2018-04-08 / Insight

Autism presents challenges for emergency services

BY PHIL FOLEY
810-452-2616 • pfoley@mihomepaper.com

LAPEER COUNTY — In an emergency situation the ability to communicate clearly can mean the difference between life and death. Every day first responders, firefighters and police are faced with people whose ability to communicate is hampered by pain and panic.

There is growing issue facing emergency services workers — autism. Autism is a brain development disorder resulting in difficulties related to social interaction and communication.

According to recent estimates from the Centers for Disease Control’s Autism and Developmental Disabilities Monitoring Network, autism affects about 1 in 68 children. A 2015 CDC study reported that between 2000 and 2010 the prevalence of autism increased by nearly 120 percent.

That’s one of the reasons the Almont Township Fire Dept. devoted its March 19 training session to autism.

Another reason struck a little closer to home. Three years ago, Almont firefighters spent the better part of a day searching more than a square mile when the autistic son of one of their colleagues went missing.

The boy was eventually found hiding in is parent’s house. “We had dogs out. We had heat-seeking drones,” recalled Almont Fire Chief Don Smith.

He said firefighters talking about that incident, which ended well, prompted him to bring in an autism trainer.

Goodland Township Fire Chief Don Bissett, who’s also president of the Lapeer County Fire Chief’s Association, said his group has talked about Autism Spectrum Disorder (ASD) training, but as far as he knows, Smith is the first chief in the county to do it at the department level.

Smith said the ASD training is becoming more common. He noted it will be included in the eight classes offered at the Michigan State Firemen’s Association conference May 17-19 in Port Huron.

He expects between six and 10 of his firefighters will attend the conference, but he doesn’t know which classes they’ll sign up for.

Bissett said during his 33 years as a firefighter, he’s never encountered a problem with someone with autism.

“The biggest thing I learned,” said Smith, “is there is no hard and fast rule for dealing with autistic people. Each one is different. Each case is different. There is no baseline, it’s frightening.”

The Austism Society said that’s because people with ASD may:

• Not recognize a first responder vehicle, badge, or uniform; • Not understand what is expected of them;

• Not respond to commands;

• Run or move away when approached;

• Be unable to communicate with words;

• Only repeat what is said to them;

• Communicate only with sign language, pictures or gestures;

• Avoid eye contact;

• Appear argumentative or stubborn;

• Say “No!” or “Yes!” in response to all questions;

• Have difficulty judging personal space;

• Try to avoid sensory input (e.g., flashing lights, sirens, crowds) due to hypersensitivity;

• Have a decreased cognitive ability when experiencing heightened anxiety or frustration;

• Become anxious or agitated, producing fight or flight responses or behaviors such as screaming, hand flapping, or self-injurious behaviors;

• Appear to be under the influence of narcotics or intoxicants;

• Have an associated medical condition such as seizure disorder;

• Be fixated on a particular object or topic, and may ask repeated questions

• Speak in a monotone voice with unusual pronunciations

• Reverse pronouns (“Can I stop?” instead of “Can you stop?”);

• Give misleading statements or false confessions;

• Have problems speaking at the correct volume;

• May, if verbal, be honest to the point of bluntness or rudeness;

• Not acknowledge physical pain or trauma due to hyposensitivity;

• Not be able communicate the extent of trauma due to a lack of understanding of healthy sexuality or appropriate boundaries in care provider or other relationships;

• Have the need for a for a Forensic Interviewer with knowledge of autism;

• Not have knowledge of the criminal justice system and the expectations to assist in prosecution.

And all of that can make emergency services personnel’s job that much more difficult.

Lapeer County Undersheriff Jeremy Howe, who holds a master’s degree in social work and was a clinical therapist before getting into law enforcement, said every deputy at the Lapeer County Sheriff’s Dept. has completed an eight-hour mental health first aid class. “It covers a wide variety of mental health issues” including ASD, he said.

He said that although it’s a one-time certification, “we probably need to look at it again.” Howe added, law enforcement managers are talking about making it a required course at police academies.

Howe said that while there are only five to 10 households around the county where deputies regularly respond to incidents involving an individual with ASD, “We do have a lot of adult foster care homes” and deputies often have no idea what they will encounter when they arrive at a scene.

When they do know they’re going to a home where an ASD individual is present, “our guys know not to go in lights and siren.”

Howe believes his deputies are “more empathetic with people who have mental problems.”

He added, “Our guys are well educated on programs like LACADA and CMH (Community Mental Health) and can point people in the right direction.”

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