory stimulation (sirens, flashing lights, crowds).
Use geographic containment and maintain a safe distance until aggression diminishes.
Remain alert to the possibility of outbursts or impulsive acts.
Assess for symptoms of psychosis; delusions or hallucinations.
Do not express anger, impatience or irritation.
If possible, allow the person to de-escalate themselves without your intervention. Throw them a blanket or a towel, to allow them to self-soothe.
Touching the autistic person may cause a protective "fight or flight" reaction, especially on the shoulders or near the face. Announce your actions before initiating them.

In Custody

If you take an individual into custody and suspect (even remotely) the person may have autism, alert jail authorities; it is essential that the person be segregated. Additionally, contact the DA about the case for further advice or directions. These individuals do best in isolation. Seclusion from other inmates will also reduce the risk of abuse and injury by the general jail or prison population toward the autistic person. The individual should be placed on the detention facility’s mental health roster for psychiatric evaluation.

What If a Crime Has Been Committed?

Whether as offender or victim-witness, persons with autism will present dilemmas in the interview and interrogation room. Their concrete answers, conceptions, and reactions to even the most standard interrogation techniques can confuse even the best trained detectives. When questioned, they are likely to repeat words or copy body language. They may not respond to questions/commands/directives at all.

The Autistic Suspect: Individuals with autism frequently confess to crimes they did not commit or make misleading statements in order to please the detective. Their inappropriate responses, such as lack of eye contact, giggling, indifference or lack of remorse can lead to a misinterpretation of guilt. The interviewer must ask very specific and clear questions. Avoid questions that may be interpreted as a suggestion to the person. “What did you do?” is a more appropriate question than, “Did you steal the watch?” Establish timelines with the person; where, what, how, who questions are best. Ask questions that require a narrative response instead of a yes/no answer. Autistic individuals seldom lie; be alert for a spontaneous disclosure of evidence. Avoid body language and metaphorical questions that may confuse the individual.

Autistic Victims of Crime: Due to their vulnerability, people with autism are frequently the victims of crime. As your uniform and equipment may frighten them, try to interview them in plain clothes. Consider having a person the victim trusts present at the interview. Be patient; take time to establish a rapport. The victim may only give an evidentiary statement once (consider video or audio taping the interview).

Conclusion

Fortunately, more developmentally disabled individuals now carry some form of medical alert so that if they cannot speak, their identity and type of disability can be determined. Officers must recognize the characteristics of autism, and understand the associated risks to intervene appropriately.

Additional Resource

Autism and Emergency Services Training Book

http://www.autismnd.org/Documents/ems.pdf