1. 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 ’

2. Whakapūpūtia mai ō mānuka kia kore ai e whati Cluster the branches of the mānuka so that they will not break

3. 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

4. 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 over- react to sensory information

5. All cartoons by Mat Friedmann, copyright 2009-2012: www.dudeimanaspie.comwww.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.

6. 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)

7. 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

8. 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.

9. 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.

11. 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.

12. 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.

14. 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 NZ ASD Guideline part 5: Living in the community – relevant recommendations

15. 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 Recommendations

16. Typical behaviour escalation

17. Adapted from chart on: http://www.autism-help.org/behavior-intro-autism.htm 1.Bright lights 2.Pain 3.Noisy environment 4.Tired 5.Tone of voice 6.Being told off 7.Difficulty processing information 1.Bright lights 2.Pain 3.Noisy environment 4.Tired 5.Tone of voice 6.Being told off 7.Difficulty processing information 1.Close curtain 2.Offer Panadol * 3.Offer reassurance 4.Redirect to quieter place 5.Ask if he wants a break 6.Use neutral tone 7.Ask one question at a time An example:

18. 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) ‘Catastrophic reactions’ primarily due to

19. 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 Warning signs of potential meltdown

20. 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 Activity

21. A pproach the person in a quiet, non-threatening manner U nderstand that touch may cause ‘fight or flight’ T alk in a moderate, calm voice I nstructions should be simple and direct S eek all indicators, evaluate and adjust your actions accordingly M aintain 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 What is an appropriate response?

22. 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

23. 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 The S.C.A.R.E.D technique continued EMPATHY DEVELOP INTERVENTIONS / STRATEGY Wherever possible take time to restore the relationship with individual and family by visiting after the event

24. 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.

25. 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!

26. 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!”

27. 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

28.  Altogether Autism - www.altogetherautism.org.nzwww.altogetherautism.org.nz Autism NZ – Local name/phone www.autismnz.org.nz www.autismnz.org.nz Ministry of Education - www.minedu.govt.nzwww.minedu.govt.nz Local contacts Ministry of Education – CYF – CAMHS – Further information