Thread by @alysanmati

We are starting with the defence re-examination of Dr Westphal (day 7 on the stand). First the judge has a q. Follow along here or at the link below: thestar.com/content/thesta…

Justice Molloy wanted to know how many people in the population have autism spectrum disorder (what the best estimate is). Westphal said it's currently considered to be 1 in 60 people.

The defence has read a tonne of stuff from cross-examination back to Westphal, in which he appears to agree w Crown that Minassian knew what he was doing was morally wrong. Westphal said he may not have picked up on the subtlety of the questions.

His position on Minassian's capacity for moral decision-making (that he could not do it in a meaningful way) hasn't wavered.

Defence asks about the diff between communication and social communication. Westphal says reading face and body language is such a key part of understanding what someone means. That's stripped from text messages.

Defence asks about the questions about Minassian's communication in everyday settings being at the level of a child. He says he thinks of Tom Hanks in Big pretending to be a child. Westphal says he hasn't seen the film.

Crown objects, said he could have explained this in chief.

The judge says she doesn't like this concept of being "like a two year old" very much and neither do many people with disabilities. It's a concept she finds problematic. It just doesn't work for someone who is an adult, with an adult intellect.

Westphal says he could not agree more. The comparison to a child came up re the Vineland testing, and that is one reason some don't like it. He says it can be looked at it in percentiles as well.

Westphal agrees that it causes a lot of problems to do those child-level comparisons. Defence asks how Westphal understood the question about this asked by the Crown.

Westphal said he was trying to convey the Vineland test findings.

Defence asks about relationship between IQ and autism (Westphal says you can't connect the two). Westphal said there is an academic literature about this. This is why they look at "adaptive function."

Looking at a paper titled: "The misnomer of 'high-functioning autism': Intelligence is an imprecise predictor of functional abilities at diagnosis."

Crown objects, why was this not raised in cross.

Judge says she understands the point. But she wants to get as much information as possible. Says she will allow cross-examination on it by the Crown if he wants.

Westphal says we can get into "squiggly lines" if we want to look at a graph. There is a divergence between between IQ and adaptive functioning scores, and that increases with age. Point is that Minassian fits into this.

(Crown objection was this it was not raised in exam-in-chief, not cross as I wrote. The Crown only got it last night so they need time before they ask questions if any about it).

Talking about notes again. Defence asking about Crown assertions re Westphal not reading the Crown psych notes. Defence points out one note that is basically reflected verbatim in the report.

Defence now asking about a line of questioning the Crown had about Minassian and job interviews. Westphal said he didn't recall talking to Minassian about this area.

Defence asks if reviewing the interview notes would refresh his memory.

"Anything to help my memory," W says.

Now looking at another part of Westphal's report in which Minassian said he'd be surprised if any of his victims would want revenge. He said: 'I knew there were survivors...I was imagining if I was in the hospital with broken bones, I would be inconvenienced or uncomfortable."

According to Westphal interview notes, Minassian used the term devastating re in his parents in terms of hiding his plan from them. Westphal said his parents would have tried get him professional help. His concern was they'd interrupt his planning.

Taking the morning break for ten minutes now.

Now talking about Minassian's interest in the Bible. It's something he is currently excited about and so is more expressive about it.

Defence now asking about the Crown's line of questions about Minassian's time in college, and his social interactions.

Minassian said he felt "invisible, a grain of dust."

He felt "intense isolation," Westphal said.

Also didn't have any romantic relationships.

He told Westphal he thought things would change in college or the military, that his social life would get better but it didn't. "He realized that things would remain the same."

Defence: Does it matter if these are his own ideas, of if he is repeating the ideas of others (re the Bible.)

Westphal thinks Minassian's idea of the Bible as a source of hope would have come from discussions with someone.

Defence is going to replay a clip now of the Minassian interviews.

Interview with the police officer that is. It's the part where he asks about what Minassian would say to the victims. Minassian said he doesn't know what he'd say and if he'd apologize.

