In a quiet corner of the Los Angeles County Public Defender's Office, a unique team is quietly reshaping the way the criminal justice system treats people with cognitive disabilities. While the American legal system is often criticized for its one-size-fits-all approach, this specialized unit stands out for its focus on some of the most vulnerable defendants—those whose intellectual and developmental challenges have often gone undiagnosed and unsupported for decades.
The story, as reported by NPR, begins with lawyer Noah Cox, who several years ago started noticing a troubling pattern among his clients. "I wanted to know their account of what happened. And I'd ask them questions," Cox recalled. But many of these individuals struggled to provide even a basic explanation of their circumstances. "And it seemed like they were having challenges related to some sort of intellectual ability," he explained. This wasn’t just a handful of cases—studies confirm that people with intellectual and developmental disabilities, such as Down syndrome and fetal alcohol syndrome, are vastly overrepresented in the nation’s prisons and jails.
These are conditions that can limit learning and reasoning, making it difficult for people to hold down jobs, live independently, or even distinguish between friends and those who might exploit them. Once inside the criminal justice system, individuals with such impairments often find themselves in an environment that is ill-equipped to meet their needs. Instead of rehabilitation, incarceration can make their situations even worse.
Cox and his colleagues were determined to disrupt this cycle. "Our team is often the first time that somebody is accurately diagnosed. It is sad to me that a lot of my clients at age 30, 40, 50 are being diagnosed for the first time by the criminal legal system," Cox said. It’s a sobering reality: for many, the criminal justice system is their first encounter with a professional who recognizes their disability.
The Los Angeles County Public Defender’s cognitive disabilities unit is one of the only teams of its kind in the country, and it’s not hard to see why. The work is resource-intensive, requiring a small army of lawyers, paralegals, interns, and social workers. Together, they dig through years of personal and medical records, interview family members, and coordinate with neuropsychologists to ensure clients are properly evaluated. The goal? To build a case for diversion—an alternative to prison that offers treatment and support rather than punishment.
The experience of Jimmy, a 56-year-old man from East LA, illustrates both the challenges and the promise of this approach. For as long as he can remember, Jimmy has struggled to stay out of trouble—with his family, with teachers, and with the police. "I couldn't control myself. I wasn't aware of my sicknesses. I wasn't aware of anything, really—you know?—that anything was even wrong, you know?" Jimmy shared, reflecting on a lifetime marked by confusion and frustration. He’s been homeless, battled drug addiction, and spent years cycling in and out of prison for a variety of offenses.
When Jimmy landed in Cox’s office facing a burglary charge—his third strike, which could have meant a harsh sentence—he struggled to communicate what was important to him. Cox remembered, "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." It was only after a neuropsychological assessment that the truth emerged: Jimmy had a mild intellectual disability that had never been identified during his childhood.
With this new diagnosis, Jimmy became eligible for disability services in California. The team sprang into action, gathering as much information as possible and interviewing his family to piece together his story. His sister, Sylvia, recalled, "They were actually trying to help him. And it was very new to us." She had always sensed her brother was different—he was late to crawl, late to speak, and struggled to complete a simple paper route. School was a constant challenge, and he began getting into trouble with the law before his teenage 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 reflected.
The diagnosis was validating for Jimmy’s family. "We always knew it. So it was very validating," Sylvia said. After much discussion, Jimmy opted for a two-year diversion program as an alternative to prison—a decision that was ultimately approved by both the prosecutor and the judge.
Today, Jimmy’s life looks radically different. On a sunny afternoon in LA's Ladera Park, he goes through his workout routine with a program designed for adults with disabilities. "I do my pushups right here, like, 50. And you feel it burn, you know?" he said, grinning. He now lives in a group home, attends therapy, and is about a third of the way through his two-year diversion. The changes are profound. "All I can say is that it offers more than prison has to offer me, you know? Because I'm—just changed my life completely. I don't even use drugs anymore. I don't—I'm not homeless anymore. I'm not frustrated anymore. I'm just—I traded in my life for a new one," Jimmy said.
Each previous release from prison felt like taking one step forward, then three steps back. But now, with a support system in place, Jimmy is looking at his life as a clean slate. And that’s exactly the point, Cox emphasized. "Jimmy himself made a decision that he wanted to invest in his future. This is his opportunity for a real life." Cox added, "And hopefully, he's the last lawyer Jimmy will ever need."
Jimmy’s story is a powerful testament to what can happen when the criminal justice system pauses to recognize the humanity—and the needs—of those it serves. The Los Angeles County Public Defender’s specialized unit is still a rarity in America, but its impact is unmistakable. By helping clients like Jimmy access treatment and the right kinds of support, the team is proving that sometimes, the best defense is simply understanding.
As the nation grapples with questions about mass incarceration and the treatment of people with disabilities, the work being done in Los Angeles offers a glimpse of a more compassionate—and more effective—approach to justice.
