DeEscalation Techniques for Individuals who have Intellectual Disabilities

De-Escalation Techniques for Individuals who have Intellectual Disabilities and/or Mental Illness Part 1: Introduction/Background

Introduction Story Time!

Who are we talking about? • Individuals with an Intellectual Disability (May also be called Developmentally Disabled; Formerly called Mentally Retarded): • Definition of Intellectual Disability: A person who has certain limitations in their mental capabilities, which impacts that individual’s intellectual and adaptive level of functioning. • These deficits have an onset during a person’s developmental period (birth/childhood), and cause a child to intellectually develop more slowly than other children.

Who are we talking about? • Intellectual disabilities affect an individual’s functioning level in two primary ways: – Intellectual Functioning = Includes things like reasoning, problem solving, judgment, and the ability to learn from past experience – Adaptive Functioning = Includes things like self-care, language/communication skills, social judgment, money management, etc.

Dual Diagnoses: • It is believed that around 1/3 of people with intellectual disabilities also have a co-occurring form of mental illness (NADD, 2005). • People who have both intellectual disabilities and mental illness often have challenges related to coping skills, emotion regulation, interpersonal skills, and impulse control.

Another Key Factor to Consider: • In addition to the presence of intellectual disabilities and mental illness, current research indicates that trauma is a third key factor to understand about people with challenging behaviors. • What exactly is trauma? An event or series of events that is experienced by the individual as physically or emotionally harmful, and potentially life threatening. Trauma has a lasting effect on the individual’s functioning and mental, physical, social, emotional, and/or spiritual well-being.

Examples of Trauma: • Some examples of potentially traumatic events: – Abuse: Sexual, physical, emotional, domestic violence in the home, bullying, etc. – Loss: Death, neglect, abandonment, war, etc. – Chronic Stressors: Poverty, racism, a family member with substance abuse, etc.

Effects of Trauma: • What types of things does trauma do to people? – Negatively impacts a person’s ability to cope with future stress – Negatively impacts social relationships with others – Changes physiological responses (i. e. fight or flight); causes a chemical response which may impact ability to recall information correctly – May contribute to problematic behaviors, such as aggression, self-injury, and criminal behavior – Additional symptoms include flashbacks, nightmares, sensitivity to noise/touch, lack of concentration • Story Time: Cliff

Prevalence of Trauma: • More than 84% of adult mental health clients have a history of some form of trauma (Meuser et al, 2004). 50% of female and 25% of male mental health clients have experienced sexual assault (Read et al, 2008). • 70% of individuals with intellectual disabilities have been abused at least once in their lifetime, with 90% of those victims experiencing significant abuse on multiple occasions (Baladerian, Disability Awareness Project). • Individuals with a disability are four times as likely to be victims of a crime as the non-disabled population.

Why All This Talk About Trauma? • Given these numbers, it makes sense to assume that any individuals we’re working with have experienced trauma, even if we don’t know their personal history. • We need to develop a skilled and nuanced approach to situations involving individuals with intellectual disabilities and/or mental illness, that understands trauma and can hopefully avoid an explosive outcome.

Preview of Part Two: • • • The role and triggers for aggression Patterns of Anger What not to do when someone starts to get upset Effective strategies to use for de-escalation What happens next?

Thank You! Randall Huber Investigative Agent Analyst rhuber@summitdd. org Darann Warner Senior Manager dwarner@summitdd. org