Up First from NPR – "Defending the Disabled" (Jan 18, 2026)

Episode Overview

This Sunday Story from Up First goes deep into the intersection of disability rights and the criminal justice system. Host Ayesha Rascoe and NPR criminal justice correspondent Meg Anderson explore how people with cognitive disabilities are disproportionately entangled in the legal system—both as defendants and victims—and spotlight an innovative program in Los Angeles aiming to provide better support and fairer outcomes for such individuals.

Key Discussion Points & Insights

1. The Overlooked Link Between Disabilities and the Criminal Justice System

• Prevalence of Cognitive Disabilities in Defendants

  • Many entering the criminal justice system have cognitive impairments affecting thinking, memory, problem solving, and judgment. Without intervention, these problems persist or worsen.
    • (Meg Anderson, 00:38)
  • Statistic: People in prison are more than twice as likely as the general population to report a disability, with cognitive disabilities being most common (07:08).

• Barriers Faced by Defendants

  • People with cognitive disabilities are less able to articulate basic facts or understand proceedings, putting them at a severe disadvantage (Noah Cox, 02:28; Meg Anderson, 02:59).

• Double Vulnerability: Victims and Offenders

  • These individuals are also over twice as likely to be victims of violent crime (07:08).

Quote

“People in state and federal prisons are more than twice as likely to report having any disability compared to the general population. But the most common disability they report is a cognitive one.”
— Meg Anderson (07:08)

2. Invisible and Undiagnosed: How Cognitive Disabilities Go Unrecognized

• Invisible Impairments

  • Many struggle for years without formal diagnosis or documentation, often dismissed as simply “bad” or failing (Leanne McKinsley, The Arc, 08:20).
  • Cognitive disabilities can stem from causes as varied as fetal alcohol syndrome, Down syndrome, brain injury, mental illness, or developmental / intellectual disability (05:47).

• Cycle of Vulnerability and Escalating Troubles

  • Without support, individuals may be exploited or become involved in crime simply due to misunderstandings, poor judgment, or being easily influenced. Poverty frequently worsens the problem, limiting access to diagnosis and intervention (09:08).
  • A lack of early support makes people more likely to be repeatedly ensnared by the justice system (09:39; 09:46).

Quote

“Often the disability goes unrecognized… or even just kind of dismissed as irrelevant.”
— Leanne McKinsley (08:20)

3. The LA County Public Defender’s Novel Program

• Recognizing a Pattern

  • Noah Cox, a public defender, noticed many of his clients couldn’t coherently explain basic facts—not necessarily about crime, but about daily life. He suspected underlying, unaddressed cognitive barriers (02:28).

• Founding a Unique Team

  • In 2021, Cox established a specialized unit—the only one of its kind in the country, as far as he knows—to identify, support, and advocate for clients with cognitive impairments (10:20).
  • The team includes Cox, two social workers, volunteer attorneys, and graduate student interns (10:57).

• Operating with Scarce Resources

  • No separate budget; relies on resourcefulness and unpaid or volunteer labor (11:08).

• Their Process

  • Phase 1: Receive referrals for potentially impaired clients, then conduct initial cognitive testing at no cost (11:26).
  • Phase 2: If impairment is found, argue in court for treatment and services (sometimes “diversion” programs) instead of prison—proposing comprehensive support plans to judges (17:30).

Quote

“It seemed clear that there was a tremendous number of these individuals. But it also became clear that not enough work had been done to identify these people, to recognize their problems. So we set about to try and figure all this out.”
— Noah Cox (03:28)

4. Case Study: "Jimmy"

• Background

  • Jimmy, 56, grew up in East LA; has been homeless, in and out of jail or prison since childhood—mainly crimes tied to drug use and poverty, but also serious felonies (13:55).
  • His sister describes a rough upbringing with abuse and undiagnosed developmental delays (19:16–19:55).

• Legal Turning Point

  • On his third strike (facing 25 years to life), public defender Cox requested cognitive testing, revealing significant intellectual disability, poor memory, and executive function (16:42).
  • Cox's team then built a detailed case showing Jimmy’s lifelong impairment, gathering records/interviews to demonstrate the disability originated in childhood (18:34).

