State of Iowa v. Darreon Corta Draine ( 2019 )


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  •               IN THE SUPREME COURT OF IOWA
    No. 18–1292
    Filed December 6, 2019
    STATE OF IOWA,
    Appellee,
    vs.
    DARREON CORTA DRAINE,
    Appellant.
    On review from the Iowa Court of Appeals.
    Appeal from the Iowa District Court for Scott County, Mark D. Cleve
    (motion for competency evaluation and plea) and Henry W. Latham II
    (motion in arrest of judgment), Judges.
    A defendant appeals his conviction for willful injury resulting in
    serious injury, in violation of Iowa Code section 708.4(1). DECISION OF
    COURT    OF    APPEALS     AND   JUDGMENT       OF   DISTRICT    COURT
    AFFIRMED.
    Mark C. Smith, State Appellate Defender, (until withdrawal), and
    Melinda J. Nye, Assistant Appellate Defender, for appellant.
    Thomas J. Miller, Attorney General, Tyler J. Buller, Assistant
    Attorney General, Michael J. Walton, County Attorney, and Andrea L.
    Glasgow and Caleb J. Copley, Assistant County Attorneys, for appellee.
    2
    WIGGINS, Chief Justice.
    The State charged Darreon Draine with willful injury resulting in
    serious injury, in violation of Iowa Code section 708.4(1) (2018). He was
    sixteen years old at the time he allegedly committed the crime. His counsel
    filed a reverse-waiver motion requesting the district court transfer the case
    to the juvenile court. The district court denied the reverse-waiver motion.
    Counsel then moved the court to suspend the proceedings and order a
    competency evaluation for Draine.         The court also denied this motion.
    Draine decided to plead guilty. After entry of his plea, Draine filed a timely
    motion in arrest of judgment. The court denied the motion in arrest of
    judgment and sentenced Draine.        Draine filed his notice of appeal on
    July 18, 2018.
    Draine raises three issues on appeal. First, he claims the district
    court erred in denying his request for a competency evaluation shortly
    after it denied his reverse-waiver motion. Second, he argues the court
    erred in overruling his motion in arrest of judgment. Finally, he argues
    the court should have ordered a competency evaluation following his
    motion in arrest of judgment.
    We transferred the appeal to the court of appeals.          It affirmed
    Draine’s conviction on May 15, 2019.         The court of appeals found the
    district court did not err in not ordering an initial competency hearing. It
    also found “Draine [did] not identify any specific facts upon which the
    court should have relied to hold a preliminary hearing and find probable
    cause to order a competency evaluation following the motion in arrest of
    judgment.” Finally, it found the district court did not abuse its discretion
    when it denied Draine’s motion in arrest of judgment. Draine asked for
    further review on May 31, 2019, which we granted on June 18, 2019.
    In the 2019 legislative session, the general assembly amended Iowa
    Code section 814.6(1) (2019). The amendment denies a defendant the
    3
    right of appeal from a guilty plea, except for a guilty plea to a class “A”
    felony or in a case where a defendant establishes good cause. 2019 Iowa
    Acts ch. 140, § 28 (to be codified at Iowa Code § 814.6(1)(a)(3) (2020)). The
    amendment’s effective date was July 1, 2019.        See Iowa Code § 3.7(1)
    (2019). The State in its supplemental brief argues we should apply the
    amendment retroactively.       Thus, the State contends, we have no
    jurisdiction of the appeal regarding Draine’s guilty plea or the district
    court’s denial of Draine’s motion in arrest of judgment under this
    amendment.
    We addressed this jurisdictional issue in State v. Macke, 933
    N.W.2d. 226, 235 (Iowa 2019). There we held the amendment to section
    814.6(1) is not retroactive and the statutes controlling appeals are those
    that were in effect at the time the judgment or order appealed from was
    rendered. 
    Id. Therefore, we
    do have jurisdiction of this appeal.
    As to the merits of the appeal, when reviewing an application for
    further review, we retain discretion to review all the issues raised on appeal
    or in the application for further review, or only a portion thereof. Gits Mfg.
    Co. v. Frank, 
    855 N.W.2d 195
    , 197 (Iowa 2014). In our discretion, we
    choose to review only the jurisdictional issue raised by the State on further
    review.   Accordingly, the court of appeals decision stands as the final
    decision as to Draine’s claims the district court erred in failing to order a
    competency evaluation prior to Draine’s guilty plea and at or near the time
    Draine filed his motion in arrest of judgment.        The court of appeals
    decision also stands as the final decision regarding Draine’s claim the
    district court abused its discretion when it denied his motion in arrest of
    judgment. Consequently, we affirm the district court’s judgment in this
    matter.
    4
    DECISION OF COURT OF APPEALS AND JUDGMENT OF
    DISTRICT COURT AFFIRMED.
    Waterman, Mansfield, and Christensen, JJ., join this opinion.
    Mansfield, J., files a concurring opinion in which Waterman and
    Christensen, JJ., join. Appel, J., files a dissenting opinion. McDonald, J.,
    takes no part.
    5
    #18–1292, State v. Draine
    MANSFIELD, Justice (concurring specially).
    I join the majority opinion. I write separately to explain briefly why
    I agree with the determinations of the district court and the court of
    appeals that did not find probable cause to believe Darreon Draine was
    “suffering from a mental disorder which prevent[ed] the defendant from
    appreciating the charge, understanding the proceedings, or assisting
    effectively in the defense.” Iowa Code § 812.3(1) (2018). To be sure, the
    dissent raises some legitimate overall concerns about juveniles and their
    competency to stand trial.         However, I am not convinced they are
    manifested in this particular case.
    A critical point is that Draine had been seen repeatedly over the
    years by mental health professionals, partly at the insistence of his
    mother.      They had diagnosed his issues as behavioral.       This is not a
    situation of a young man falling through the cracks and not receiving
    diagnosis or treatment.      In December 2017, a detailed evaluation by a
    psychiatrist concluded that Draine exhibited “ADHD Combined type,”
    “Conduct      Disorder    Childhood-Onset,”     “Nonadherence     to   Medical
    Treatment,” “Oppositional Defiant Disorder,” and “Intellectual Disability
    Mild.”     In fact, an earlier note had stated, “The doctors think he is
    functioning higher than what his IQ shows.” On January 9, 2018, the
    same psychiatrist followed up with the Iowa Department of Human
    Services and gave the following verbal recommendation:
    [B]ecause this is primarily behaviors he really should go into
    the juvenile system and be held accountable for these
    behaviors as medicines are not a fix . . . [H]e has been given
    every opportunity at every level to work on these behaviors
    and has chosen not to do so.
    6
    Two weeks later, Draine beat up a thirty-year-old staff member at
    his latest placement, giving him a concussion along with other cranial and
    facial injuries and leading to the criminal charge in this case.
    Thus, when Draine’s attorney filed his April 2018 motion for
    competency evaluation in the present case, a psychiatric evaluation of
    Draine had just occurred four months earlier. This psychiatrist, like other
    mental health professionals before him, had concluded that Draine’s
    issues were mainly behavioral. The district court reviewed these records
    and discussed them when it denied Draine’s motion for competency
    evaluation.
