Transcript ASD for Police rev 101212

ASD for Police
Developed by Jason Johnson and Jo Dowell
July 2012
Based on the New Zealand Autism Spectrum Disorder
Guideline and adapted from
‘Autism Spectrum Disorder (ASD): A resource for educators’
Whakapūpūtia mai ō mānuka kia kore ai e whati
Cluster the branches of the mānuka so that they
will not break
Acknowledgements and thanks
Many thanks to:
• Mark (not his real name) and his parents, for agreeing to
share Mark’s experiences. They say they are more than
happy to think that their story will help others
• Senior Sergeant Alison Ealam, Greymouth Police, who
requested this professional learning package
• Deborah Lipsky, the author of ‘Managing Meltdowns’, for
permission to reference her books. We acknowledge
Deborah as the creator of the S.C.A.R.E.D. technique
• Mat Friedman, for his cartoons
• Dr Paul Taylor, for permission to refer to his analogy
between PC and Apple Mac computers
What is ASD?
Autism spectrum disorder (ASD) is the name for a
group of conditions where a person has a noticeable
delay or difficulty in three important areas of
development:
•
communication
•
social interaction
•
thinking
In addition, many children with ASD under- or overreact to sensory information
All cartoons by Mat Friedmann, copyright 2009-2012: www.dudeimanaspie.com
His blog promotes a greater understanding of people on the autism spectrum
and gives you a window into his everyday life, its highs and lows, with both
honesty and humour.
What is it like to be a person with ASD?
Each person with ASD will be very different
because of:
• their level of difficulties in each area
• their family setting and circumstances
• their level of intellectual ability
• individual factors such as personality
Some people with ASD also have other disorders (such
as epilepsy)
More about ASD
• ASD (autism spectrum disorder) includes autism
and Asperger syndrome, as well as some other
disorders with similar features
• ASD is a developmental disorder. What you
might see will vary with age and will vary over
time
• There is also a group of people who have
significant difficulties in one or two of these
areas, but who may not meet the criteria for an
ASD
Communication characteristics
People with ASD:
•
often develop communication or language later than
their peers
•
may have unusual ways of making themselves
understood
•
can have difficulty in understanding others
•
sometimes use language in an unusual way
•
do not always understand gesture, facial expression
or body language.
Social interaction characteristics
People with ASD may:
•
not join in with play or social opportunities
•
like to do things on their own
•
not respond to greetings, smiles or waving
•
not know how to share their toys or things of interest
to other people
•
have difficulty with conversation, social situations, or
social rules.
Thinking or behaviour characteristics
People with ASD may:
•
prefer routine and structure, and like to do things
in a particular way or order
•
dislike change or moving from one place or activity
to another
•
have poor organising or problem-solving skills
•
have unusual movement patterns
•
have strong interests in particular subjects.
Sensory characteristics
People with ASD can sense things differently and:
• react to loud noises or particular smells
• under- or over-react to pain
• have difficulties with their personal space
• react to different textures (shiny, smooth, rough)
• have unusual motor movements (such as toe
walking)
• react to visual stimuli (busy environments, bright
lights)
At times it is necessary to make some adaptations to
their environment to ensure their well being.
NZ ASD Guideline part 5: Living in the
community – relevant recommendations
• Minimise stress
• Prevent behaviour that leads to
victimisation or criminal offending
• Teach legal rights
• Prepare information in advance in
case of contact with police
• Families and whānau need to
know how to support person with
ASD if in contact with the police
Recommendations
Police and other services need to know:
• How to recognise when a person
has ASD
• The impact of ASD on the behaviour
of the person, and their likely
responses to others
• Strategies to ensure that the legal
rights of all people concerned are
upheld
• How to communicate effectively with
people with ASD
Typical behaviour escalation
An example:
1.
2.
3.
4.
5.
6.
7.
Bright lights
Pain
Noisy environment
Tired
Tone of voice
Being told off
Difficulty
processing
information
1.
2.
3.
4.
Close curtain
Offer Panadol *
Offer reassurance
Redirect to
quieter place
5. Ask if he wants a
break
6. Use neutral tone
7. Ask one question
at a time
Adapted from chart on: http://www.autism-help.org/behavior-intro-autism.htm
‘Catastrophic reactions’ primarily due to
• Sudden change, being taken by surprise, caught off
guard
• Not understanding reason for sudden change
• People in authority failing to explain, carefully,
sequentially, and descriptively what will happen in any
situation
• Someone failing to respond to question in concrete,
literal way
• Sensory overload
• Being asked to multitask or integrate multiple
sensory inputs
Notes used with personal permission from ‘Managing Melt Downs; Using S.C.A.R.E.D Calming
Technique with Children and Adults with Autism’ (Lipsky D., and Richards W., 2009)
Warning signs of potential meltdown
• Pacing back and forward or in circles
• Increasing self – stimulating behaviours (stimming) for
example, flapping hands
• Perseverating on one topic
• Repeating words or phrases (echolalia)
• Difficulty answering questions (cognitive breakdown)
• Stuttering or slow speech
• Resistance to disengaging from ritual
• Becoming mute
Activity
Take your slip of paper, read and
discuss:
• what is the response suggested?
• why is it suggested?
• any implications, reflections or
thoughts in relation to your work?
Share back thoughts to the rest of the
group
What is an appropriate
response?
