Barbara J. Morvay
A first responder who is able to identify a person with autism can then respond in a way which best supports the individual.
You are dispatched to a scene with gunshots fired. Upon arrival, you observe three men fleeing from the scene. You and your partner are able to apprehend two of the individuals. Another squad car has arrived on the scene and the officers are providing support to secure the scene and the situation starts calming down. At that point, you observe another individual huddled on the ground. The individual is exhibiting unusual behavior. He is rocking back and forth and appears to be singing to himself. As you approach to determine his condition, the rocking behavior increases. You ask, “Are you hurt?” The individual does not respond to your question. You ask again, “Are you hurt?” As you get closer, the individual’s behavior intensifies; he begins to hit himself in the chest with his hand. What do you do? How do you handle the situation? The best advice in this circumstance is to step back and observe. Does the intensity of the behavior lessen? If it does, you established a comfortable space for the individual and you may deal with him without harm.
Advising you to step back may go against your instinct to approach and intervene. Do not try to stop the behavior; this may escalate the individual’s self-stimulating behavior. For certain individuals who are disabled or who have special needs, behavior such as this may be a self-soothing and calming mechanism. At this point, responding officers should limit physical contact because some disabled individuals cannot cope with touching. This individual has already demonstrated increased agitation when you got too close. Speak to him in a calm voice; don’t talk loud or yell. At this point, the crime scene is under control. Explain that you are there to help.
Understanding that a person with special needs may not be able to respond appropriately is essential. In an intense law enforcement incident, such an individual may not understand what is happening. They may not be able to effectively communicate and may appear to be more of a threat because of their noncompliance which may be “non-willful.” As “suspects,” such individuals may not understand commands or instructions. They may be overwhelmed, confused or fearful. They may nod their head in a yes or no manner; however, this may not indicate a consistent yes or no response. They may have difficulty describing facts or details and will often demonstrate confusion. The individual could have a cognitive or verbal impairment. Here, it is important to remember that noncompliance is not the basis for violence.
Autism Spectrum Disorder
Autism, also called Autism Spectrum Disorder (ASD), is a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, which adversely affects a child’s educational performance.The areas that may be affected are: behavior; communication; cognition; and social skills.
Autism may also be called Autistic Disorder; Autism Spectrum Disorders (ASD); Pervasive Developmental Disorder (PDD); Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS); and Asperger’s Disorder.
There are a multitude of behavioral characteristics an autistic person may develop. Some individuals demonstrate many of the characteristics and some may have just a few. There are varying degrees of autism. People with autism may be high functioning and be intellectually gifted in specific areas or they may have mild, moderate or severe cognitive impairment.
Individuals with Autism Spectrum Disorder
The Center for Disease Control and Prevention (CDC) report of April 26, 2018, states that one out of 59 children (one in 37 boys and one in 151 girls) have been identified as having an Autism Spectrum Disorder. Autism is four times more common in boys than girls. These statistics have been increasing over the past 20 years. Since autism is a lifelong disability, children with autism grow up and face significant challenges as adults. Law enforcement officials and other first responders will encounter persons with autism frequently. Why? Due to their unusual behavior, people with autism may not be immediately recognizable as such and persons encountering them may be frightened or concerned by their behavior. Frequently, someone calls 911 because they see a person who looks disoriented or unusual wandering in the community; the call was not placed because of a crime being committed. Wandering is a significant problem since the person with autism does not understand danger. This factor places the individual in situations which puts them at greater risk.
Autistic individuals are not all alike. There are variations in understanding, cognition, functional level, and individual response which could be either mild, moderate or severe. Yet, they do have two important characteristics in common – their difficulty with socialization and with communication. Even if the individual is nonverbal, do not assume that he cannot understand basic language. One of the most obvious signs of autism is stimming which is self-stimulatory behaviors and unusual repetitive behaviors.
