rewrite this title How one legal team is building support for people with cognitive disabilities

A few years ago, Noah Cox noticed something about some of the people he represented in court. They struggled to communicate, think logically or problem solve.

“I wanted to know their account of what happened, and I’d ask them questions. And many of them would struggle with a basic explanation,” says Cox, a lawyer in the Los Angeles County Public Defender’s Office. “It seemed like they were having challenges related to some sort of intellectual ability.”

What Cox was seeing was indicative of a broader trend: Studies show people with intellectual and developmental disabilities are overrepresented in the nation’s prisons and jails.

He set out to break that pattern, forming a team within the public defender’s office known as the neurocognitive disorder team. It’s a pioneering effort built on the premise that prison is not always the right place for people with these types of disabilities.

‘A cycle of being involved in the system’

There are many reasons why someone might experience a cognitive impairment, including conditions such as Fetal Alcohol Syndrome, Down Syndrome, a traumatic brain injury, or an intellectual disability, which can limit learning and everyday tasks.

But many of Cox’s clients were never diagnosed with any sort of disability. That doesn’t surprise Leigh Anne McKingsley, senior director of disability and justice initiatives for The Arc, a nonprofit that advocates for people with intellectual and developmental disabilities.

“Often the disability goes unrecognized,” McKingsley says. “They could have gone through their school system not ever really passing much, but it never got documented.”

She says it can be easy for people like this to fall through the cracks. That can lead to trouble. Compared to the general population, people with intellectual and developmental disabilities are more likely to be the victims of violent crimes.

But that can go in the other direction, too.

“Often people with intellectual disabilities are misunderstood, and that can lead to this cycle of being involved in the system,” McKingsley says.

A person with this kind of impairment may not understand consequences or be able to discern who’s a friend and who isn’t. They can be highly suggestible, McKingsley says, and more easily led during a police interrogation.

“They go into a system that doesn’t address their disability. They probably come out much worse and more likely to commit more crime or get involved with people that will,” she says.

‘I wasn’t aware’

Jimmy is 56, and a native of East LA. He’s wirey, with tattoos on his neck and glasses that are a little too big for his face. NPR is not using his last name because he and his family worried about the stigma of his criminal record.

For as long as he can remember, he has been getting in trouble – with family, with teachers, with the police.

“I wasn’t aware of anything, that anything was even wrong,” he says. “It took me a while to understand things.”

Jimmy has been homeless, struggled with substance abuse, and been in and out of prison most of his life. He came to Cox’s office on a burglary charge. It was a third strike, meaning he already had two violent felonies on his record and would now face a harsher sentence.

“I remember meeting Jimmy,” Cox says. “He was trying very hard to tell me something that was very important to him. But I could not understand what he was trying to say.”

Cox asked the judge to appoint a neuropsychologist to evaluate Jimmy. His initial testing showed weak cognitive skills, and an IQ low enough to indicate impairment.

“It became apparent that this was somebody who had a developmental disability, who had not been identified when he was young,” Cox says.

‘They were actually trying to help’

Cox, along with a small team of paralegals, interns and social workers, wanted to make the argument that a diversion program, an alternative to prison, would be more appropriate for Jimmy.

Being diagnosed with a developmental disability, defined as beginning in childhood, would make Jimmy eligible for California’s regional centers, a network that provides support to people with these conditions. Access to such support could improve his chances at diversion.

So the team gathered as many records as they could, and interviewed Jimmy’s family to get a sense of his childhood.

“They were actually trying to help him. And it was very new to us,” his sister Sylvia says.

Sylvia has always known something was different about her brother. He was late to crawl and speak. He couldn’t remember how to adjust the bathtub water temperature. He struggled in school. She says he started getting in trouble with police before he even hit his teen years.

“I think it was a self-fulfilling prophecy for him. The more he was labeled bad, I think the more he became bad,” she says.

After all the interviews and tests, Jimmy was diagnosed with a mild intellectual disability, one he’d had since he was a child. He was 54 years old.

‘I’m not frustrated anymore’

Skeptics of diversion say they can be too lenient on offenders. But Ricardo Garcia, the public defender who leads the LA County office, says if done right, it can address a person’s underlying issues, whether they’re related to mental health, substance abuse, or a cognitive disorder.

Los Angeles County Public Defender Ricardo Garcia says diversion can address a person’s underlying issues, when done correctly.

Philip Cheung for NPR

hide caption

toggle caption

Philip Cheung for NPR

“You give them purpose and you teach them the skills for self-determination,” Garcia says. “It’s not telling individuals how to live their life better. It’s showing them options so they become aware and can decide for themselves with all the best information available to live the life that most people want to live.”

Jimmy is now a third of the way through his two-year diversion plan. He lives in a group home, attends therapy, and most days he comes to LA’s Ladera Park as part of a day program that works with adults with disabilities. His days are looking a lot different than they used to.

Jimmy is now viewing his life as a clean slate.

Philip Cheung for NPR

hide caption

toggle caption

Philip Cheung for NPR

“I go to my therapy. I come to this program. I’m busy all the time,” Jimmy says. “All I can say is that it offers more than prison has to offer me, because I’ve just changed my life completely. I don’t even use drugs anymore. I’m not homeless anymore. I’m not frustrated anymore. I’ve traded in my life for a new one.”