After the Webinar: Intervening with Trauma and IDD in Families. Q&A with Dr. Michael Gomez

Webinar presenter Dr. Michael Gomez answered a number of your questions after his presentation, Intervening with Trauma and Intellectual-Developmental Disabilities in Families: What Criminal Justice Professionals Need to Know. Here are just a few of his responses.


Audience Question: Can you speak on working with adults who have IDD, such as what to do, what professionals need to show, that they are meeting with the adult-specific needs? 

Michael Gomez: And thank you, said, I love that question. things that because one of the groups we see that gets missed is adults with IDD. And kind of the very short, maybe oversimplified answer to your question is everything we’ve talked about, right now, that kids with IDD need, they still need as adults. And I think that the systems forget that. They’re like, “Well, they’re out of school, so they don’t need educational services.” Like, “Are they going to be learning any new task in the next 60 years?” “Yeah, like, they work in a factory.” “Then they need support for that.” And the Feds definitely have it. Most states have that even live in Texas, and Texas is not known for being the most enlightened legislation for IDD, but they have it. If you have a disability and you were like had ID or ASD or FAS when you were a kid, you’re going to need to follow that up. Because I think sometimes the adult systems think it stops, and sometimes that is just due to lack of education. Sometimes the languages I want to do it, but they’ll still need the same stuff. They’ll still need that support around like educational services, you know, day-to-day living, adaptive behavior. So, maybe a little more nuanced answer is if you could focus on for adults if we can get teams focused on their adaptive behavior and not just things like their legal standing. Because sometimes they legal standing is very important, but sometimes people just stop there like, “Well, I need to know who the conservatorship is.” Great. Do they know how to clothe and feed themselves? Because if they don’t, getting, when they get them facility, that does. But if there’s a chance they do, then we need to be getting them as independent as possible. And so , the adaptive behaviors get lost a lot. So, by kind of shorter recommendation, for a very important question is make sure that the team or whoever that provider is not missing the adaptive behaviors or something to call skills of daily living, day-to-day things.


Audience Question: Do you have any advice for law enforcement? I dealt with an autistic adult male, who was approximately 60 and appeared to understand what I was saying. But I have no tools to help him or explain what he was doing wrong. 

Michael Gomez: Actually, this was one of my partner in crime here to Justice Clearinghouse, Dr. Wes Dotson. So, if you get a chance to see a Dr. Wes Dotson talk, he’s now at Missouri.  He talks about that specifically; I’m basically going to repeat what Dr. Dotson said. Two things that kind of come to mind is that vast this you can get their advocate, guardian, conservator, whatever that is. Do it. I work a lot with cops when I was back in Texas, they don’t know. I mean, there’s the elite, you’ll have kids who are not even adults, but there’ll be like 15, but they look like a 35 and they have intellectual disabilities. So, they basically are functioning like a second grader on a good day. But they’re like 6’1″, 280 lbs. and they’re being aggressive. And so, what we usually work on is like if you have any doubt, this is also a —– thing by the way, because I know that that’s a very real thing for law enforcement. Do you have like, do I need to contact somebody, like you see the person you guys often, like we on our side is a therapy team, a behavioral health team who put a lot of work is like hey, if you’re lost, if you’re wandering, you’d like, make sure you tell people I need my mom, her name is Jeanette. I need and so I all right, they rang the bell, let’s get the person in here and then often they can clarify that. Again, it doesn’t always work, but it’s like, just almost as a —– thing. Let’s make sure we get their counsel, their advocate, their guardian, and there as fast as possible, because they can often be a helpful translator for the process. The other thing was kind of goes back to our like concrete part for development is, which I actually would say cops, are really good at it, to their defense, is a lot of repetition. A lot of repetition is like, “I need to do to put your hands on the car. Please put your hands on the car.” The only thing I see some cops trip up on, is they start getting verbally, kind of amped up which I do, I don’t like repeating myself. I guess, just like I am pretty empathetic with that mindset. And so, but the continual repetition of it, like, “Please put your hands on the car.” Another thing, again, to cops’ credit, at least the ones I’ve worked with is they often talk about, and this is nothing empirically-based that I can site, that they have like a gut feeling like something’s off with this person, not in a dangerous way. But this isn’t like your standard person I’m walking in who, like committed a B&E. And so, if you do get that feeling, and I would go to instead of treating like someone who’s broken the law, let’s treat them like someone that is in medical distress. Because cops also have a really good background responding to medical distress scenarios, and also not knowing if it’s a medical distress scenario or if it’s like criminal activity, or both. And so, I think those are some of the muscles that I’ve seen cops have already pre-built in the law enforcement personnel that they can use to their advantage when they’re working with population, mostly adults or people who look like adults who have like autism, intellectual, disability. Repetition. But without the like getting upset, amped up over it. Medical distress instead of like leading with the criminal activity unless it’s very obvious. Like, they have a loaded nine mm in their hand that’s a different scenario than they’re walking around yelling. Those are two different scenarios, but those would be kind of my first thoughts on that. But again, I would recommend Dr. Dotson anything you can see with Dr. Dotson. Yeah. He has asked, one of his passion things is working with law enforcement personnel to do better at contacts, first contacts with people with IDD.