Persons with autism might demonstrate certain behaviors and characteristics. For example, they may be unable to understand a dangerous situation; wander in a neighborhood or be drawn to bodies of water, traffic or other dangers; be overwhelmed by flashing lights, certain sounds, loud noises, sirens, or fire; be afraid of a person in uniform or a firefighter in turnout gear; demonstrate curiosity and reach for objects or equipment such as a shiny badge or handcuffs or even your gun; react in an inappropriate manner; react by trying to run away or try to hide; not respond or understand commands such as “stop” or “put your hands up”; have difficulty with speech or language or be nonverbal; not respond to his (or her) name; appear to be deaf; not make eye contact; act out by biting or hit themselves or others; display repetitive behaviors (known as stimming) by rocking back and forth, hand flapping, hitting, head rolling, spinning, or other similar behaviors; have auditory, sensory or visual perception issues; have other medical issues such as a seizure disorder; not respond to pain in a typical way and may not be able to explain their pain; act very nervous, cry out or vocalize loudly, using unfamiliar sounds; not understand consequences or right from wrong; and not have a sense of modesty, therefore, undressing or inappropriate touching may be observed.
If a first responder is able to identify that a child or adult may have autism, he (or she) can then respond in a way which best supports the individual.
How to Interact with a Person Who Has Autism
First and foremost, assess the situation to determine if any reasonable threat exists. Remember that an autistic individual may demonstrate atypical behaviors described earlier. If there are people around who know the person, listen to what they have to say. They may have important information about this individual, such as if he can speak, or is deaf, or has a cognitive impairment or a seizure disorder. This information is essential to the task at hand. Their information can help de-escalate a situation.
If the autistic person has a caregiver who is present, work with him (or her) to establish a sense of safety and cooperation.
Do not get too close to the person; give the person space. Getting too close may agitate the individual causing them to act out. Determine who will be the lead professional interacting with the person and stick with it. Ask your partner or others at the scene to step back. This is important, since the individual is already in distress and having difficulty. Having the person focus only on one person is essential.
Limit noise and distractions. In this regard, try to limit the amount of unnecessary chatter around the person. Less talking and distractions around the person translates to faster control of the situation.
Take your time with the individual. Initial contact is the point where things could go wrong. People may be watching and they all have smartphones which could video the event as it develops. Spend the necessary time now rather than having the event portrayed in a negative way on the evening news.
Tell them your name and what you are doing. Be specific – people who are autistic do not understand things which may be obvious to other people. This process takes some time.
For example:
“My name is John. I am here to help you.”Tell them who you are. Assume they do not understand what the uniform represents.
“I am a _________________.” (fill in the blank with a police officer, sheriff’s officer, etc.)
Now, wait …
Say, “You don’t have to talk to me.” Repeat, “I am here to help you.”
“You can shake your head or move your hand if you hear me.” This takes the pressure off the need for verbal communication which may be difficult. Remember, the autistic individual may be in panic mode, frightened and disoriented.
If the person responds, consistently offer praise and say thank you. “Thank you for letting me know you understand.”
Tell them what will happen and what you will be doing before you do it. This is very important. For example, “I am going to walk around you to make sure you are okay.”
Recognize that, even if the person appears to be hurt, they may not be able to understand. They may be confused and disoriented. They may not react to pain the same way others would.
They may have low muscle tone (known as hypotonia) which can affect the brain, the central nervous system or the muscles. Therefore, they may appear limp which could mask serious injuries. The individual may also have a coordination disorder which makes it difficult to access a person’s physical status.
Attention to detail is of the utmost importance. Just because the individual does not seem to be aware of the injury does not mean they are not experiencing pain. When dealing with a person with autism who has an injury, the best course of action would be to call for an ambulance. At this point, you would not want to transport an individual with autism in a squad car. The injuries could be more serious than they appear and there may be underlying medical conditions which are not visible. Therefore, it is always best to get professional medical help. An abundance of caution is best in these circumstances.
It would be best for you to say, “I see you are hurt. I am going to help you.”