• Outcome

  • Jimmy qualified for California’s regional center services for developmental disabilities—which are lifelong, taxpayer-funded programs—after a thorough and rare adult eligibility review (21:02–21:23).
  • Instead of prison, Jimmy lives in a supervised group home, attends daily therapy, receives mental health and substance abuse counseling, and must comply for two years; otherwise, he risks prosecution (22:04).

Quotes

“It was just a revolving door, man. It’s like I would take two steps forward and then back down another three steps... problems with the way that I lived my life.”
— Jimmy (14:47)

“All I can see is that it offers more than prison has to offer… it’s impacted my life to the point where, you know what? I don’t even use drugs anymore. I’m not homeless anymore… I traded in my life for a new one.”
— Jimmy (29:25)

5. Bigger Questions: Accountability, Effectiveness, and Public Perception

• Controversy Over Diversion
  • Critics argue diversion is too lenient given real harm by some offenders (22:41).
  • Lisa Dugard (Purpose Dignity Action) states the “punishment = accountability” viewpoint is deeply ingrained but not evidence-based; incarceration often makes people worse, not better (23:34).

Quote

“We have all been raised in an environment that teaches that negative consequences are what we do when we take a problem seriously.… So doing it differently codes as minimizing the harm.”
— Lisa Dugard (23:34)

• Real Requirements for Success
  • Programs must: ensure victims feel safe, provide robust support (housing, healthcare, relationships, purpose), and tackle root causes of crime (26:41).
  • Success metrics are elusive: Is it total avoidance of crime, or reduction in recidivism? The LA team is so new, it’s too early to draw conclusions (28:06).

Quote

“It isn’t better just because it’s happening outside of the legal system. And so if what we do is poor, then pretty soon society is just going to say, well, that was a nice idea. But actually… putting people in jail is the only thing that really, quote, unquote, works.”
— Lisa Dugard (25:53)

Four Pillars for Effective Alternatives (Lisa Dugard, 27:05)

• Safe place to live
• Access to healthcare
• Building connections
• Finding hope or meaning

Notable Quotes & Memorable Moments

• “You wouldn’t know him from anybody else—that's part of the thing I love about this, is that when he's successful, you wouldn't know him from anybody else.”
  — Noah Cox, on his clients’ hard-won normalcy (01:40)
• “It makes me feel bad for him… he didn’t get any extra support and he was labeled as bad and that’s it. I think it was a self-fulfilling prophecy for him.”
  — Jimmy’s sister Sylvia (20:14)
• “If you do all that, you can have unexpected allies, right, like police and prosecutors, even victims who just don’t want what happened to them to happen to anyone else.”
  — Meg Anderson (27:59)

Important Segment Timestamps

• 00:38 — Linking cognitive impairment and criminal justice; public defender’s experience.
• 02:28/03:28 — Noah Cox describes recognizing the pattern.
• 07:08 — National statistics on disabilities among prisoners and victims.
• 08:20/09:20 — Advocacy insights: disabilities going undiagnosed; intersection with poverty.
• 10:20–11:47 — Description of LA Public Defender's program and workflow.
• 13:30–22:41 — “Jimmy’s” full story: from arrest to diagnosis to diversion.
• 23:03–26:41 — Lisa Dugard on criticisms and design of diversion programs.
• 28:06 — Challenges in measuring program success.
• 29:14–29:51 — Jimmy reflects on his progress and the impact of support.

Tone & Style

The episode blends journalistic rigor with empathy, using personal stories and expert analysis to illuminate systemic failures and emerging solutions. Many interviewees speak with a directness and humanity that underscores the stakes for real people caught in bureaucratic or punitive cycles.

Conclusion

"Defending the Disabled" is a probing look at how the criminal justice system still struggles to address the needs and potential of people with cognitive disabilities. The LA County Public Defender’s pioneering program highlights both hope and daunting challenges in creating a more humane and effective approach—one that provides genuine support and, possibly, a path out of the revolving prison door.