Webinar presenter Wes Dotson answered a number of your questions after his presentation, More Case Studies in Criminal Justice Interactions with Individuals with Autism Spectrum Disorder. Here are just a few of his responses.
Audience Question: Most research and interventions for people with autism is focused on children with autism, but the fastest growing area of newly diagnosed people with autism are older teens and adults, not kids. How does this change what first responders should be doing?
Wes Dotson: A great question. One of the dirty little secrets of Autism research is that well over 75% of our literature only includes people 15 years old and younger. They’re overwhelmingly white. They’re overwhelmingly male, and they’re overwhelmingly children. So, we don’t have nearly as much really high-quality literature about intervention for teens and young adults with autism or women with autism. But the things that we know still suggest that effective supports are effective supports. So visual supports, clear communication, time, and space. Those things work across the board. We also know with older folks, especially older folks who are verbal, that cognitive behavior therapy and those types of interventions are really effective because they often focus on identifying rules and routines and seeing triggers, and noticing things and patterns in ways that maybe aren’t natural for folks with autism. So, I can’t give you a super long list that everything that works with kids works with adults, But I will say that best practice still basically holds up. So, creating stability and predictability, teaching people what to do, instead of what not to do, and focusing on teaching effective communication. So, teaching them how to read their environment, to figure out what’s important, and what to notice, and then helping them learn to communicate effectively in that environment. Those three elements still hold and are still vital when we’re working with adults with autism just as much as when we work with kids.
Audience Question: Could you address interactions with victims who are overstimulated or not well-resourced to frame their complaints/reports in a coherent way?
Wes Dotson: What a great question. That’s almost its own webinar that I don’t feel qualified enough to lead. But I will say this, we know very little about how best to help victims report. What we know about being overwhelmed, though, is that once you’re there, the first thing you must do is create calm. So, if someone’s already completely overwhelmed, or if they’re completely shut down or they’re at the stage where they’re just ultimately stressed the first thing we must do is allow that to pass. You will not have effective communication and overwhelm. So that’s that time and that space piece. Once you have gotten through that, the struggle is that folks with autism tend to be very direct and black-and-white. And so, they’re not going to be good at choosing impact words. So, if we’re doing a victim impact statement or we’re trying to get them to say, has harm been done? As a DA, they’re going to want to know if there has been harm, or if are they victimized? And if you look at someone with autism and say, “Are you hurt?” and they say, “Well, I’m not scratched, he didn’t hit me. I don’t have any bruises.” They may not be able to represent emotional damage in the same way as they’re very literal, they look down and go, “I don’t have a mark on my body.” They’re making a literal statement, but somebody who’s an investigator says, “Victim indicates they’re not hurt, there wasn’t damage as a result of this.” So, be very aware of your language if you’re doing an interview with a victim, “What did you do? What happened?” Asking the normal questions like, “How did you feel about it?” “What impact is that having on your ability to sleep?” Folks with autism very rarely have the same awareness of the connection of those things. So, they’re going to struggle to connect that, “Oh, the reason I’m struggling to sleep is because I’m having a trauma response.” They may need help to recognize those patterns, and that’s where cognitive behavior therapy has been powerful. And, in fact, there’s a wonderful variant called Trauma-Focused Cognitive Behavior Therapy. One of my great colleagues, Michael Gomez, is deeply involved in that community he’s presented for folks here, you can find some of his work. Trauma-Focused Cognitive Behavior Therapy is one of the only tools we’ve seen in the literature that helps folks with autism process trauma in a way that helps them see the connections and communicate them. So, from a victim advocacy standpoint, being able to have access to support, to learn, to communicate that impact, or even recognize that impact in a way that can then be communicated, is a big part of getting to the other side. We tend to see, not just with women, we know the women’s trauma is often minimized. But we see the same thing in autism, that they’re not taken seriously, because they can effectively communicate, and it’s often because they don’t recognize how that trauma and adverse reactions are interacting in a way to cause problems. They focused on the literal what occurred in that instance. I don’t think that’s the solution, but that’s, that’s what I’ve got right now.
Audience Question: What advice do you have for parents of children with autism to help reduce the chances of a negative interaction with law enforcement?
Wes Dotson: What a great question. So, my recommendation in that regard is don’t let the first interaction be in an emergency. So, folks with autism need routine and rules. They do really well with advance notice. So, don’t wait. Teach them what to do in a traffic stop, and teach them how to respond to a police officer or a fireman. We actually know kids with Autism who died in house fires because they run from the firemen. So, the firemen are coming to get them out of the house. And they run from the firemen because they don’t recognize the firemen’s help and they’re afraid, they go to their bed or their safe space and pass away. So, what I always tell parents is don’t let that be their first interaction. Call your local police department. Figure out who your beat officers are, and they’re often very happy to stop by your house and meet your kid. So, let your kid meet the police officers most likely to be coming to their home. Same thing. Go to the fire station, and let them see a fire truck. Most police departments, fire departments that I’ve ever worked with are more than happy to do things like show up and put on the gear, and let the kid meet you, and do the hose. Think about the situations like a car wreck, or a traffic stop, or whatever your specific concern might be that you’re likely to have, and then write a social story. Practice it, literally practice it. I have absolutely seen police officers, a fireman, and first responders be willing. I’ve had parents take their kids to the airport, and TSA has literally let them practice going through security and experience everything when the kid is calm and on a good day. So then if they do have a bad day, it’s not the first time. You can also, in some jurisdictions, actually register your home in the 911 dispatch system to say that you have a child with autism and I strongly encourage families to do that as well if it’s available to basically call, so that when you call, when a call comes in to dispatch, they get a flag that says there’s a nine-year-old with autism in the home. You can share things like being terrified of the color green or fascinated with Spider-Man whatever details that will help in those responding officers and responding firemen, be most likely to be successful with your kid or also something that can be really powerful. So, plan ahead.