Westphal says this is "striking." He also asked Minassian about this. Minassian gave him a different (though also a strange one). Westphal said the police answer was more "unprocessed." Minassian could have incorporated things he'd discussed with others into his answer to W.

Defence: Crown said you were pursuing a narrative, a personal agenda of sorts. Is there anything personal or professional for you for being involved in this case?

W: To say something about negative impact in a case that has impacted so many people is not right...

But it's not a good thing at all. He's been part of the autism world for as long as he could be. You know what people's reactions have been. It is a difficult area.

Doesn't think this experience helps him professionally at all.

Westphal said everyone agrees Minassian has autism. He has impaired empathy. I think it is beyond there that people disagree. "To me it is very very clear (he) didn't understand the wrongfulness of his actions" and that stems from his development of empathy and moral reasoning.

He doesn't see anything in the other reports that strongly disagrees with that, or in his interviews.

That's it for re-examination.

Taking lunch break. Crown will see if they have questions for Westphal about that new article.

Back. The Crown doesn't have questions about article but does about the Vineland. The adaptive function test was done by Minassian's dad.

That's it, Westphal is done.

"I know it's been a long road," says the judge, thanks him for being here.

W: "Thank you for listening."

Okay, starting with the Crown's first witness. Dr. Percy Wright, a psychologist I think based out of CAMH. He's making a solemn affirmation to tell the truth. Crown Cynthia Valarezo is going to be doing the exam-in-chief.

He is accepted as an expert in forensic psychologist. But we are going to go through his CV a bit anyway. He's at both CAMH and Waypoint.

*forensic psychology. He's testified in not criminally responsible cases since 1995 and evaluates defendants for fitness and criminal responsibility.

He has assessed a number of people for NCR with autism spectrum disorder characteristics but has not testified in those cases. Those cases involved a co-morbidity, most often an intellectual disability, or psychosis, schizophrenia.

Since 2000 he's done assessments and recommendations for "high-functioning people with ASD" who have had issues at universities, as students or faculties, with regulatory bodies or employer. Some difficulty with their behaviour or social judgment.

He said he has never done a not criminally responsible assessment on someone with the "cognitive" strength of Alek Minassian.

He reviewed Dr. Bradford's report and Dr. Mamek's (?) reports, and later the data.

He has not reviewed Dr. Woodside's report but has reviewed the Westphal report and the transcript of the interviews with Minassian. Haven't read the notes in detail.

He also got a range of test data from the psychologist, Dr. Loftin, who worked with Westphal.

Crown: Do you agree with Minassian's autism spectrum disorder diagnosis.

Wright does. He is reading the DSM definition.

Wright stresses the history factor of autism diagnosis. Can have problematic behaviour that doesn't manifest in adulthood. But the diagnosis can be linked to childhood behaviour. Not a lot of diagnoses work that way.

Wright says can used the ADIR test in both childhood and adulthood. It's given to a caregiver, like the Vineland. Would normally be done by social worker. He also by the time he gets involved, the diagnosis clear and the q is how severe is it.

Wright says no question Minassian has autism spectrum disorder. Not sure it needs to be clearer via the ADI. The ADOS is done for observation but he prefers other tests, like to see how they do when faced with a task.

ADOS doesn't assess directly and systematic cognitive inflexibility or understanding of non-literal concepts. He prefers to do this directly.

Crown asks about "hyper-focus" and "hyper-fixation." Can terms be used interchangeably.

Wright: These terms are about a continuum of recurring thought or interest, that they have different abilities to get their mind away from. Can be enjoyable, like math or mechanical thing.

Or it can be a focus on touching a body part, or interest in video games. The terminology is not as important as knowing there is a wide-range of severity.

Wright says Minassian does describe a special interest or preoccupation with science, astronomy, math, video games. But they don't intrude into his thought process. Not the focus of all his conversations.

Didn't overpower his ability to think of other things.

Crown asks for example of an overpowering thought in his experience since 2000.

Wright said he can, but will modify so the people can't be identified.

