Webinar presenter Dr. Wes Dotson answered a number of your questions after his presentation, What Criminal Justice Professionals Need to Understand about Autism Spectrum Disorder. Here are just a few of his responses.
Audience Question: As a therapist at a maximum-security women’s prison, I’ve read about how ASD symptoms can present differently in women. Often, it seems that women are not diagnosed as quickly with an ASD because the criteria have been normed primarily on males. And so, with this in mind, are there any special characteristic behaviors to look for in an adult female that’s on the spectrum?
Dr. Wes Dotson: What a great question, and absolutely the case. We are only in the last 5 or 10 years really learning what autism looks like in girls who don’t have concurrent mental impairment IQ deficits. One of the most common ways we see autism manifest, especially in young women, is as anxiety and social withdrawal avoidance. Young girls are often not allowed to escape social interactions in the same way that little boys are. So, they often make better eye contact, they have better manners because they’ve been forced to, but because they’ve been forced to engage in a lot of really uncomfortable social behaviors, you will often see a lot more anxiety responses especially, during interactions, a lot more withdrawal, you tend to see more of that behavioral fixation come out where they’re not allowed to show their social anxiety as emotion. So, it shows up in that behavioral rigidity side and the repetitive behaviors and the fixation on routines. And so, you might see much bigger reactions to surprises or disruptions in routine, because that’s where it’s allowed to come out. If that makes sense.
Audience Question: Are there tips, and suggestions that you can give when you have someone that is on the spectrum that is or is about to give court testimony?
Dr. Wes Dotson: Oh, that’s all in a way, that’s a whole webinar itself. What I’ll say about preparing someone with autism to do anything is the more structure you can give them, the more ways you can practice them better. So, give them the questions they’re going to be asked in advance. Practice giving testimony. Let them do as many parts of the routine as possible before they get there. I’ve known DAs who will let someone with autism, come to the courtroom and sit in the chair, see the environment, and practice like, “You’re going to walk in this door, you’re going to do this, you’re going to do that,” because every piece of that process and experience that you can make predictable so that the first time they do it is not on the stand, the better. You know, if, the very first time they have to think about articulating an answer to a question, is right when it was asked on the stand. That’s going to be incredibly difficult for them. So, you want to give them as many opportunities as possible, to have practiced every piece of that routine in advance.
Audience Question: I work with autistic people via e-mail sometimes. Are there any particular tips for working with autistic people via e-mail other than communicating directly and with compassion?
Dr. Wes Dotson: Understand that what you see in the e-mail is exactly what they intend and say. We know digital communication is hard for everybody, there is no tone in the e-mail. And if you think about all the ways e-mail feels awkward, that is amplified times 10 with someone with autism, but I will also say ironically for some of the folks with autism I work with, they prefer that because email is a purely literal and black and white medium. And so sometimes they’re much more comfortable expressing themselves in e-mail because they have the time to craft the answer, and they look at what they wrote. And if that’s what they meant, that’s what they’re sending. So, understand that e-mail is going to be a little awkward. But take exactly what they say is what they say. Don’t read anything else into an e-mail with someone with autism. Email, it’s their communication. And they’re going to interpret your responses in the same way? So that can work to your advantage because you don’t have to wonder about subtext or sub-meanings, or did they mean to imply this? Like, nope. What’s in the e-mail? That’s what they meant. And they’re going to expect the same from you.
Audience Question: I am a police officer in Bermuda. Do you recommend handcuffing a subject that is on the spectrum? Or what suggestions can you make in this situation?
Dr. Wes Dotson: That’s a hard thing to answer specifically because obviously, you need to make that decision in regard to the safety of everyone on the scene. So, if in your judgment, that person presents enough of the threat that they need to be restrained, you’re going to have to do that regardless of whether they’re comfortable with it or not. That said, if at all possible, if you’re dealing with someone with autism, the less touch and the less constraint you can put on them, often the better at keeping them calm. That, by the way, holds true for anybody. So, nobody likes to be restrained anytime you’re physically constrained or restrained, there’s a physiological response that your body’s going to have that doesn’t like that. Most specifically, for someone with autism, like if you don’t feel like there’s enough of a threat to warrant being cuffed. But maybe ————————- put them back in the car, if they can just sit in the back of the car and not be cuffed, they’re probably going to stay calmer. If you do, don’t surprise them with it. If you’ve got to cuff them, warn them that you’re going to cuff them, tell them what you’re going to do. That way, at least, they’re prepared for it. If you just grab someone with autism and they don’t see that touch coming, it’s almost a universal, push, or shove away and resist. A lot of folks with autism pick up a resisting arrest charge because they were touched unexpectedly, and they were just trying to get away from the touch. And the officer saw it as active resistance, and it wasn’t. It’s just they didn’t see it coming, and they were surprised, and it wasn’t a fight back, it was a defensive response.