    Furthermore, while attorney representations to the court should
    always be taken seriously, the district court here did exactly that. Draine’s
    attorney made three points at the hearing. First, he noted that in their
    most recent meeting, Draine had “misidentified [him] as his juvenile court
    attorney as opposed to his District Court attorney initially.” This strikes
    me as unexceptional for a person who is enmeshed in the legal system and
    has different appointed counsel serving different roles.       Second, the
    attorney said that after he “got through what [he] wanted to get through
    fairly quickly, probably in about 20 minutes or so,” and as he was getting
    ready to leave, Draine threatened him “first for talking with him and then
    for looking at him.” Third, the attorney relayed secondhand reports of
    Draine urinating all over his jail cell and “engag[ing] in continuous
    threatening behavior at the jail.” The district court specifically discussed
    the second and third representations in its ruling on Draine’s motion,
    finding them characteristic of the previously diagnosed behavioral issues.
    We also have transcripts of the guilty plea and sentencing
    proceedings. These support the conclusions of the district court and the
    court of appeals that Draine understood the proceedings against him and
    7
    his issues were behavioral. Notably, at the guilty plea hearing, Draine and
    his counsel made a clarification about Draine not having struck the victim
    with a radio:
    MR. TUPPER: Your Honor, just for clarity of the record,
    Mr. Draine and I had discussed this matter multiple times
    previously. He does indicate that the portion of the Minutes
    of Testimony in the police reports where it is said he struck
    Mr. White with a radio -- he indicates that didn’t happen, but
    he does admit the other portions of the assault where he was
    striking Mr. White with his fist. So there is a portion of the
    Minutes that he does disagree with, and I just wanted to
    clarify that.
    THE COURT: Very well.
    MR. TUPPER: Do you agree with that?
    THE DEFENDANT: Yeah.
    Then, at sentencing, Draine made the same clarification without the
    assistance of counsel:
    I shouldn’t go like to prison or nothing, because I didn’t hit
    the dude with a radio, I hit him with my closed fist. So I
    shouldn’t go to prison or Eldora or anything like that. I should
    be on probation here with my mom, you know, my family. So
    that’s all I got.
    Accordingly, not only did Draine understand the charges against him, he
    understood them well enough to insist on making a factual clarification
    and argue why it should mitigate his punishment.
    State v. Einfeldt is a different case. See 
    914 N.W.2d 773
    (Iowa 2018).
    There, the defendant had a prior diagnosis of mental illness and was
    engaging in bizarre courtroom behavior. See 
    id. at 781–83.
    State v. Kempf
    is also a different case. See 
    282 N.W.2d 704
    (Iowa 1979). There, the
    sixteen-year-old defendant had a “limited grasp of reality,” was allowed to
    plead guilty against his attorney’s recommendation, and was sent for a
    8
    psychiatric evaluation following the guilty plea that the district court
    disregarded. See 
    id. at 707–10.
    For the foregoing reasons, I specially concur.
    Waterman and Christensen, JJ., join this special concurrence.
    9
    #18–1292, State v. Draine
    APPEL, Justice (dissenting).
    Thirty years ago, the commentary to the ABA Criminal Justice
    Mental Health Standards declared that “present mental incompetency . . .
    is the single most important issue in the criminal mental health field.”
    ABA Criminal Justice Mental Health Standards, standard 7-4.1 cmt.
    intro., at 168 (Am. Bar Ass’n 1989). In my view, this comment is as true
    today as when it was first made. The issue of adjudicative competence in
    this case demands thorough and careful consideration.
    After examining the record, I conclude the district court did not
    properly consider the cumulative impact of factors in the record related to
    the competence of the defendant: intellectual disability reflected in an IQ
    of 60, a history of Attention Deficit Hyperactivity Disorder (ADHD) and
    Oppositional Defiant Disorder (ODD), the age of the defendant and the
    impact of age on psychological development, and the professional
    statement of counsel regarding his ability to communicate with the
    defendant. When these factors are cumulatively considered, I conclude
    there is enough here to inquire further by requiring a competency
    examination by a qualified professional.
    As a result, I respectfully dissent.
    I. Introduction.
    Darreon Draine is an African-American youth who was charged at
    age sixteen with willful injury causing serious injury in connection with
    an alleged assault on a staff member at the Annie Wittenmeyer residential
    program in Davenport, Iowa. After the charge was filed, Draine filed a
    motion for reverse waiver into juvenile court. In support of his motion,
    Draine produced various medical records.        Among other things, the
    records showed an IQ of 60, diagnosis of ADHD and ODD, and a long
    10
    history of irrational behaviors.   Statements appear in the records that
    Draine “does not appear to understand how his behavior negatively
    impacts others;” that at age thirteen, his general intellectual abilities were
    estimated to be “in the extremely low range;” and that his verbal
    comprehension skills were also “in the extremely low range.”              His
    perceptional reasoning skills were said to be in the borderline range,
    scoring in the (lowest) second percentile.
    A juvenile court officer filed a reverse-waiver investigation report,
    which advocated that the reverse waiver be granted.        According to the
    reverse-waiver investigative report, Draine’s mental health limitations “can
    be better handled in Juvenile Court Services in conjunction with [the]
    Department of Human Services.” The district court, however, denied the
    motion for reverse waiver.
    Draine’s counsel then filed a motion with the district court to
    suspend proceedings and order Draine to undergo a competency
    evaluation. After a hearing, the district court denied the motion.
    Two weeks after the district court denied the motion for a
    competency evaluation, Draine signed a plea agreement, pleading guilty to
    the pending charge. The court held a hearing, accepted the plea, and
    ordered preparation of a presentence report.
    Draine next filed a motion in arrest of judgment, and his attorney
    sought to withdraw. The district court granted the motion to withdraw
    and set a hearing for the motion in arrest of judgment and sentencing. At
    the hearing, Draine asserted he did not realize he was entering a guilty
    plea during the plea proceeding. The district court denied Draine’s motion
    in arrest of judgment and continued sentencing. Because of his age, the
    provisions of Iowa Code section 901.5(14) (2018) applied, thereby making
    Draine eligible for a deferred judgment or sentence. The district court,
    11
    however, determined that a prison term was most appropriate and
    sentenced Draine to an indeterminate ten-year term of imprisonment.
    II. Overview of the Role of Competence in Criminal Justice.
    A. Introduction.      The common law long recognized that an
    incompetent defendant could not be subject to criminal punishment.
    Modern caselaw continues to embrace the notion that an incompetent
    defendant cannot be brought to trial in a criminal proceeding. Drope v.
    Missouri, 
    420 U.S. 162
    , 171, 
    95 S. Ct. 896
    , 903 (1975); Dusky v. United
    States, 
    362 U.S. 402
    , 402–03, 
    80 S. Ct. 788
    , 788–89 (1960) (per curiam).
    Why has the law generally required that a criminal defendant be
    competent in order for the state to impose criminal sanctions?           Two
    reasons have been advanced. An incompetent defendant cannot provide
    meaningful or adequate assistance to counsel, and as a result, in our
    adversarial system the reliability of verdicts is undermined. See United
    States v. Merriweather, 
    921 F. Supp. 2d 1265
    , 1303 (N.D. Ala. 2013) (“[T]he
    Dusky standard requires that a defendant have some ability to confer
    intelligently, to testify coherently, to follow and evaluate the evidence
    presented, and have some awareness of the significance of the proceeding
    and some ability to understand the charges against him, the defenses
    available to him, and the basic elements of a criminal trial.”). In addition,
    personal autonomy is undermined by the criminal trial of an incompetent
    defendant. While lawyers are generally vested with the authority to make
    certain tactical decisions, fundamental decisions, such as the decision
    whether to plead guilty, lie with the criminal defendant. See Godinez v.