Approach the person in a quiet, non-threatening manner
Understand that touch may cause ‘fight or flight’
Talk in a moderate, calm voice
Instructions should be simple and direct
Seek all indicators, evaluate and adjust your actions
accordingly
Maintain a safe distance
Based on “Contact with Individuals with Autism: Effective Resolutions” by Dennis
Debbaudt and Darla Rothman PhD that appeared in ‘The FBI Law Enforcement Bulletin’,
April 2001
The S.C.A.R.E.D technique
SAFE
CALM
AFFIRMATION
ROUTINE
Don’t: touch, restrain or leave alone
Do: Remove unwanted stimulation or guide to
less stimulating environment, remove social
pressure
Don’t: try to ‘reason’ with individual, get angry
Do: talk in strong, calm, reassuring voice, use
concrete, literal, descriptive language, ask for
clarification
Don’t: ask unnecessary or open ended
questions, challenge emotional or verbal
responses
Do: Use name, validate individual,
acknowledge that they are doing their best
Don’t interfere with harmless routines
Do: reflect behaviour by mirroring, encourage
routine as means for gaining self control, and
provide environmental supports, offer
reassurance
The S.C.A.R.E.D technique continued
EMPATHY
DEVELOP
INTERVENTIONS
/ STRATEGY
Don’t: Lecture about effect behaviour is
having on others, humiliate or shame,
demand eye contact
Do: Put yourself in their shoes,
acknowledge and identify with their
fear, show you are there to support the
person and not to make them do
something they don’t understand
Don’t: rely on generic strategy, develop
strategy without consultation with
individual and their family
Do: work with individual to develop
concrete behaviour strategies for
assistance during meltdown
Wherever possible take time to restore the relationship
with individual and family by visiting after the event
Profile for Mark
DOB 9/8/98
Parents: Rachael and Graeme Parks
20 Safe Street, Greymouth
Ph: (03) 777 7777
Medical diagnosis: Pervasive Developmental Disorder
Attention Deficit and Hyperactivity Disorder
Moderate Intellectual Disability
Mark is medicated but for up-to-date information on what he is currently taking his parents need to be consulted
as this can change often. Mark’s diagnoses place him on the autism spectrum, meaning that he has underlying
delays with his communication skills, his social skills and his cognition, often displayed through his challenging
behaviour. Associated with this is his lower intellectual functioning shown predominately through his adaptive
(life) skills. Some of Mark’s challenging behaviour is hard for him to control due to his disability but there is an
element of learnt behaviour that gains Mark the desired response from others. Consistent and firm responses to
challenging behaviour prior to escalation are necessary for Mark to learn strategies to cope across settings.
Appropriate responses to behaviour:
• Be aware of changes in Mark’s subtle behaviour – twitches, flicking, ripping and hoarding material/equipment.
• Offer heavy lifting activities when he appears anxious
• Speaking to Mark in calm, clear, short direct phrases.
• Ensuring he knows what is happening by using short simple phrases
• Provide him with opportunities to show you that he is calming while still being aware and vigilant of his state
of arousal.
• Give space if needed, he likes to run; this may help him to blow off steam. Follow him in the least obvious
way possible.
• Restraint is the last resort and is best done by two people who are trained in appropriate techniques.
A positive example from a family
After an initial response to a police call out where Mark was displaying
aggression special education staff developed a ‘profile’ with Mark and his
family to raise awareness about his individual needs. Senior Sergeant
Allyson Ealam set up a folder in the watch house to collect these profiles.
Using information from the profile police have effectively deescalated a
number of situations involving Mark in a calm and supportive manner.
Key points from family interview:
• “They don’t just think he is another ‘bad kid’ from a ‘bad family’”
• A call out for supposed ‘drunk and disorderly’ behaviour worked out ok
because the police recognised who Mark was
• “Before the profile we had to stay on the phone to COMS the whole time
and we couldn’t go looking for Mark. We had to answer lots of questions
and repeat information to different people”
• A friend’s boy with special needs is now frightened by police because of
his negative impression after the first experience (behaviour escalated,
had to be restrained by 5 officers) Mark likes police!
Key points from family interview continued
•“They are a lot more understanding now, they know most of the
behaviour is out of Mark’s control”
•“Victim support was organised in case we needed it, we get great help”
• “[the officer] changed the topic to draw Mark into a different discussion,
like we do, rather than talking about the problem”
•“They talk to Mark like a human being, at his level, and listen to his side
of the story when he is ready to speak (‘come on, mate, what’s going
on…’ , ‘he sat on my bed and talked to me about my car collection
(special interest))”
•“They make it personal and really care about us rather than just being
another statistic
A suggestion from Dad….
“Consider having a folder of profiles in main centres where 111 calls are
managed. They could pass information about the child to the first
respondent. Just like you would for a violent offender. Families like us
wouldn’t mind updating the photo once a year.”
A final word from the family: “Thank you, you are brilliant!”
Prevalence and cause
• The wider spectrum of ASD is thought to affect about
1% of the population or more than 40,000 New
Zealanders
• The cause(s) of ASD are not known, but genetic
factors are considered important
• While there is no cure, a great deal is known about
how to minimise the impact of the condition and many
children (and young people) make good progress
• Many studies suggest that parental concerns about
developmental delays in their children are usually
well-founded
Further information

Altogether Autism - www.altogetherautism.org.nz
•
Autism NZ – Local name/phone
www.autismnz.org.nz
•
Ministry of Education - www.minedu.govt.nz
•
Local contacts
Ministry of Education –
CYF –
CAMHS –