Audience Question: How should a person on the spectrum be housed in custody and should supervision plans be designed to accommodate those on the spectrum?
Dr. Wes Dotson: This is something I wish we knew more about. We know in incarceration, folks have autism and I know from personal experience, especially with the case of the young man I’m working with now. They often end up in solitary confinement because trying to interact with the general population because they’re socially awkward, they get in trouble. So, the Director of the jail that this 25-year-old, when we were talking about it said, “I know solitary confinement is not appropriate, and he didn’t do anything to deserve it. But if I put him with the general population, they will kill him.” Because he was engaging in some pretty bad verbal behavior, where when he didn’t like somebody, and wanted them to go away, he engages in a lot of insulting verbal behavior, and when you drop N-bombs in a county jail, your life’s in danger as a white guy. So, a lot of times, it needs to be accounted for in regards to what that particular inmate’s struggles. Because I can also say there are a number of folks with autism who actually want to be in jail, find the jail environment to be much less stressful and overwhelming than a hospital or a therapeutic environment. Because the jails are a very rigid place, there are fixed routines, there are fixed rules. They are enforced in a very rigid way. You know exactly what time things happen, you do the same thing every day. And so, for some folks with autism, you don’t have to do anything as a jail administrator, they’re going to, I hate to say it this way, but they almost take to that environment like a fish to water because it is so structured and so black and white, that as long as you’re communicating those rules and expectations, they’re fine.
Audience Question: Are there resources for parents of children living with ASD after they’re arrested and involved in the justice system?
Dr. Wes Dotson: Not a lot. There are some folks who work in that world, the ———– with Autism Speaks, our lawyers who do a whole lot of autism advocacy issues. And they’ve put out a book called Autism in the Law, which covers many, many aspects of autism in the law. But they’re one of the leaders in that conversation nationally. There are, unfortunately, not a lot of formal resources at that level. There are more resources about autism in law enforcement for incarceration. There’s a book called Autism and Law Enforcement, that you can find on Amazon fairly cheaply, and there is some training. I’ve got some resources here that I put at the end of the slide show that first one there, the Autism Speaks stuff on autism in law enforcement is for law enforcement but they can also help families. But unfortunately, there’s not a ton out there. I wish there were more.
Audience Question: How do you get someone to re-engage with court obligations such as drug screening, meeting with a probation officer, or meeting with a judge when they’ve been without a sanction for an extended period of time?
Dr. Wes Dotson: I wish there would be one answer for that because often that’s driven by the individual, but I’m going to answer it as if it’s somebody with autism. A lot of breakdowns for folks with autism are around a misunderstanding of rules and expectations. So maybe they don’t realize what those expectations are or what the rules are. They’ve missed some aspect of the requirements and are not doing it out of non-compliance but are doing it out of ignorance, of not understanding. The other pattern I see in this with folks with autism is that if they are being called back to an environment in which there’s consistent failure, they avoid the really scary social environment. So, like, if they don’t know what to do and they don’t know what to expect and the social interactions always go poorly. Sometimes they just avoid it. They may want to follow the rule, but they’re so scared and unsure of what’s going to happen when they do that. They just avoid it outright. So, I often will try to focus on talking to somebody to say, you know, people with autism are very literal and are rule-governed. So, there’s great value, and just saying, “Why aren’t you doing this?” And then take their response literally if they say, “Well, I don’t like the judge.” That may seem like a weird answer, but to someone with autism, that is why they didn’t do it, “Okay, why don’t you like the judge?” “I never know what to expect.” “Well, we can address that. We can start talking about, well, here’s what to expect, or we can practice. What that interaction might look like, and that actually sets out. I didn’t do this on purpose. But the webinar in July is going to be case studies on how to have these kinds of conversations. I’m actually going to model some interactions that you can have to help someone with autism prepare for those kinds of things. And very often, it’s that preparation that can reduce the anxiety and give them a routine or a rule, they don’t have any to follow. That makes them more likely to engage or more comfortable engaging.