    Moran, 
    509 U.S. 389
    , 396, 
    113 S. Ct. 2680
    , 2685 (1993) (“A criminal
    defendant may not be tried unless he is competent, and he may not waive
    his right to counsel or plead guilty unless he does so ‘competently and
    intelligently.’ ” (citation omitted) (quoting Johnson v. Zerbst, 
    304 U.S. 458
    ,
    12
    468, 
    58 S. Ct. 1019
    , 1025 (1938))). An incompetent criminal defendant is
    not able to exercise his right to engage in plea bargaining. Although the
    rationale for incompetence doctrine is not complicated, the doctrine, as
    will be seen below, has proven uncertain in its application.
    B. Approach of the United States Supreme Court.
    The United States Supreme Court has generally addressed the
    question of the competence of criminal defendants in three cases. These
    Supreme Court cases generally describe a competence standard but are
    largely ambiguous as to its application.
    The most frequently cited case dealing with competency to stand
    trial is the one-page per curiam opinion in Dusky, 
    362 U.S. 402
    , 
    80 S. Ct. 788
    . There, the Supreme Court articulated what amounts to a general
    formula for determining competency in a criminal trial. In Dusky, the
    Supreme Court, quoting from the brief of the solicitor general declared that
    “the record in this case does not sufficiently support the findings of
    competency to stand trial.” 
    Id. at 402,
    80 S. Ct. at 788. Further citing
    from the solicitor general’s brief, the Dusky Court declared
    that it is not enough for the district court judge to find that
    “the defendant (is) oriented to time and place and (has) some
    recollection of events,” but that the “test must be whether he
    has sufficient present ability to consult with his lawyer with a
    reasonable degree of rational understanding—and whether he
    has a rational as well as factual understanding of the
    proceedings against him.”
    
    Id. at 402,
    80 S. Ct. at 788–89.
    After Dusky, the Supreme Court decided Pate v. Robinson, 
    383 U.S. 375
    , 
    86 S. Ct. 836
    (1966). In Robinson, the defendant had what the Court
    characterized as “a long history of disturbed behavior.” 
    Id. at 378–82,
    86
    S. Ct. at 838–40. At trial, the defense offered four witnesses who testified
    that Robinson was insane. 
    Id. at 383,
    86 S. Ct. at 841. The defense,
    13
    however, did not make a motion for a hearing to determine competence to
    stand trial. 
    Id. at 384,
    86 S. Ct. at 841. The Robinson Court held, however,
    that it would be “contradictory to argue that a defendant may be
    incompetent, and yet knowingly or intelligently ‘waive’ his right to have the
    court determine his capacity to stand trial.” 
    Id. The Supreme
    Court found the evidence in Robinson sufficient to
    require a hearing on the issue. 
    Id. at 385,
    86 S. Ct. at 842. The Robinson
    Court recognized that the Illinois Supreme Court had declared that the
    evidence in the case was not sufficient to require a hearing “in light of the
    mental alertness and understanding displayed in Robinson’s ‘colloquies’
    with the trial judge.” 
    Id. The Robinson
    Court stated that while Robinson’s
    “demeanor at trial might be relevant to the ultimate decision as to his
    sanity, it cannot be relied upon to dispense with a hearing on that very
    issue.” 
    Id. at 386,
    86 S. Ct. at 842. The Robinson Court determined that
    there was sufficient doubt as to the defendant’s present competency to
    require a hearing on the issue.      
    Id. In Robinson
    , the Supreme Court
    rejected the notion of a limited remand to determine the competency issue
    because of the difficulty of such a retrospective determination. 
    Id. at 386–
    87, 86 S. Ct. at 842
    –43.
    Finally, the United States Supreme Court decided Drope, 
    420 U.S. 162
    , 
    95 S. Ct. 896
    . In this case, the defendant was charged with the rape
    of his wife. 
    Id. at 164,
    95 S. Ct. at 900. Early on, the defendant filed a
    motion for a psychiatric evaluation with a psychiatric report attached to
    the motion.     
    Id. The report
    diagnosed Drope as suffering from
    “(1) [s]ociopathic personality disorder, sexual perversion[,] (2) [b]orderline
    mental deficiency[, and] (3) [c]hronic [a]nxiety reaction with depression.”
    
    Id. at 164
    n.1, 95 S. Ct. at 900 
    n.1. No action was taken on the motion.
    
    Id. at 164
    –65, 95 S. Ct. at 900. As the trial date approached, counsel filed
    14
    a bare bones motion for a continuance stating that “the defendant is not
    a person of sound mind and should have a further psychiatric examination
    before the case should be forced to trial.” 
    Id. at 165,
    95 S. Ct. at 900.
    During trial, Drope’s wife testified that her husband was sick and needed
    psychiatric care. 
    Id. at 166,
    95 S. Ct. at 901. She also testified that “on
    the Sunday prior to trial[,] he tried to choke her to death.” 
    Id. at 179,
    95
    S. Ct. at 907. During the prosecution’s case, the defendant shot himself
    in a failed suicide attempt and did not appear for trial. 
    Id. at 166,
    95 S. Ct.
    at 901.    Ultimately, a motion to continue the trial was denied, the
    defendant was convicted on the rape charge, and the Missouri state courts
    affirmed the conviction. 
    Id. at 166–67,
    95 S. Ct. at 901.
    The Supreme Court reversed and remanded. 
    Id. at 183,
    95 S. Ct. at
    909. The Drope Court emphasized that the combination of the pretrial
    showing, the testimony at trial, and the defendant’s suicide attempt was
    sufficient to trigger further inquiry. 
    Id. at 180,
    95 S. Ct. at 908. The Court
    noted that there were “no fixed or immutable signs which invariably
    indicate the need for further inquiry to determine fitness to proceed.” 
    Id. But regardless
    of whether a pretrial hearing should have been conducted,
    the Drope Court ruled that once the defendant attempted suicide during
    the course of trial, proceedings should have been suspended until an
    evaluation could be obtained. 
    Id. at 181–82,
    95 S. Ct. at 908–09.
    The important point here is that the decisions of the United States
    Supreme Court have not developed in detail precisely what is required to
    trigger a hearing on the issue of competency to stand trial and further, on
    what competency to stand trial means. See United States v. Housh, 
    89 F. Supp. 2d 1227
    , 1229 (D. Kan. 2000) (noting that few cases have given
    meaning to “rational understanding” under Dusky); State v. Garfoot, 
    558 N.W.2d 626
    , 633 (Wis. 1997) (Abrahamson, C.J., concurring) (“Many
    15
    questions remain unanswered: What decision-making abilities are
    encompassed by the Dusky formulation? To what extent do the Dusky
    tests include an accused’s appreciation of the trial’s significance and his
    or her own situation as a defendant in a criminal prosecution? What is
    the relation between the Dusky tests and legal rules relating to decision-
    making by criminal defendants?”). It is clear, however, that the failure to
    make a motion or the filing of a bare bones motion does not relieve the
    court of its responsibility to independently determine the issue of
    competency.    See 
    Drope, 420 U.S. at 176
    –77, 95 S. Ct. at 906–07;
    Robinson, 383 U.S. at 
    384, 86 S. Ct. at 841
    .        Further, the issue of
    competency is to be determined considering the accumulated factors, but
    not single factors in isolation. Drope, 420 U.S. at 
    180, 95 S. Ct. at 908
    .
