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Incredibly different
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Autism .. ?
Sue Mulcahy
Impact of Autism on Policing
Topics
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Autism Act 2009
Government Strategy for Adults with Autism (policing elements)
Vulnerability for Involvement in criminality
Vulnerability in Police Settings
Assessment and Detention
Memory and Recall
Emotion
Communication, Best Evidence, and Special Measures
Police Expectations
Autism Act 2009
• Background – sets out to enable adults with autism to;
– have more opportunities to lead fulfilling and rewarding lives
– know that they can depend on public services to treat them fairly as
individuals to enable them to live independently within the
community
• Autism Act 2009
– Unprecedented as first ever disability specific legislation in UK
– Sets out to ensure fair and equal access to public services
– Places statutory duty on UK Government to publish its Strategy for
Adults with Autism in England
• Autism Strategy: ‘Rewarding and Fulfilling Lives’
(DoH, 2010)
– to increase and improve understanding of autism amongst police
– to improve access to police services and wider criminal justice system
– because adults with autism typically fall between two stools - learning
disability and mental illness (autism falls within neither category)
Quotes from Governmental Strategy
“Professionals have a habit of asking with person with [autism] for insight into
their own problems – the person struggles to find a reasons and comes up
with whatever they can think of at the time.”
“People think that autistic people are being rude or arrogant and ban them
from cafes, pubs, cinemas, etc. They call the police who also believe the
autistic person to be arrogant, rude etc and then arrest them for a public
order offence.”
‘Training for frontline staff should focus less on theory of autism and more on
giving staff insight into how autism can affect people, drawing directly on
the experiences and input of adults with autism and their families’
(Department of Health, 2010)
Autism & Criminality
• Majority of autism sufferers is law-abiding and not involved in
violent activities
(Frith, 1991 & Barry-Walker et al, 2004)
Suspects
• Criminal behaviours are often strange and bizarre to the
extreme
(Katz et al, 2006)
• Intoxication at time of offending and use of knives or guns less
common than in other groups
(Whaland et al, 2006)
• Autism alone is not a risk factor for serious violence; 84% of
offenders also have mental health problems (Newman et al, 2008)
• Autism psychopathology has been linked to sexual serial
killings
(Silva et al, 2004)
• More easily led, manipulated or coerced into criminal activity
by others
(Gudjonsson et al, 2004)
Reasons for criminal behaviour
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Exploitation by others
Interruptions to routines leading to disruptive behaviour
Difficulties understanding social clues
Obsessional tendencies/morbid interests
(Howlin, 1997)
• Distinction between people and things is less sharp than is
normally expected
(Tantum, 2000)
• Psychological compartmentalisation .... in ways that would be
difficult to understand or incomprehensible to most people
(Baron-Cohen, 2003)
Victimology
• Dearth of empirical literature on victimology – e.g. Petersilia’s
(2001) review on crime victims with developmental
disabilities
• Particularly vulnerable to bullying, exploitative crimes, being
led into criminality by others without understanding and far
more likely to be victims than perpetrators due to social
impairment
(Howlin, 2007, Tantum, 2008)
• Greater time spent on-line (Benford, 2008); may be especially
vulnerable to involvement in contemporary criminality
involving internet including grooming, fixation, radicalisation,
high-tech crime and cyber threat related
Recognition - Autism Spectrum Disorder ‘labels’
ICD-10 - Pervasive Developmental Disorders (PDD)
Childhood Autism
Atypical Autism
Asperger’s syndrome
PDD – unspecified
(World Health Authority, 2007)
DSM IV – Axis 1: Mental Disorder (i.e. not* personality disorder)
Autistic disorder
Asperger’s disorder
PDD – not otherwise specified (‘atypical autism’)
(American Psychiatric Association, 2000)
Other labels in common usage
Kanner’s Autism
Regressive Autism
Classic Autism
High Functioning Autism (HFA)
(without learning difficulties, i.e. IQ>70)
Autism Spectrum Disorder*
Characterised by qualitative impairments in reciprocal social
