Developmental Disabilities CIT / CIP Training Developmental Disabilities

Characteristics A Severe, chronic disability a person has which: Is due to mental or physical impairment or a combination Limits function in 7 specified areas: Self care Receptive and expressive language Learning Mobility Self-direction Capacity for independent living Economic self-sufficiency Severe & Chronic, but onset before age 22 Is likely to continue for the persons entire life.

Types of Disabilities Cerebral Palsy Brain injury - TBI Epilepsy Other neurological conditions similar to cognitive disabilities and not related to mental illness, AODA, Dementia, etc Autism Spectrum Disorder Visual impairment Deaf

Developmental Disability vs Cognitive Disability Developmental Disability includes both cognitive and physical disabilities May stem from the same disorder such as Down Syndrome or may be a combination of disorders Cognitive/Intellectual Disability is based on IQ and mental functioning May stem from nonphysical causes

Causes of Developmental Disabilities Genetic Problems during pregnancy Alcohol or drug use Disease Malnutrition Environmental toxins Problems at birth Prematurity Low birth weight Oxygen deprivation Birth injury 20% of cerebral palsy due to birth injury 70% due to brain trauma intra-uterine

Causes continued….. Problems after Birth Childhood diseases Traumatic Brain Injury Environmental toxins Poverty

Comorbidity (Dual Diagnosis) People with developmental disabilities are more likely to have: Anxiety disorders OCD Seizure Disorders AD/HD Depression Other psychiatric disorders

Impact Research estimates people with disabilities: Have 4-10 times increase risk of becoming victims of crime Constitute 4-10% of the prison population (higher in juvenile facilities and jails) Make up between 10-20% of calls to police 7 times more contact with police than members of the general public Much more likely to be a crime victim

Common Calls Sexual Assault Suicidal Attempts or Gestures Aggressive Behaviors Physical Violence either towards the person with the disability or by them Theft/robbery or assumed attempts

Common Issues faced by First Responders Communication Limited vocabulary or speech impairment Difficulty understanding or answering Short attention span, easily confused Behavior Inappropriate with peers, opposite sex, officers Easily influenced by others Easily frustrated and show it Difficulty with concepts Reading and writing Transitioning Time

Strategies to Consider Look for Clues Watch behaviors Talk to caregivers or others who know the individual Modify language Model calm body language Model behavior you want them to display Be aware of sensory issues and limits Control noise, flashing lights, crowds or multiple people speaking as much as possible.

How to Modify Your Language Speak directly to the person Keep sentences short Use simple language Speak slowly, clearly and calmly Use active and reflective listening. “Repeat what I explained to You” vs. “Did you understand what I said?” Ask for concrete descriptions and reflect back statements Avoid slang Recognize & accept inappropriate personal boundaries. Calmly explain what is acceptable Take time giving or asking for information Avoid confusing questions about reasons or behavior. The answer may really be “I don’t know.”

AUTISM Specific issues to consider related to Autism Spectrum Disorder This is the quickest growing Developmental Disorder Estimates that as of 2014, 1 in 68 children are diagnosed 1 in 42 boys 1 in 169 girls CDC estimates 1 in 150 8 year old children have a form of Autism WI sees a higher than average number of cases Funding for services better here than most states

Things to Consider with ASD Difficulties with social interactions Limited or no eye contact Struggle or do not understand nonverbal cues Limited friendships/ preference to be alone Difficulty with personal boundaries Difficulty with language/communication May repeat noises, questions, statements multiple times May have good verbal skills but 40% of children with ASD do not talk at all

Considerations, cont. Sensory integration issues: hand flapping, spinning Unusual, limited interests: vacuum, piano, toy cars Very black and white thinking: desire sameness, argumentative when and issue is identified as unfair Have tantrums: extreme emotional responses or violent behavior ( generally due to a trigger)

Issues for First Responders Persons with ASD may: Inappropriately approach or run toward officers Resist medical procedures or re-enter dangerous environments Become upset with change to routine Trigger a medical event (40% seizure prone) Not able to understand verbal commands, slang or multi step directions

Tips for interactions Maintain safe distance Talk calmly and softly Explain who you are Avoid slang Allow for slow response Avoid touch Use slow gestures (avoid rapid pointing or waving) Observe for medical alert tags Model calm body language Model behavior you want to see Manage the sensory climate (sirens, radios, crowds) Seek assistance from others on scene who know the individual Use geographic containment Evaluate for injury: person may not show pain

Tips, cont. Let the individual take the lead Use fill in the blank questioning Don’t interfere with their environment. Assure safety but allow time for person to acclimate to what is happening Don’t expect eye contact and don’t force it Personal space is relative –be prepared Don’t interfere with stimming behaviors. Watch and be aware of escalation