1. Developmental and Neurocognitive Disorders
Cara C. Wilson, Ph.D.
Albuquerque Police Department
Behavioral Sciences Division
(505)

2. Developmental Disabilities (DD)
Diverse group of severe chronic conditions (life-long)
Due to mental and/or physical impairments
Begin anytime prior to age 22

3. Some types of DD Intellectual disability (mental retardation)
Autism Spectrum Disorders
Cerebral palsy
Genetic and chromosomal disorders
Fragile X
Down Syndrome
Fetal alcohol disorders/effects

4. Intellectual Disability (MR)
Limits ability to learn (IQ below 70)
Limits ability to function in daily life
Causes—happen before age 18
Injury, disease, brain problem, genetic

5. Who is Affected? 2.5 – 3% of general population
2 – 10% of prison population
More likely to be caught
More likely to confess and be convicted
Less likely to be paroled

6. Common Traits Often picked on, victimized, humiliated
Desire for approval and acceptance—may do what others tell them
Poor impulse control, difficulty with long-term thinking, difficulty handling stress
Difficulty predicting consequences or resisting strong emotional responses

7. Autism Spectrum Disorder
Brain Disorder that impairs:
Socialization
Communication
Degree of impairment is quite variable
Typically—
Socially awkward
Have difficulty communicating
Trouble recognizing safety hazards
Don’t recognize social cues and customs

8. Prevalence of ASD
1 in 68 children
1 in 42 boys
1 in 189 girls

9. What Causes Autism? No one cause
Combination of genetic risk and environmental factors that affect early brain development
Older parents
Extreme prematurity and very low birth weight

10. What to Look for
Little or no eye contact, lack of facial expression, no interest in peers
Stimming—hand-flapping, spinning, rocking
Fixation on a specific object or subject (GUNS)
Fixation on shiny objects (BADGE)
May not respond to commands or acknowledge you
Many don’t like to be touched

11. Encounters with Law Enforcement
7x more likely than other individuals
Police usually called due to unusual behavior
May frighten or disturb others
May become frightened or over-stimulated and become challenging or offensive
May wander off and become lost

12. Interaction Guidelines
Use their name if you know it
Be direct and to the point
Use simple language; speak slowly and clearly
Give them time to understand
Repeat simple questions, allow a few seconds for response, offer praise
Use non-threatening body language
Be alert for the unexpected outburst
Be safe, do proper threat assessment

13. Dementia Umbrella term for a group of cognitive disorders
Progressive decline due to brain damage or disease
Alzheimer’s Disease most common dementia

14. Cognitive Difficulties
Dementia particularly affects
Memory, attention, language, thinking, reasoning, and perception of the world
Especially in later stages, disorientation to
Time (day, month, year)
Place
Circumstance (e.g., at hospital, don’t know why)
Person (forget identity of others, self)

15. Common traits As population ages, so does # of cases
Cause—destruction of brain cells
Affects:
Memory for day-to-day events
What has happened to them
Forget to do things, misplace items, question repetitively
GET LOST (Silver Alert)

16. May be Confused with Delirium
Delirium =“confusion out of the blue”
Some causes of delirium
poisons, fever, pain, infection, lack of sleep, food, water, drug and alcohol withdrawal (DTs)
Most common acute disorder
of hospitalized adults
(10-20%; 30-40% elderly; 80%
ICU)

17. Dementia vs Delirium: Progressive, slow onset (months to years)
Generally not immediately life threatening
No known cure
Focus is on safety, maintaining quality of life
Cognitive, attention, perceptual disturbance
Emotional Disturbance
Rapid Onset (hours to days)
May be Life threatening
Curable, reversible
Can occur in the presence of dementia
Often accompanied by hallucinations
Cognitive, attention, perceptual disturbance
Emotional Disturbance

18. Traumatic Brain Injury (TBI)
Injury to the brain caused by an external physical force
Symptoms can be mild, moderate, or severe
Headache, confusion, lightheadedness, dizziness, blurred vision, tired eyes, ringing in ears, bad taste in mouth, fatigue, lethargy, change in sleep patterns, behavioral or mood changes, trouble with memory, concentration, attention or thinking

19. Types of Injuries Closed head injury Open head injury Blast injury
No obvious external signs
crashes, falls, child abuse, domestic
violence
Open head injury
Gunshot wound
Penetrating object
Blast injury
Significant number of soldiers
returning from Iraq and Afghanistan
Long-term consequences

20. TBI and Violent Behavior
Strong relationship between TBI and violent criminal behavior
Lack of ability to control thoughts, emotions, and conduct, depending on location and severity of brain damage

21. Contact Tips for Law Enforcement
Respond supportively if person appears upset
Speak in a calm, matter of fact voice
Reassure that everything is ok and they are safe
Explain your procedures prior to action
Remind of current location and situation

22. Keys for Law Enforcement
Respect the person—more likely to be victims than perpetrators
Emphasize the person not the disability
Be aware of symptoms and potential limitations the individual may have
Understand as much as you can and don’t be afraid to ask questions
Get help when you
don’t know
STAY SAFE!
Louisiana Officer: Meets buy Autistic/disabled..befriended him always wanted to be a police officer but felt his diability would keep him from it…