interaction and communication, and a restricted, stereotyped or
repetitive pattern of interests and behaviour persisting from
early developmental period
Intellectual ability can fall across spectrum
Delay/deviance in language development can be marked or mild
(North et al, 2008)
Without speech
With speech*
Prevalence - adults in private households* in England
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1% adult population (1.8% M, 0.2% F)
8% males in social housing & 4.5% all single males
7.5% males with learning difficulties and 4.3% males in IQ range 70-85
Correlated negatively with IQ in males
(Health & Social Care Information Centre, Social Care Statistics, 2009)
• > 50% autistic population have 1Q within or above normal range
(Rice, 2009; Kawamura, 2008)
Prevalence in secure settings
• High functioning males over-represented in secure hospitals
• Prevalence in prisons and in police detention unclear
(North et al, 2008)
• 15%* most serious violence linked to individuals with autism, 63% of
whom had committed arson
(Siponmaa, 2001)
Phenotype & trait like prevalence
• Significant Autistic Traits below diagnostic threshold
• Increased incidence in families with 1+ member with diagnosis of ASD
(Piven, 1997)
Diversity within Autism Spectrum
Albert Einstein
Robert Napper - Green Chain Murders
Charles Darwin
Nicky Reilly (aka Mohammed Alim) - Exeter Bomber
H G Wells
Gary Ridgeway - Green River Killings
Thomas Jefferson
Barry George – principle suspect Jill Dando (fixation) murder
Isaac Newton
Gary McKinnon – US Computer Hacker
Ajit Singh-Mahal – 12 year old boy killed by mother
And 500,000 others (in UK)
Assessment
• Autism is mental disorder as defined under Mental Health Act
1983 i.e. Not learning difficulty or mental illness
• Multiple diagnoses and overlapping conditions common
– Epilepsy, anxiety, stress and depression
• ASDs lifelong conditions – crisis may be catalyst for diagnosis
• Commonly undiagnosed or misdiagnosed in adults
• Diagnosed via developmental history - symptoms must be
present in childhood (but may not become fully manifest until
social demands exceed limited capacities)
(American Psychological Association, 2010)
• Many generalist psychiatrists regard themselves as
unqualified to conduct assessments on people on autism
spectrum
Sensory Difficulties & Environmental Factors
• Sensation and attention difficulties most commonly in overfocusing
(Liss et al, 2006)
• Tend not to be able to attend to looking and listening
simultaneously
(Bonnet et al, 2008)
• Superior visual and auditory discrimination
(O’Riordan, 2006)
• Repetitive behaviours associated with low functioning group
and ruminating with high functioning group
(Carcani-Rathwell, 2006)
South Yorkshire Police
Custody Initiative
Sensory Difficulties – Potential Difficulties
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Strong smells
Magnified acoustics
Poorly ventilated
Little natural light
UV fluorescent lights (pulse)
Walls and surfaces baron – hard
Functional but intimidating
(PS Andy Hunt*, S. Yorks Police,
National Autistic Society 2010)
S. Yorks Police Approach
• Alternative interventions – PACE 9 – immediate rebail,
community interventions
• Enhanced review with strict time limits
• Ensuring Appropriate adults always available
• Constant supervision to prevent self-injuries*
• Use of visual information wherever possible
• No jargon, sarcasm or irony
• Instructions clear and simple
• Use of National Autistic Society ‘autism-at-a-glance’ cards
• Vulnerable tags and family intervention
“Happy to share experience with other forces” PS Andy Hunt
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Emotion
Difficulty regulating emotion
Fluctuate between ‘flat’ and heightened emotions
Tend not to identify with more complex emotions
Have difficulty expressing own emotions in real time and
anticipating emotional response of self and others
• Difficulty in recalling emotions and memories of emotional
experiences
• Emotional understanding lags behind intellectual
understanding which can result in confusion
• May not understand impact of criminality, whether as suspect
or victim, at time of incident, for long time after incident or
possibly not ever
Communication, Attention & Physical Responses
• Difficulties in turn-taking and recall within conversation
• Use ‘I’ and ‘Me’ less than most people and difficulties in
organising thoughts in terms of time (Colle et al, 2008)– leads to
difficulties in distinguishing between what is and isn’t
relevant.