    Finally, the apparently rational responses to court colloquies does not
    provide, standing alone, a basis for denying a hearing on competency if
    other factors are present. 
    Robinson, 383 U.S. at 385
    –86, 86 S. Ct. at 842.
    On the issue of what is meant by “rational understanding,” it is clear
    that mere factual understanding as to time and place displayed in Dusky
    is not sufficient. Any determination of rational understanding must
    include consideration of decisional competence. See 
    Godinez, 509 U.S. at 412
    –13, 415–16 & 415 
    n.3, 113 S. Ct. at 2693
    –94, 2695–96 & 2695 n.3
    (Blackmun, J., dissenting) (emphasizing the ability of a defendant to make
    reasoned decisions regarding their representation); State v. Debra A.E.,
    
    523 N.W.2d 727
    , 732 (Wis. 1994) (noting inter alia that defendant is
    incompetent when unable to make decisions committed by law to the
    defendant “with a reasonable degree of rational understanding”). A leading
    authority on juvenile competency in court settings has stated that
    decisional competence involves “the ability to consider the potential
    consequences of several options, to make subjective judgments about the
    16
    desirability and probability of those consequences, and to compare them.”
    Thomas Grisso, The Competence of Adolescents as Trial Defendants, 3
    Psychol., Pub. Pol’y, & L. 3, 8 (1997) [hereinafter Grisso, The Competence
    of Adolescents].   Restated by another authority, decisional competence
    means the ability to make choices reserved for the defendant within the
    criminal justice system such as whether to demand a jury trial, represent
    oneself, testify, be present, or plead guilty. Terry A. Maroney, Emotional
    Competence, “Rational Understanding,” and the Criminal Defendant, 43
    Am. Crim. L. Rev. 1375, 1389–90 (2006) [hereinafter Maroney]; see also
    Elizabeth S. Scott & Laurence Steinburg, Rethinking Juvenile Justice 160
    (2008) (stating defendants must have “not only [the capacity for] adequate
    factual and rational understanding, but also the ability to consider
    alternatives and make a choice in the decision-making process”).
    The need for decisional competence is especially important for
    juveniles. As noted by Grisso and Steinberg, “[m]any of the differences
    between adolescents and adults have to do with their ability not merely to
    understand things, but to use information to make decisions.” Thomas
    Grisso & Laurence Steinberg, Juvenile Competence: Can Immaturity Alone
    Make an Adolescent Incompetent to Stand Trial, 9 Juv. Just. Update 1, 14
    (2003).
    Determining whether a juvenile defendant has sufficient decisional
    competence for adjudication is not a task subject to quick seat-of-the-
    pants judgment. Such determinations require
    a highly particularized inquiry into whether the defendant’s
    perception and understanding of relevant aspects of the world
    are accurate; whether she is able to engage in appropriately
    flexible reasoning; and whether she can formulate, express,
    maintain, and implement choices.
    Maroney, 43 Am. Crim. L. Rev. at 1400.
    17
    The question in this case is whether such a particularized inquiry
    should have been ordered by the district court.
    C. Iowa’s Approach to Competency in Criminal Proceedings.
    Iowa Code section 812.3(1) provides the framework for implementing the
    due process requirement that a defendant be competent in a criminal
    proceeding. Iowa Code section 812.3(1) provides that at any stage of a
    criminal proceeding a competency hearing may be required when the
    district court finds probable cause that there exist “specific facts showing
    that the defendant is suffering from a mental disorder which prevents the
    defendant from appreciating the charge, understanding the proceedings,
    or assisting effectively in the defense.” When a district court orders an
    evaluation, Iowa Code section 812.4 establishes a timeline for the
    evaluation.
    We have stated there is a presumption that the defendant is
    competent. State v. Lyman, 
    776 N.W.2d 865
    , 874 (Iowa 2010), overruled
    on other grounds by Alcala v. Marriott Int’l, Inc., 
    880 N.W.2d 699
    , 708 &
    n.3 (Iowa 2016); State v. Rieflin, 
    558 N.W.2d 149
    , 152 (Iowa 1996),
    overruled on other grounds by 
    Lyman, 776 N.W.2d at 873
    ; State v.
    Pedersen, 
    309 N.W.2d 490
    , 496 (Iowa 1981).           That presumption is
    determinative, however, only when the evidence is in equilibrium. 
    Lyman, 776 N.W.2d at 874
    ; 
    Rieflin, 558 N.W.2d at 152
    ; 
    Pedersen, 309 N.W.2d at 496
    .
    We have observed that probable cause under the statute exists when
    a reasonable person would believe there is a substantial question of the
    defendant’s competency. State v. Kempf, 
    282 N.W.2d 704
    , 706–07 (Iowa
    1979). We have relied upon federal precedent declaring that the standard
    of review is “whether a reasonable judge . . . should have experienced
    doubt with respect to [the defendant’s] competency to stand trial.” State
    18
    v. Mann, 
    512 N.W.2d 528
    , 531 (Iowa 1994) (quoting Griffin v. Lockhart, 
    935 F.2d 926
    , 930 (8th Cir. 1991)).
    In making the determination regarding whether to order an
    evaluation, we rely on the totality of circumstances. 
    Pedersen, 309 N.W.2d at 495
    . In making that determination, we have noted that a lawyer’s report
    or professional statement plays an important role. State v. Einfeldt, 
    914 N.W.2d 773
    , 780 (Iowa 2018). Whether the defendant can communicate
    effectively with counsel is also a critical factor. 
    Rieflin, 558 N.W.2d at 152
    .
    Subnormal intelligence is one factor to be considered but does not
    necessarily require a finding of incompetence.       State v. Stoddard, 
    180 N.W.2d 448
    , 449, 451 (Iowa 1970) (noting IQ scores of 78 and 75 in
    previous testing, denoting severe mental retardation, was a factor to
    consider regarding competence). Other factors for consideration include
    any prior medical opinion of which the trial court is aware, the defendant’s
    apparent irrational behavior, and other demeanor that suggests a
    competency problem. 
    Mann, 512 N.W.2d at 531
    .
    We review whether a trial court should have ordered a competency
    hearing de novo. 
    Einfeldt, 914 N.W.2d at 778
    ; 
    Mann, 512 N.W.2d at 531
    .
    A trial court’s discretion does not play a role in the determination. 
    Einfeldt, 914 N.W.2d at 780
    ; State v. Edwards, 
    507 N.W.2d 393
    , 395 (Iowa 1993).
    We have not had many occasions to consider the competency of a
    juvenile.    In Kempf, however, we considered whether a competency
    evaluation should have been conducted of a sixteen year old “of borderline
    intelligence with emotional development lower than his 
    age.” 282 N.W.2d at 709
    .     After canvassing the record, including in-court colloquies, we
    concluded that a competency hearing should have been ordered. 
    Id. at 710.
    We emphasized in Kempf the need to consider the cumulative effect
    19
    of various factors in determining whether a competency hearing should be
    ordered. 
    Id. In applying
    the above principles, it is important to recognize the
    preliminary nature of the inquiry.        In Einfeldt, we noted that it was
    important that “district court judges not put the proverbial cart before the
    horse in the competency 
    setting.” 914 N.W.2d at 782
    . Under Iowa Code
    section 812.3, the district court is not initially called upon to make a
    determination of competency, but only that the defendant be evaluated
    regarding the competency issue. 
