FREDERICK, Md. (AP) - A Frederick County support group is urging increased police training related to developmental disabilities after a man with Down syndrome died in police custody.

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The group FRIENDS of Frederick County said Thursday that people with Down syndrome may have weak chest muscles or skeletal structures that could put them at greater risk of unintentional harm.

Group President Denny Weikert says those characteristics could increase the risk of harm from lying face down with one's hands behind one's back.

The Frederick County Sheriff's Office says 26-year-old Robert Ethan Saylor ended up on the floor after a struggle with three deputies who had handcuffed him while trying to forcibly remove him from a Frederick movie theater on Jan. 12.

The state medical examiner's office has ruled the death a homicide.