Webinar presenter Dr. Wes Dotson answered a number of your questions after his presentation, Individuals with Autism Spectrum Disorders: Characteristic Behaviors, Challenges and Tips for Successful Interactions for Justice Professionals. Here are just a few of his responses.
Audience Question: As a dispatcher, Kelsey wants to know if there’s a good way of knowing if a caller is someone that is on the spectrum, and if so, what suggestions you would give her to give instruction to them to help some help someone else, for example, with CPR?
Dr. Wes Dotson: If someone calls you and in the first couple of conversational terms, you notice that they are being that very literal thing that I talked about – so somebody saying, you know, “I’ve been told I have to call 911”. They’re talking in rules. They’re saying, “When I do this, I’m supposed to do that, or I’m supposed to do this”. Or if they’re saying, “You told me this, you asked me this question.” If they’re responding in ways that are highly, highly literal, that’s often a marker that you’re going to hear in communication. As you know, people with autism it’s something you’ll feel within usually one or two conversational turns. The beauty of that, that works to your advantage is that being literal means they’re going to do exactly what you tell them to do. If you’re trying to help them through what to do in a situation, they will typically be 100% compliant with your guidance. The trick is to make sure and to check in with how did you say it versus how did you mean it? If you’re giving instruction like, “Okay, I need you to go over next to the person, I need you to bend over and tell me if they’re still breathing. I need you to see if you see bleeding anywhere”. As you’re doing instructions like that, you can say, “What did I just tell you to do? or what did you hear me say?” Let them say it back to you as a check for understanding. And then that way you may catch one of those “Oh, I said that but what I really need you to do is this”. So I would say if you’re giving instruction at the moment, say, “Okay, I need you to go check if they’re still breathing. “What do I want you to do? What did I ask you to do?”, “Check if they’re still breathing”, “Okay”? “You’re going to do this and this? What does that look like?” “I’m going to bend over, I’m going to do this”. So I would check-in and ask them to repeat back. Since you’re not going to be able to see them, you can’t physically see their behavior, ask them to describe their behavior. Because people with autism are concrete and literal. They’ll tell you exactly what they’re doing. And so that can help kind of navigate to things.
Audience Question: Do you have suggestions on how to talk to a child with ASD regarding possible abuse that they’ve experienced.
Dr. Wes Dotson: I’m going to say that you don’t do that lightly. You’re absolutely right. That’s going to be a lot of what the December webinar is about how does abuse manifest and specifically how my kids on the spectrum talk about or not talk about abuse in ways that are traditional red flags or triggers. It always comes back to that literalness and the ability to process. And so understanding that, for example, if you ask a person with autism, has anyone ever touched your penis? They’re going to say, “Yes”, because the doctor has or a parent has while they’re changing them. Or, “Has your daddy ever done this?” Well, they’re going to take that literally. If it happened, the answer is yes. But there are circumstances under which that wouldn’t be problematic. It can be really difficult to parse those things apart.
Audience Question: Do you know of any law enforcement agencies that are examples of implementing best practices and training their officers?
Dr. Wes Dotson: I would fear that I’m missing people that are doing it well. In a couple of the links that I sent you on the law enforcement links, especially the National Center for Missing Exploited Children, the roll call video, they have some partner law enforcement agencies that they’ve been working with to develop law enforcement training. I would encourage you to follow a couple of those links to see some examples of how police departments are doing this. National Center for Missing Exploited Children especially has been doing some amazing work and helping build awareness at various levels of training from that basic kind of roll-call video to these more advanced kind of webinar series. What I will say too is that what it looks like to do best practice, as in all kind of community based policing is going to be context-specific as well. What best practices in a small rural community might look a little different than a large urban area. There are things that I can do in West Texas that maybe aren’t as realistic or possible in a large city. I can tell my family, for example, that call dispatch and have your patrol officer come by the house and meet your kid because there might only be two or three officers that patrol that neighborhood, and we all know each other. That’s a way to be proactive, that may not be as possible in St. Louis or New York City. But I think it’s a great community that’s starting to emerge. And I think if you follow some of those links, or especially National Center for Missing Exploited Children’s references, you’ll see some examples of departments that are doing this sort of stuff really, really well.
Audience Question: How do you recommend we communicate with our nonverbal individuals that have autism?