    Id. We cited
    authorities in Einfeldt noting
    that the threshold for a hearing to determine competency as “not difficult
    to reach by design” and “very low in order to cleanse all cases of doubts
    about competence.” 
    Id. (citing Blakeney
    v. United States, 
    77 A.3d 328
    , 398
    (D.C. 2013); Richard J. Bonnie, The Competence of Criminal Defendants:
    Beyond Dusky and Drope, 47 U. Miami L. Rev. 539, 463 (1993)).
    We also addressed the issue of remedy in Einfeldt. Because of the
    difficulties of retrospective reconstruction of competency, we declined to
    allow a limited remand for the sole purpose of proving the ability of the
    defendant at the time of trial. 
    Id. at 783.
    III. Application of Principles to the Present Case.
    A. Indicia of Incompetency Present in This Case. In this case,
    the record reveals several potential factors to be considered in determining
    whether to inquire further into the Draine’s competence. First, the medical
    records submitted indicate that Draine had an IQ of 60.          Second, the
    medical records show a history of ADHD. Third, the records show that
    Draine had a long history of irrational behaviors, cumulating in a
    diagnosis of ODD. Fourth, it is undisputed that Draine was sixteen years
    of age at the time of trial. Finally, his lawyer stated that he questioned his
    client’s competency. The question before us is whether these factors in
    20
    the aggregate, combined with any other circumstances in “the record[,]
    contain[] information from which a reasonable person would believe a
    substantial question of the defendant’s competency exists” and so
    “require[] a hearing on the issue of competency.” 
    Kempf, 282 N.W.2d at 706
    .
    We first consider the issue of what in the past has been referred to
    as mental retardation but is now generally identified as intellectual
    disability. 1    There is, perhaps, a threshold question of whether an
    intellectual disability qualifies as a “mental disorder” under Iowa Code
    section 812.3(1). I think it does. The current Diagnostic and Statistical
    Manual of Mental Disorders includes intellectual disability as a mental
    disorder. See Am. Psychiatric Ass’n, Diagnostic and Statistical Manual of
    Mental Disorders 20, 33 (5th ed. 2013) [hereinafter DSM-5] (noting that all
    neurodevelopmental disorders, of which intellectual disability is one,
    qualified as mental disorders).             Certainly there is a point when the
    limitation of a defendant’s ability to think rationally, assist counsel, and
    make decisions reserved to the defendant amounts to incompetence to
    stand trial.     See Commonwealth v. Wooten, 
    269 S.W.3d 857
    , 864 (Ky.
    2008). A statute that did not allow consideration of low intellectual ability
    would run the grave risk of unconstitutionality under applicable due
    process precedents.
    There is reason to believe that Draine has an intellectual disability,
    and there is evidence in the record that he has an IQ of 60. The American
    Psychiatric Association indicates that an intellectual disability is marked
    1We   use the phrase intellectual disability to refer to conditions formerly described
    as mental retardation. See State v. Linares, 
    393 P.3d 691
    , 692 n.1 (N.M. 2017) (“We are
    aware that it is no longer acceptable to describe individuals with developmental
    disabilities as ‘mentally retarded.’ This now-defunct phrase is part and parcel of a
    rhetoric that dehumanized and delegitimized valuable members of our society.”).
    21
    by   “[s]ignificantly     subaverage       intellectual     functioning:     an    IQ    of
    approximately 70 or below on an individually administered IQ test,” plus
    impairments        in   adaptive      functioning       such     as    communication,
    social/interpersonal skills, functional academic skills, self-care skills, self-
    direction, work, or safety.         See Am. Psychiatric Ass’n, Diagnostic and
    Statistical Manual of Mental Disorders 49 (4th ed., text rev. 2000). 2 Persons
    with IQ scores of 70 or below often “present difficult assessment and
    treatment problems with frequently unexplored linguistic and cognitive
    obstacles.”      David R. Katner, The Mental Health Paradigm and the
    MacArthur Study: Emerging Issues Challenging the Competence of Juveniles
    in Delinquency Systems, 32 Am. J.L. & Med. 503, 516 (2006) [hereinafter
    Katner].       In any event, medical records characterize his intellectual
    abilities “in the extremely low range” and indicate he demonstrated “poor
    verbal abstract reasoning and work knowledge skills.” Both lower age and
    lower IQ compound in terms of an individual’s level of impairment
    regarding competency generally, with IQ scores being lower on average
    among individuals detained or incarcerated than in society generally. See
    Thomas Grisso, et al., Juveniles’ Competence to Stand Trial: A Comparison
    of Adolescents’ and Adults’ Capacities as Trial Defendants, 27 L. & Hum.
    Behav. 333, 346–50, 356 (2003).
    2Note   that, consistent with a general shift in verbiage from “mental retardation”
    to “intellectual disability,” the DSM-5 similarly changes its verbiage to be consistent with
    changes in the law and the “common use [of the term] by medical, educational, and other
    professions and by the lay public and advocacy groups.” DSM-5 at 33. Additionally, the
    DSM-5 notes a shift in their delineation in various levels of severity, defining them now
    “on the basis of adaptive functioning, and not IQ scores, because it is adaptive functioning
    that determines the level of supports required. Moreover, IQ measures are less valid in
    the lower end of the IQ range.” 
    Id. While I
    accept and note this change, nevertheless we
    also include the language from previous iteration of the DSM as another indicia that a
    competency evaluation is required in this case.
    22
    I do not regard the presence of evidence of an IQ of 60 as providing
    some kind of bright line on the question of competency, but it is a red flag.
    As noted by the Wisconsin Supreme Court,
    The State is correct in that [intellectual disability] in and of
    itself is generally insufficient to give rise to a finding of
    incompetence to stand trial. However, a defendant may be
    incompetent based on [intellectual disability] alone if the
    condition is so severe as to render him incapable of
    functioning in critical areas. Thus, the determination of
    competence is an individualized, fact-specific decision. It is
    for that reason that expert testimony regarding a particular
    defendant’s mental capabilities is necessary.
    
    Garfoot, 558 N.W.2d at 631
    –32 (majority opinion) (citations omitted)
    (emphasis added). As suggested by Garfoot, the caselaw regarding the
    competence of individuals with intellectual disability is highly contextual
    and often the subject of expert analysis. See, e.g., People v. Campbell, 
    133 Cal. Rptr. 815
    , 818, 820 (Ct. App. 1976) (affirming an expert evaluation of
    defendant, taking into account the diagnosis of mild mental retardation
    with an IQ range of 69–79, did not render this particular defendant
    incompetent to aide in their own defense); State v. Linares, 
    393 P.3d 691
    ,
    698–700 (N.M. 2017) (affirming finding of incompetence where defendant
    had IQ of 68, and therefore had an intellectual disability, but also exhibited
    limited intellectual functioning); 
    Garfoot, 558 N.W.2d at 628
    –29, 633
    (affirming trial court finding defendant with IQ of 64 was incompetent
    when expert testimony supported trial court decision).
    But if IQ is not necessarily determinative, neither can it be ignored.