Audience Question: Can you talk about the prevalence of IDD and trauma in adopted children, especially if it’s possible to compare this to kids in foster care. 

Michael Gomez: The short answer is always we’re just beginning to get that data, so it actually right where we need to be. What we probably needed that data a couple of decades ago and we kind of have it. But it’s not as clean as we’d like it to be. In part because the Association for Early Childhood, the early childhood like adopted and foster tend to meld together. And so, it kind of misses especially your later age range kids. The running joke for us, researchers that researchers assume that teens don’t get adopted. Which I’m not saying that it’s easy for a team to get adopted, but that tends to be left. A lot of the teen adoption literature is, I think, way better than it was 10 years ago. But it kind of left them out a little bit, just like we left out adults with autism in the literature. But the very short answer from the data we currently have, in our best guess, prevalence of trauma and IDD, adopted versus foster. It’s looking similar. We’re seeing some specific spikes in certain domains with certain subpopulations. But for the most part, if we’re not seeing like, mass like kids who are adopted or having or trauma and or IDD, the kids who are in foster care. We’re not seeing that like for significant across the board, but we are starting to see some differences with maybe some subpopulations. So, as a light, as an example, kids who have the early childhood, like 0 to 5, type of like, neglect trauma that we’re seeing that they’re having a lot more out the gate functional impairment with their IDD. All of that might be resolved, whereas we’re seeing some of our kids who get caught later down the road, they’re looking like they’re having more of the, like IDD symptoms and more symptomatic. But we don’t know if that’s because they’re really legitimately more symptomatic like at 10 versus at 5, or that they got untreated for so long, that’s why they’re more symptomatic not because of anything the foster system did. The last thing I’ll say on that because I feel it’s important to say, is, placement disruptions are things I really hammer home with the team, because those definitely impact the exacerbation of the trauma symptoms for sure, and a lot of the IDD impairments. It doesn’t create the autism; it just makes the symptoms kind of escalate. And the thing I, the short version I use for people is the relationship between displacements for foster kids and symptomology is basically the same as back surgeries. Basically, the more back surgery you have and the closer those back surgeries are, in chronological time, the less likely you are to return to original functioning. So, placement destruction as a back surgery, essentially. And, sometimes, you need back surgery, but you don’t want to have like five back surgeries in four months, right? And, so, that’s what I usually try to emphasize to people who, especially like child welfare things and legal.


Click Here to Watch a Recording of Intervening with Trauma and Intellectual-Developmental Disabilities in Families: What Criminal Justice Professionals Need to Know 


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