Dr. Wes Dotson: Visual is your friend. What I’ll say is that very often, if you’re encountering nonverbal individuals on the spectrum in the community, they’ll be with a caregiver, or they’ll have some kind of support with them. It may be a visual picture card. It may be an electronic device, it may be an iPad. Someone who’s nonverbal with autism who is out in the community will often have some kind of communication support in place or around. So check your environment and look to see Is there’s a caregiver there. There are actually pre-produced communication boards. So earlier in my slideshow when I showed some of the cards, one of them there actually had a couple of picture-based communication choices on the communication card. That would be something that an individual would hand to the officer. And it was choice boards like how am I feeling: happy, angry, sad, calm, and a few other choices. There are some materials that can be created or provided that are often the visual supports, it may be: “Do you need help, Yes or no?” Very often with nonverbal, we’re going to use a picture-based communication system of some kind. Ideally, when you’re interacting, you’re going to have a caregiver or parent or somebody there who can give you access to the system. If not, there are some basic picture schedules and things that you can create or use that are downloadable and I can’t on one screen, open my links sheet up. But I’m pretty sure I gave you a link to one of the materials pages that can give you some of those.
Audience Question: Would someone with autism hug and hang on to a parent during a situation.
Dr. Wes Dotson: Yes. That whole handling surprises or not handling surprises well and tending to overreact to crisis can sometimes be reflected in a refusal to leave an environment. We can sometimes see them they’ll grab onto a parent or they’ll want to go to a safe, unfamiliar place. That absolutely can be a common response, especially in sensory overwhelm. We may see someone with autism, ducking behind a familiar person cover their ears, close their eyes, and refuse to leave. Every year kids with autism died because they run back into a burning home because they’re afraid of firemen and they’re going to their safe place and they don’t discriminate that that safe place isn’t safe anymore. So yes, that’s a very, very common response. Even if it’s not physically clinging, it’s often being very reluctant to leave a familiar or what they perceive to be a safe place.
Audience Question: Is intense eye contact ever an indicator of autism?
Dr. Wes Dotson: Yes. So eye contact is difficult for people with autism. Social cues are difficult for people with autism. Most people with autism avoid eye contact. Most people with autism have often been told for most of their lives, that that’s not polite, and that they need to make better eye contact. Because of that, you’ll often see a disjointedness and for our higher functioning or older people on the spectrum, who’ve been told for years to make eye contact, it may be that it’s not that they don’t make eye contact, is that they over-fixate on, oh, this is a person in authority, I have to make eye contact to show them that I’m listening. And then they just stare laser beams right through the back of your head. So it can also be a marker that someone is staring without breaking eye contact without knowing how to look away for a few seconds and break the stare. It can also be that way. Absolutely. I don’t think it’s the most common but it absolutely happens. We see in our college students, for example, it was like “yeah, I don’t have to make eye contact” and then they overgeneralize that and just stare and if we see that we’re often going to look for – it’s a more flat out stare. They’re not normally like puffing their chests out or engaging and what would be more kind of that prison yard we’re-about-to-fight stare. But it can be that they’re just looking and it’s often that it’s a very wide-eyed and if you move your head, you’ll see that they’re following your eyes even as you move your head. It’ll look like they’re trying to make sure they don’t break eye contact. That’s easier to say. But that’s really what I’m often looking for- is like, okay, they’re looking at me and as I move away or break eye contact, and they keep trying to follow it. If someone’s staring you down, they’re not moving their head. They’re trying not to follow what they’re going through you. someone with autism is trying to keep eye contact as they have to are going to follow you and it’s going to be really, really awkward.
Audience Question: Misty suggested that law enforcement officers may want to try to carry noise reduction headphones for emergency situations, to try to help a person with autism. Your thoughts on that or any agencies doing that?
Dr. Wes Dotson: I’m not aware of any agencies formally doing that. I’m aware of a large number of families who preventively do that. It’s one of the strategies we do teach our families for kids with sensory sensitivities, is to have available ways to help simplify the environment. You’ll often see they’re carrying hoodies. Sometimes if a kid with autism is overwhelmed, they’re going to put a hoodie on, put headphones on, and give them an iPad. And then they’re staring at the iPad, which reduces the visual field. So does the hoodie. And then the headphones are helping kind of keep it calm. That’s the sort of strategy we’re using. If the person with autism and your environment is not the focus of your investigation or is not the focus of your interaction, and you just need them to be safe in the environment while you do the rest of your business, that can be one of the better strategies. Let them go to a safe place, and then give them a way to basically phase all this out.
Click Here to Watch a Recording of Individuals with Autism Spectrum Disorders: Characteristic Behaviors, Challenges and Tips for Successful Interactions for Justice Professionals.