    IQ consistently is related to competence, with the likelihood of competence
    declining with lower IQ scores. Geoffrey R. McKee & Steven J. Shea,
    Competency to Stand Trial in Family Court: Characteristics of Competent
    and Incompetent Juveniles, 27 J. Am. Acad. Psychiatry & L. 65, 69–72
    (1999). As has been noted in the literature, juveniles of low intelligence
    23
    [are] much less likely to appreciate that the court was
    proceeding adversely against them, to be able to assist their
    attorneys with a defense, or to understand and weight the
    ramifications of the decisions they alone must make (e.g. plea
    bargaining, testifying).
    Geoffrey R. McKee, Competency to Stand Trial in Low-IQ Juveniles, 19 Am.
    J. of Forensic Psychiatry 3, 11 (1998).
    It is important to note that the literature also suggests that the
    impairment caused by intellectual disability is often not recognized by
    attorneys and the courts.
    According to most commentators, legally significant
    impairments due to mental retardation are largely
    unrecognized by attorneys and courts. . . . “[E]fforts that
    many mentally retarded people typically expend in trying to
    prevent any discovery of their handicap may render the
    existence or the magnitude of their disability invisible to
    criminal justice system personnel.” Impairments become
    visible enough to trigger evaluation, it is thought, mainly when
    the defendant is also mentally ill or acts in a bizarre or
    disruptive fashion.
    Richard J. Bonnie, The Competence of Criminal Defendants with Mental
    Retardation to Participate in Their Own Defense, 81 J. Crim. L. &
    Criminology 419, 420–21 (1990) [hereinafter Bonnie] (footnotes omitted)
    (quoting James W. Ellis & Ruth A. Luckasson, Mentally Retarded Criminal
    Defendants, 53 Geo. Wash. L. Rev. 414, 458 (1985) [hereinafter Ellis &
    Luckasson]).
    The failure to recognize intellectual disability is due in part to the
    phenomenon called masking.       Persons with intellectual disabilities are
    often shamed by their limitations and go to great lengths to mask it by
    feigning understanding and comprehension and seeking to appear normal.
    See ABA Criminal Justice Mental Health Standard, standard 7-5.9 cmt., at
    318 (noting many mildly and moderately disabled individuals have learned
    to devote a considerable amount of effort to hide their disability); Morgan
    24
    Cloud, et al., Words Without Meaning: The Constitution, Confessions, and
    Mentally Retarded Suspects, 69 U. Chi. L. Rev. 495, 513–14 (2002) (noting
    that police, lawyers, and judges may not realize that a person who
    successfully masks his or her ability has a disability); Ellis & Luckasson,
    53 Geo. Wash. L. Rev. at 458 (noting many try to prevent discovery of their
    disability and attempt to “pass” as a neurotypical person).
    Because of the above factors, the role of an expert, as pointed out in
    Garfoot, is important in determining the competence of defendants like
    Draine. A key element to the assessment is the skill and qualifications of
    the expert. Without expert testimony, however, we are left making a poorly
    informed guess.
    The second factor present in the record is ADHD. Standing alone,
    it seems clear that in most cases ADHD would not be sufficient to establish
    incompetence. But if a person who is intellectually disabled also has a
    history of ADHD, the question becomes more complicated.          Could the
    comorbidity of ADHD and intellectual disability impact competence to
    make important decisions associated with adjudication like deciding
    whether to enter into a plea bargain? See DSM-5 at 61–63 (noting ADHD
    substantially affects social function and, in some cases, cognitive
    functioning as well); David J. Bridgett & Michael E. Walker, Intellectual
    Functioning in Adults with ADHD: A Meta-Analytic Examination of Full Scale
    IQ Differences Between Adults With and Without ADHD, 18 Psychol.
    Assessment 1, 10 (2006) (When ADHD is accompanied by a comorbid
    condition, the cognitive deficit is more pronounced.); Barry C. Feld,
    Competence and Culpability: Delinquents in Juvenile Courts, Youths in
    Criminal Court, 
    102 Minn. L
    . Rev. 473, 519–20 (2017) [hereinafter Feld]
    (noting juveniles with ADHD may have difficulty concentrating or
    communicating with attorney and this may compound developmental
    25
    incompetence); Erik G Willcutt, et al., Validity of Executive Functioning
    Theory of Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review,
    578 Biological Psychiatry 1336, 1336 (individuals with severe ADHD suffer
    cognitive impairments, including deficits in executive and adaptive
    functioning).
    The third factor present in the record is a long history of irrational
    behaviors, usually involving violent behavior. The record in this case is
    replete with outbursts and violent behaviors that appear to be irrational.
    Draine was diagnosed with ODD.        The medical records demonstrate a
    history of anger, paranoia, and even violence toward people who are trying
    to help him, including his mother, staff, and his attorney.
    Both Draine’s diagnosis of ODD and his documented behavior
    suggest problems with adaptive behavior, a significant element in the
    diagnosis of intellectual disability. And again, the question is whether the
    interaction of his intellectual disability, ADHD, and ODD increases the risk
    of incompetency sufficient to require further inquiry. See Thomas Riffin,
    Competence to Stand Trial Evaluations with Juveniles, 32 New Eng. J. on
    Crim. & Civ. Confinement 15, 18–19 (2006).
    In considering the violent history of Draine, an African-American
    juvenile, it is important to be vigilant that decision-making is not impacted
    by implicit racial bias. As noted by one commentator,
    [M]ental illness among minority youth often goes undiagnosed
    or misdiagnosed because the symptoms they exhibit tend to
    have an “aggressive tenor,” which cause the youth
    immediately to be perceived simply as threatening instead of
    potentially subject to undiagnosed and untreated symptoms
    of mental illness.
    Kasey Corbit, Note, Inadequate and Inappropriate Mental Health Treatment
    and Minority Overrepresentation in the Juvenile Justice System, 3 Hastings
    26
    Race & Poverty L.J. 75, 83 (2005); cf. Kristin Henning, Criminalizing
    Normal Adolescent Behavior in Communities of Color: The Role of
    Prosecutors in Juvenile Justice Reform, 98 Cornell L. Rev. 383, 383 (2013)
    (finding that “scientifically supported notions of diminished culpability of
    youth are not applied consistently across races” (emphasis omitted)).
    The fourth factor in the record is the defendant’s age. At the time of
    trial, Draine was sixteen. He had notable mental capacity problems early
    in his life. One of the criteria for an intellectual disability is the onset of
    disability at an early age. See DSM-5 at 33 (noting intellectual disability
    has its onset “during the developmental period . . . includ[ing] both
    intellectual and adaptive functioning deficits in conceptual, social, and
    practical domains”).
    Further, as has been recognized, adolescent brain development lags
    behind adults. See Roper v. Simmons, 
    543 U.S. 551
    , 569–70, 
    125 S. Ct. 1183
    , 1195–96 (2005) (finding that due to the adolescent brain’s lack of
    maturity, juveniles have an underdeveloped sense of responsibility and are
    reckless and impulsive). Moreover, “[n]o recent data provide reason to
    reconsider the Court’s observations in Roper about the nature of
    juveniles. . . . [D]evelopments in psychology and brain science continue
    to show fundamental differences between juvenile and adult minds.”
    Graham v. Florida, 
    560 U.S. 48
    , 68, 
    130 S. Ct. 2011
    , 2026 (2010); see
    Miller v. Alabama, 
    567 U.S. 460
    , 471–73, 
    132 S. Ct. 2455
    , 2464–65 (2012)
    (affirming Roper and Graham, based “not only on common sense—on what
    ‘any parent knows’—but on science and social science as well”); State v.