(Colle et al, 2008)
• Literal interpretation of meanings and rigid thinking (Frith, 2001)
• Difficulties in shifting and sustaining attention (Bonnet et al, 2008)
• Involuntary facial expressions affected and associated often
accompanied with involuntary sound productions
• Recognising emotion in facial expressions, especially fear, is
suggested as a potential factor in sustained violence
(Baron-Cohen et al, 2007)
Memory & Recall
• Difficulties in working memory; long term memory unaffected
but complexity affects recall; short term memory unaffected
• Recall events involving themselves less well than events
performed by peers
(Bowler et al, 1997)
• Experience of social situations different (Gras-Vincendon et al,
2008) and recall tends to feature less social elements than for
most people
(Gaigg et al, 2008)
• Understanding of language is unaffected, even though may
not use speech, as is immediate memory. Recall of faces,
social scenes and dynamic spatial awareness affected
(Williams et al, 2005)
• Superior performance in tasks relying on detection and
graphic reproduction of visual elements
(Caron et al, 2004)
Vulnerability at Investigative Interview
• HF individuals may not be recognised as vulnerable by police
by virtue of apparent competent use of language and
presenting as intellectually capable. However may face
difficulty with demands of police interview
(North et al, 2008)
• Free recall elicits less information, especially gist in AS group,
but no difference in amount of additional information
obtained using general and specific questions. More reliant on
questioning to facilitate recall
(McCrory et al, 2007)
• Significantly less accurate when interviewed using CI but no
difference when interviewed using SI
(Maras, 2010)
• Suggestibility level no different in AS group as a whole but
scores vary more than for general population
• Compliance significantly greater in AS group (North et al, 2008)
Achieving Best Evidence
• Special measures likely to achieve best
evidence irrespective of level of functioning
• Quiet interview room and calm approach
critical
• Allow plenty of time
• Single interview unlikely to result in best
evidence
• Preparation – seek advice from appropriate
adult, intermediary or NAS helpline
• CI found not to be helpful - SI preferable
• Avoid open questions and make more use of direct
questions
• Allow lots of thinking time
• Encourage to say if ‘cannot remember’ or ‘do not
know’ (beware over-compliance)
• Frequent summarising and checking of
understanding by interviewer and interviewee
• Avoid making inferences
• Use of diagrams recommended
• May volunteer ongoing trickle of new or additional
evidence after interview
Manage Expectations
• Don’t underestimate potential for misunderstandings even if
person appears articulate and intelligent
• Assume requirement to check understanding frequently
during and between interviews
• Remember that conforming to social norms is difficult for
those on the autism spectrum
• Remember sophisticated coping strategies are common and
can mask true extent of communication difficulties
• Don’t assume apparent contradictions are result of dishonesty
• Be tolerant if person appears more upset than might
ordinarily be expected
• Bear in mind this group highly susceptibility to mental health
problems, easily damaged, difficult to treat and, following
upsets, tend to have extraordinary long recovery times
Resources
National Autistic Society
Helpline: 0808 800 4104 (open Monday to Friday, 10-1600)
Available at:
Autism:http://www.autism.org.uk/working-with/criminal-justice.aspx
Autism Alert Cards and Autism ‘at-a-glance cards’
Autism: a guide for criminal justice professionals
(ACPO endorsed)
And At:
http://www.autism.org.uk/Living-with-autism/Adults-with-autism-orAsperger-syndrome/Self-advocacy.aspx -
Self-advocacy booklet for adults (including advice for criminal
justice professionals)
Understanding autism
will assist me in my work ... all
officers need to be aware
of this
Questions?
[email protected]