Some people, unless you start talking about the preoccupation topic, won't have a conversation. Could be about a device or vehicle. In more higher-functioning people at universities, found history pre-occupations, like national origin history.

Like with Minassian, can be about mathematical formulas. This can interfere with functioning and thought processes. It can manifest much more severely than with Minassian.

There is a socio-sexual test he administered (I didn't get the full name). He uses it for people like Minassian. Looks at dating and courtship behaviour, why don't I get dates. Assess sexual knowledge.

Not just talking abt concepts, also involves pictures/ scenarios of real people and make judgments about what to do in context. Minassian talked through his thoughts when trying to navigate test (quite common for people with ASD).

What was unusual was the amount of time he took. Most people could almost immediately identify pedophilic content. He took his time to go through, understand. Chance to show how much theory of mind and perspective-taking he has.

Wright notes this area can be an issue in more severe cases of autism. He thinks of it like "how much of it do you have." Involves knowing people think differently and also people are not machine-like. People have their own internal experiences and are not logical.

With Minassian, in thinking about why a woman might respond in some way based on her history and experience, it was telling how much theory of mind he demonstrated. He got virtually all the right answers on this test.

(I don't have a copy of this report yet, and how I wish I did).

Wright says other tests look at cognitive flexibility. A proverbs test is v useful for people with autism. May find it hard to use metaphors (Minassian doesn't have this issue), or show abstract thinking.

Minassian scored in the average range which surprised him. He doesn't respond quickly but got well in the average range. In the multiple choice section he was quick and got them all right.

Wright said high-level moral reasoning does require the ability to have non-concrete or non-literal thinking. The 20 questions test looks at planning ahead, not just what's in front of you. Ppl with severe autism struggle with it. Minassian did fine.

He did another test about sensory-bound thinking and concrete thinking (I missed the name). No difficulties with that test, well above average. Showed cognitive flexibility and did not display "stimulus-bound thinking."

Crown asks what that last thing means.

Linked to impulsivity and not planning ahead. Easily tempted. Respond quickly to what you see.

He's now talking about a colour-words test where RED is spelled in the colour green as example.

Minassian does fine.

Minassian, in the withholding areas, he got average to high-average.

Crown: If you had to summarize, what can you tell us about his strengths and ability.

Wright: Better than other people with autism with non-literal meaning. Better than average resistance to impulsivity.

Taking a break now.

Crown: What did the testing reveal about weaknesses

Wright: No scores below average. The only thing was the time he took to answer, which is not part of the score. He takes time to talk through the non-literal meanings (he got a 105).

Now talking about the Shipley-2 test (?). It's an intelligence measuring test. Important to know in thinking about tests they do on children. Different from the WAIS test done by Westphal's group.

The Shipley vocab part is multiple choice, so less problem-solving. Not much cognitive processing from the person. More about how info is in there. Minassian got the high-average range (118).

Another part involves problem-solving, how creative, perceptive, flexible can you be. Would expect someone like Minassian with high-functioning ASD (formerly Asperger's) to struggle on block patterns bc it's visual. Used to be called non-verbal learning disability.

He performed average on that area, but it's lower than his vocabulary. In line with someone with high-functioning ASD. He has trouble driving, trouble with sports, motor behaviour. What was surprising was the abstraction part.

That's the part about how able are you to figure out difficult problems. He got 131 in this area, very superior range. Only 9 of the 25 questions are about math. Wright said he was "amazed" by his performance

Crown: Why?

Wright: He didn't show "autistic logic" he didn't make the item fit his way of thinking in the moment. he was able to continue to understand the difficult items until he got it right. He got 22 of 25 correct.

He often give this test to grad students or psychiatric residents and very few get that number right. He's driven and able to figure out complex concepts. He notes these are not interpersonal concepts, not about that area. But speaks to how severe his "autistic thinking" is.

Wright says not a strong history of Minassian having angry outbursts. Not much expression of anger, and he gives a "compelling" description of not expressing his anger to people but holding it in and engaging in school shooting fantasies as part of the anger-resolving process

Regarding a test on anger, no sign he was underreporting his anger. appeared up front about his experience. more focus on resentment and "stewing" on historical perceived mistreatment.