    Sweet, 
    879 N.W.2d 811
    , 815–16 (Iowa 2016) (noting the prevailing
    scientific view on brain maturation, that “up until the age of about twenty-
    five there is a period of rapid change or development in the adolescent
    brain. . . . [including in] impulsiv[ity], and as people get older, ‘[they] learn
    27
    . . . the skills to inhibit behavior’ ”); State v. Null, 
    836 N.W.2d 41
    , 54–56
    (2013) (noting favorably the Roper, Graham, and Miller precedents, along
    with the hard and social science underlying their rationales). While Roper
    and its federal and state progeny generally deal with concepts of cruel and
    unusual punishment, the science behind these cases is also germane in
    other criminal justice settings. See J.D.B. v. North Carolina, 
    564 U.S. 261
    ,
    271–75, 
    131 S. Ct. 2394
    , 2402–05 (2011) (recognizing developmental
    psychology in context of Miranda warnings and false confessions); see
    generally Lindsay C. Malloy, et al., Interrogations, Confessions, and Guilty
    Pleas Among Serious Adolescent Offenders, 38 L. & Hum. Behav. 181
    (2014) (finding youth especially susceptible to confession, both true and
    false, when faced with interrogation techniques, and suggest special
    safeguards when interacting with youth who are suspects). Draine was
    sixteen at the time of trial, an age that had been suggested as the threshold
    for mandatory competence evaluation for juveniles. See Stephen Bell, Tate
    v. State: Highlighting the Need for a Mandatory Competency Hearing, 28
    Nova L. Rev. 575, 601–03 (2004) (suggesting under the age of sixteen for
    mandatory evaluations).
    Admittedly, we are not dealing with a very young defendant that
    some authorities believe should be presumed incompetent. See Grisso,
    The Competence of Adolescents, 3 Psychol., Pub. Pol’y, & L. at 23
    (suggesting a “legal presumption of incompetence to stand trial for youths
    younger than 14, when they face proceedings that may lead to criminal
    adjudications (including juvenile court transfer hearings)”). Yet, here we
    are dealing with a juvenile that also appears to have an intellectual
    disability as reflected by a low IQ, which is potentially compounded by
    additional mental disorders (ADHD and ODD). There is reason to believe
    that the cognitive development of children with intellectual disabilities lags
    28
    behind the cohort generally. Erika Fountain & Jennifer L. Woolard, The
    Capacity for Effective Relationships Among Attorneys, Juvenile Clients, and
    Parents, 14 Ohio St. J. Crim. L. 493, 504 (2017) (noting impairment arising
    from low IQ is greater for adolescents than young adults); Thomas Grisso,
    Dealing with Juveniles’ Competence to Stand Trial: What We Need to Know,
    18 QLR 371, 379 (1999) [hereinafter Grisso, Dealing with Juveniles’
    Competence] (noting intellectual disability “often produces a lag in youths’
    cognitive and social development, requiring a longer time before their
    capacities mature to a level typical for them in their adulthood”); Katner,
    32 Am. J.L. & Med. at 507 (postulating as to the overlapping impact of
    developmental immaturity due to age and developmental immaturity due
    to mental disorders). This is particularly important if the defendant is not
    simply to understand key issues facing him in the criminal process but to
    appreciate the consequences of choices.          Further, aside from the
    combination of intellectual disability and immaturity, some studies
    suggest that fifteen to seventeen year olds were not the equivalent of adults
    in understanding trial proceedings. See Geoffrey R. McKee, Competency
    to Stand Trial in Preadjudicatory Juveniles and Adults, 26 J. Am. Acad.
    Psychiatry Law 89, 95–97 (1998); Jeffrey C. Savitsky & Deborah Karras,
    Competency to Stand Trial Among Adolescents, 74 Adolescence 349, 355
    (1984).
    In any event, while some experts conclude that the cognitive
    development of sixteen year olds is often the equivalent of adults,
    psychosocial development still lags behind.      Psychosocial development
    includes processes such as responsibility, perspective, and temperance.
    See Elizabeth Caufmann, et al., How Developmental Science Influences
    Juvenile Justice Reform, 8 U.C. Irvine L. Rev. 21, 23–26 (2018) (finding that
    despite advancement in cognition, psychosocial maturity is delayed due to
    29
    a so-called “immaturity gap”).      Such psychosocial factors impair an
    adolescent’s decisional competence.       See Brian G. Sellers & Bruce A.
    Arrigo, Adolescent Transfer, Developmental Maturity, and Adjudicative
    Competence: An Ethical and Justice Policy Inquiry, 99 J. Crim. L. &
    Criminology 435, 445–51 (2009) (exploring the impact of a variety of
    psychosocial factors on competence and noting that it may make no
    functional difference whether incompetence is due to mental illness or to
    psychosocial immaturity); Laurence Steinberg, et al., Age Differences in
    Future Orientation and Delay Discounting, 80 Child Dev. 28, 39–41 (2009)
    (finding developmental deficits in adolescents compared with adults,
    especially   related   to   understanding   and   consideration   of   future
    consequences); Twila A. Wingrove, Note, Is Immaturity a Legitimate Source
    of Incompetence to Avoid Standing Trial in Juvenile Court?, 
    86 Neb. L
    . Rev.
    488, 498–502, 505–06 (2007) [hereinafter Wingrove] (noting that juveniles
    are psychosocially impaired as compared to adults and that some
    psychosocial factors clearly implicate legal competence of juveniles).
    It may be argued that the limited development of a juvenile is not a
    “mental disorder” under the statute. It would seem odd, however, to not
    consider the age of a criminal defendant in determining competency.
    Consider, for instance, the reasoning in an unpublished decision by
    the Iowa Court of Appeals:
    Limiting incompetency in delinquency proceedings to
    cases in which the child is incompetent by reason of a “mental
    disorder” would fail to recognize that a juvenile’s inability to
    appreciate the charge, understand the proceedings, or assist
    effectively in the defense may be the result of immaturity, lack
    of intellectual capacity, or both. We conclude that limiting
    determinations of incompetency in juvenile cases to those
    cases in which the inability to appreciate, understand, and
    assist is based on a “mental disorder” would offend rights to
    due process.
    30
    In re A.B., No. 05–0868, 
    2006 WL 469945
    at *3 (Iowa Ct. App. Mar. 1,
    2006). The reasoning of In re A.B. was expressly adopted by the court of
    appeals in a published opinion. See In re J.K., 
    873 N.W.2d 289
    , 295–96
    (Iowa Ct. App. 2015); see also In re Hyrum H., 
    131 P.3d 1058
    , 1061–62
    (Ariz. Ct. App. 2006) (permitting developmental psychology to be
    considered in analysis of “competence” under statute); Timothy J. v. Super.
    Ct., 
    58 Cal. Rptr. 3d 746
    , 751–52 (Ct. App. 2007) (holding no requirement
    of mental or developmental disability under applicable statutes); Feld, 
    102 Minn. L
    . Rev. at 522 (recognizing the need for courts to use “special
    procedural safeguards . . . to protect [juveniles] from improvident
    decisions” on the basis that “formal equality [in the treatment of adults
    and juveniles] results in practical inequality”); Wingrove, 
    86 Neb. L
    . Rev.
    at 506 (implicating psychosocial immaturity in the totality of juvenile
    competency considerations). But see State v. Swenson-Tucker, No. 32944-
    1II, 
    2006 WL 401699
    , at *4–5 (Wash. Ct. App. Feb. 22, 2006) (finding that
    under Washington’s legal framework, incompetency arises only as a “result
    of mental disease or defect” and not from immaturity).        A somewhat
    different approach was taken by the Indiana Supreme Court. In In re K.G.,
    
    808 N.E.2d 631
    , 638 (Ind. 2005), the Indiana court held that the statute
    defining competence simply did not apply to juveniles.