Use simple sentences and speak slowly. Do not yell. You may have to repeat your statement.
Give the person time to process and respond. Tell the person, “I am calling some of my friends to help. They will come in an ambulance.”
If possible, ask the ambulance and first responders to shut off the flashing lights and the siren as they approach the scene.
It is essential for you to stay with the autistic person.
At this point, you have established a rapport with the person. You are now their caretaker. Your interactions and demeanor have provided a level of safety and the individual knows you will not hurt him. Therefore, your continued presence is necessary for a successful outcome.
Be alert to the signs of increased frustration (rocking, vocalizing, self-stimming) and try to eliminate the source, if possible, thereby reducing the possibility of negative behavior.
Do not try to stop the person from their self-stimulating behavior; this may cause physical acting out and more self-injurious behavior. If you have a blanket or a towel available, offer it to the individual or place it near the person. It may provide a sense of comfort and they may reach for it and hold on to it. If they are sitting on the ground, bend down to their level. Don’t stand above them – this may be perceived as aggressive behavior.
Sometimes, the autistic person may demonstrate negative behavior as an indication of a need. They may need to go to the bathroom, or they may be in pain, or cold, and hungry or afraid and may not be able to communicate that need. Try to take care of a few of their basic needs, this can change everything for the better. It would be good practice to always have a blanket or towel in your vehicle. If you do, place it near the person. It provides a sense of comfort and security, as well as warmth which is important in establishing a sense of trust.
Do not rush the process and do not allow anyone else to rush you. This could be a career defining moment. Give the situation the time and attention it deserves. This is not a typical encounter; it requires your utmost patience, humanity and compassion.
The following example of an encounter gone viral effectively demonstrates a situation which went wrong. It can be used as a learning tool.
Buckeye, Arizona – September 2017
While on patrol near a park, a police officer approaches a 14-year-old autistic boy. The boy is standing on the sidewalk playing with a string – manipulating the string from side to side, up and down, backwards and forwards. The officer asks the boy what he is doing; the boy responds, “I am stimming.” The officer asks again and the boy says, “A string.” The officer then asks, “Do you have any ID on ya?” The boy says “No.” Things escalate from there. The officer tackles the boy, mistaking his mannerisms for signs of drug use or perhaps a reaction to an inhalant. The boy can be heard repeating, “I’m okay! I’m okay!” – a self-soothing mechanism – as the officer spins the boy around to attempt to handcuff him. All the while, the boy is saying, “I’m okay!” I’m okay!” When the officer forces the boy onto the ground, the boy is heard saying, “I need help.”
The boy explained to the officer he was “stimming.” Stimming is a shorthand expression for self-stimulatory behavior which can be any type of repetitive movements of body parts, objects, words, phrases, or sounds. It is a common characteristic in people with autism. The officer said that the boy was displaying signs of being under the influence of an inhalant. The officer’s 21 minute body cam footage shows a boy who tried to explain what he was doing. That video has gone viral. It was posted on YouTube and scenes were played on the CBS morning and evening news. As a result of the encounter with the officer, the boy sustained multiple cuts and bruises. The boy and his mother were later interviewed by a reporter.
The video can be seen at https://tinyurl.com/y4ckkov2
After the incident, the boy’s family sent a letter to the police department asking for a few things: (1) an apology from the officer; (2) that the officer participate in an autism-related community service project; (3) more training for all the officers in the department; and (4) for the police department to pay the boy’s medical bills, particularly for the surgery needed to repair the boy’s foot. When the department failed to respond to the family, they filed a $5 million lawsuit.
Editor’s Note: This article has been excerpted from a well-written and authoritative book by Barbara J. Morvay, entitled Responding to Incidents Involving Persons with Special Needs: A Manual for First Responders. Copies of this book can be obtained from Looseleaf Law Publications, Inc., 43-08 162nd St., Flushing, NY 11358; phone (800)647-5547; or by visiting their Web site at www.looseleaflaw.com. The price of the book is $29.95 (plus shipping).