Wright said the test is in keeping with his history. No history of expressing anger directly from relatively early age. He has it and hides it and is haunted by his experience, but more so feeling of failure. In keeping with description of having anger and not presenting it.

Crown: is he an angry person who hides it from others?

Wright: it does say that, but not in a high-severity way. Surprising given the outcome of that anger. These scores are not extremely elevated. Not easily matched up with the tragic outcome here.

Now asking about PAI/MMPI tests. About temperament and cognitive style. Give the test to know if they are exaggerating their disability or undereporting it. See if they try to direct their self-reports in one way or the other.

Wright says there is no reason to believe Minassian is over or under reporting his abilities.

He finds that people who are hospitalized or in serious trouble with autism spectrum disorder generate normal profiles. Without theory of mind, hard to report on own challenges, interpersonally or internally. Minassian's profile is in keeping with what we know about him.

"He for better or worse has self-awareness of his difficulties," Wright said. In keeping with what he told Westphal he is haunted by failing academically, struggling with procrastination, a harsh self-critic as opposed to people with ASD in university who don't see the issue.

He doesn't externalize, in terms of blaming others for his perceived failures or fear of being seen of never accomplishing anything. He expressed sadness, difficult thinking clearly, self-esteem poor, feels powerless. It's an accomplishment for someone with ASD.

(In terms of being able to have self-awareness). Minassian's feelings are linked to him knowing his intellectual capabilities, Wright said.

Apparently there is a test that can only be seen by registered psychologist (not sure it's for intellectual property reasons). Anyway, hard for a non-psychologist to understand it.

Crown asks if Westphal's team ever asked for the data. Wright said no.

So now going to talk about the WAIS IQ test. Going to go through similarities and differences between the tests done by Dr. Mamek and Dr. Loftin.

Sorry, finally could look it up, it's Dr. Mamak. She worked with Dr. Bradford's team (the other defence team).

Wright said Minassian, unlike others with autism, did well in thinking non-literally and outside the box.

Crown: How is this linked to moral reasoning.

Wright: At a high level, its more than just understanding rules of conduct. Need to think flexibly and have theory of mind

Which Minassian can do, Wright says.

Now he's talking about the perceptual reasoning index, which is another area where people with autism can struggle. Part of it is figuring out visual concepts, and mental rotations figuring out a puzzle in space. His score is considerably lower.

Minassian is around average overall. It's a deficit compared to what you'd expect for his vocabulary. It is what would be predicted for someone with high-functioning autism.

Crown: What does this mean for ability to reason.

Wright: Doesn't involve interpersonal, moral concepts

Minassian did a lot better on the digit spans with Mamak than with Loftin. Wright said it's clear why. It involves listening to and then reciting back a sequence of numbers.

First in order, then backwards, then different numbers and to say them back in numerical order.

Minassian did pretty well in all of the tests with Dr. Mamak but had a brief lapse in concentration when doing Dr. Loftin's test.

Back from a break. Talking about the ADOS testing now I think. Wright commenting on the scoring other people did, noting the test is often used on children.

We are back to the famous ADOS puzzle task, where Minassian didn't ask for more pieces (we have gone over this part alot). Wright said you can look at it from an autism lens. But other ways to see it. He is anxious, detained, I would be quite hesitant.

We have been using an autism spectrum lens a lot, but we have to also look at other possible explanations for his behaviour, Wright said.

Wright observes that Minassian managed to complete his university degree without getting into trouble socially (sending inappropriate emails, accusing teachers of unfairness).

He says the Vineland adaptive conclusions rely a lot on childhood behaviour and don't reflect how he functions as an adult, or give him credit for how he has been doing lately. The age equivalent thing can also be misleading.

Wright explains that the test combines both child and adult experiences, can't undo childhood shortcomings. Wright suggests Minassian wants social interaction but avoids it. Finding from Vineland based on what he does, not what he understands.