    In this case, the question of whether developmental issues fall within
    the scope of a “mental disorder” is irrelevant.      Here, it appears the
    defendant has an intellectual disability, certainly a mental disorder under
    the statute, which is then aggravated by the lack of psychosocial
    development as a sixteen year old. See Grisso, Dealing with Juveniles’
    Competence, 18 QLR at 379 (noting mental retardation “often produces a
    lag in youths’ cognitive and social development, requiring a longer time
    31
    before their capacities mature to the level that will be typical for them in
    their adulthood”).
    The fifth factor is an attorney’s professional statement regarding the
    competency of his client. Here, the attorney’s statement was minimal. The
    attorney declared that there was a question of competence, noting that
    recently the client confused him for another attorney representing the
    client in another juvenile proceeding. The attorney also expressed concern
    about violent outbursts from his client.
    The attorney’s statement only offers modest additional support, but
    as noted in Drope, the fact that a lawyer’s advocacy falls short of
    appropriate assistant to the trial court is not fatal to the question of
    whether a competency hearing should be afforded. See 
    Drope, 420 U.S. at 177
    , 95 S. Ct. at 906.   Further, as the literature amply demonstrates,
    lawyers themselves are often not fully aware of the competence limitations
    of the juvenile defendants. See Ellis & Luckasson, 53 Geo. Wash. L. Rev.
    at 493 (noting that “the limited ability of most lawyers to recognize mental
    retardation in their clients has been well documented”).
    It is true that the defendant responded to colloquies in court. But
    Draine’s minimal responses to the court’s questions does not demonstrate
    decisional competence. For example, in Pritchett v. Commonwealth, 
    557 S.E.2d 205
    , 207 (Va. 2002), a forensic psychologist interviewed an
    intellectually disabled defendant about a forty-word story by asking a
    series of leading questions. Some of the information was not contained in
    the story, but the defendant provided an incorrect belief that he knew the
    answers. 
    Id. Indeed, when
    the defendant was told “he needed to try to
    answer as best he could,” the forensic psychologist testified,
    [The defendant] switched his answers thinking from the
    negative feedback that I was not happy with him so therefore
    32
    . . . not only [is he] answering questions that weren’t really in
    the story, but now he’s changing his answers based on that
    slight negative feedback that I gave him.
    
    Id. As noted
    by Professor Bonnie decades ago, determining the
    competence of a person with an intellectual disability “requires careful
    assessment in order to assure both that the admissions embedded in the
    plea are reliable and that the defendant understands the nature and
    consequences of the plea.” Bonnie, 81 J. Crim. L. & Criminology at 444.
    Further, Professor Bonnie warned that reliance on routine plea colloquies
    will not be adequate in determining competence:
    Routine attorney-client interactions       and    routine   plea
    colloquies will not do the job.
    At a minimum, when a plea is proffered by a defendant
    [with an intellectual disability], the judge must assure that an
    adequate clinical evaluation has been conducted, and must
    affirmatively seek to satisfy himself or herself concerning the
    factual basis for the plea and the defendant’s understanding
    of its consequences.
    
    Id. An examination
    of the transcripts shows that the questions were
    leading and generally called for yes or no answers. Draine answered the
    vast majority of the questions, thirty-one to be exact, with one syllable
    answers. One question was ninety-three words long and produced a one-
    syllable answer. It might have been a satisfactory plea colloquy when
    competence was not an issue. But the colloquy itself does not tell us much
    about Draine’s mental abilities or competence to stand trial. Even if it did,
    the teaching of Robinson is that in-court behavior cannot trump a medical
    history suggesting there might be a problem with the competence of the
    defendant. 383 U.S. at 
    385, 86 S. Ct. at 842
    .
    As indicated above, persons with intellectual disability often have
    become skilled in masking their disability because of the sense of shame
    33
    they attach to it. At a minimum, I think we can at least question whether
    this defendant had a good grasp of many of the questions posed, one of
    which contained ninety-three words. See Tate v. State, 
    864 So. 2d 44
    , 50
    (Fla. Dist. Ct. App. 2003) (finding competency hearing was required despite
    plea colloquy in which defendant acknowledged the terms of their potential
    plea); Commonwealth v. Smith, 
    324 A.2d 483
    , 489 (Pa. Super. Ct. 1974)
    (noting that despite the appearance from the colloquy that defendant may
    have had an understanding of the charges against him, and subsequently,
    of the possible consequences of a conviction, this was not enough to
    support a finding of competency).      Indeed, the United States Supreme
    Court in Robinson reversed the Illinois Supreme Court which relied upon
    the apparent rationality of the defendant’s in-court behavior in refusing to
    hold a hearing on the defendant’s competence. 383 U.S. at 
    385–86, 86 S. Ct. at 842
    –43 (citing People v. Robinson, 
    174 N.E.2d 820
    , 823 (Ill.
    1961)).
    It is also important to avoid the stereotypical belief that a person
    with intellectual disability or mental illness is likely to be a “ticking time
    bomb.” As with all stereotypes, such an assertion is overbroad. Further,
    the risk that a defendant will continue to reoffend is wholly irrelevant in
    determining competency to stand trial. In re Williams, 
    687 N.E.2d 507
    ,
    512 (Ohio Ct. App. 1997).
    B. Determination of Requirement of Competency Evaluation.
    Our caselaw properly holds that the question of whether to order a
    competency hearing is subject to de novo review by this court. 
    Einfeldt, 914 N.W.2d at 780
    ; 
    Mann, 512 N.W.2d at 531
    . Further, we are to consider
    the cumulative effect of all circumstances that indicate doubt about the
    mental competency of the defendant. 
    Kempf, 282 N.W.2d at 707
    . We are
    only to look for reasonable doubt, not a definitive determination of
    34
    incompetency. 
    Einfeldt, 914 N.W.2d at 779
    ; see also 
    Tate, 864 So. 2d at 51
    (noting that the key issue is whether the defendant may be
    incompetent, not whether the defendant is incompetent); ABA Criminal
    Justice Mental Health Standards, standard 7-4.2(a) cmt., at 178 (noting
    “[the court] need not be convinced that a defendant is incompetent to stand
    trial before ordering an evaluation, because that is the objective of an
    evaluation”).
    Based on the above five factors, I conclude that the evidence before
    the district court was sufficient to give rise to a substantial issue as to
    whether Draine had the requisite decisional competence to stand trial.
    The combination of factors in the aggregate are simply too weighty to allow
    a decision to the contrary based on no reasonable doubt.      While Draine
    may have had a degree of factual understanding of his situation, such
    understanding is insufficient to overcome the other parts of the record that
    give rise to a substantial doubt regarding his decisional competency. The
    lack of firm evidence of decisional competency is particularly troublesome
    in the plea-bargain setting, where decisional competence described in
    Godinez and Debra A.E. is critical to a fair outcome.
    C. Conclusion. Under the circumstances, I conclude that there
    was a substantial question as to the competence in Draine. As a result, I
    would reverse the district court and remand the case to the district court
    for proceedings consistent with Einfeldt.