Not sure this makes sense in tweet form really, but it is interesting in the context of what basis Westphal had for his conclusions, including the Vineland testing of adaptive function.

Wright said he is not surprised by low socialization numbers but wants to make sure the way the test works is understood. To me not surprising where the scores are.

Crown: Does it reflect his ability for the past 2/3years?

Wright: Of course not. He has a friend he sees. He got into the military. Got his degree. Got a job. Was in emotional turmoil and harsh on himself, but that is separate from his autism. Not good reflection of his function

Wright notes that Minassian's adaptive functioning scores are higher than someone with autism and an intellectual disability. That is why Minassian can function the way he does, even though there is a discrepancy between intellect/adaptive function.

Wright says he sees people at university with much more severe adaptive functioning than Minassian.

The Crown reads out the Westphal report conclusion about Minassian having child-level social skills. Wright disagrees with any suggestion Minassian has child-like reasoning. Minassian does not understand some things like cadence. He did everything I asked him to in adult way.

Westphal used a more provocative style of interviewing than me, Wright said, but Minassian stuck to his statements when challenged. A child doesn't attend university, doesn't express sadness and awareness of not getting a girlfriend due to social deficits.

He has difficulty in the use of the word child in the report.

Crown is now asking about the Empathy Quotient test. Wright doesn't use it. Empathy not typically a central piece in an NCR defence. Not a highly standardized test, he says.

Wright has difficult with Westphal's views on Minassian's capacity for empathy. He sees it as an entirely different issues from understanding actions at the time/the NCR test. Doesn't understand the emphasis on this.

Wright: the q is do you have a disorder that prevents you from knowing what you did was wrong. The focus on empathy takes the trial away from the key questions of the NCR test.

Crown: Did you see an empathy deficit?

Wright: He had 3/4 close friends growing up with shared interests. Talked about family in terms that he understood them as individuals and their experiences and who they are. Able to say it's a bad thing to kill people.

Wright: Having a lot of empathy is a good thing for helping you restrain your behaviour, but there are lots of events in a person's life which can impair empathy. People do terrible things to each other without a disorder impairing empathy.

He makes statements that he knows his actions were wrong and has empathy for his victims. So it doesn't speak to me in terms of knowledge of wrongfulness. Even if he has empathy deficit, he had a number of tools to restrain himself. Doesn't speak to what drove this behaviour.

Re lacking emotion, you can say that must be due to autism. Very real risk of over-using the autism lens. This is an individual who for many years thought about killing people. When feeling powerless and as tool for coping with anger.

This is how school shooters are described: cold and callous. Not surprising that this would change the way a person sees something like this.

Don't understand how ASD can "surgically strike" and make someone not know killing is wrong, when they can navigate other areas of life

This not a typical behaviour from autism individuals, who are generally not particularly violent. There are other non-autism things that we can look at. Doesn't see empathy as central.

Autism Spectrum Disorder is not the only explanation for the burdens he has lived with. There are other problems he has.

Wright: When you pull back and look at what he did, and his thought processes, it's more like a school shooter than autism. If you look at what he is haunted by, don't flow from autism spectrum disorder. People with ASD have trouble taking responsibility for behavior.

If they have theory of mind deficits. But he is so opposite to that. He thinks about failing his exams, that he is going to die a nobody. Not something you see in autism. More socially avoidant features.

Most people with ASD, as long they do the thing that interests them, they are okay not haunted like him. Not seeing other people with ASD obsessing over school shootings for years. Concerned about this trial's focus on autism lens only.

Wright says Minassian oscillated in his focus on school shootings, depending on his circumstances. Sometimes it made him feel better, sometimes he thought it was bad and didn't need it.

Wright said he hasn't read Dr. Woodside's report. He has everything Woodside had for his report. They were on the same page. Did have one discussion today about the video recordings, I found Minassian seeming much less relaxed than with me. Woodside said he was the same as w him

And that is it from the Crown. We are going to start a little later tomorrow at 1 p.m.