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Jewell E, Dunleavy B, Faitakis M, Pun JW, Moss S, Pei J, Mela M, Flannigan K, Tremblay M, McLachlan K. Screening and identification of fetal alcohol spectrum disorder in criminal legal settings: A realist review. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:208-270. [PMID: 38660916 DOI: 10.1002/cbm.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Screening for fetal alcohol spectrum disorder (FASD) has been identified as a promising approach to improve recognition, understanding and effective response to the unique needs of those with FASD in criminal legal settings. However, to date, there has been limited synthesis of relevant screening tools, indicators, or implementation considerations in this context. AIMS The present review aimed to synthesise evidence and develop a conceptual framework for understanding how, when, why, for whom and by whom FASD screening tools, items and/or indicators and characteristics serve to accurately identify people with FASD in criminal legal contexts, with consideration of individual and system needs relevant to effective implementation and response. METHODS A preregistered search was conducted using a modified realist review framework for both peer-reviewed articles and grey literature. Included sources were available in English, which focused on individuals with prenatal alcohol exposure and/or FASD with criminal legal involvement and offered new empirical evidence. Sources were reviewed using the Quality Control Tool for Screening Titles and Abstracts by Second Reviewer framework, extracted using a structured coding form and narratively synthesised. RESULTS The search yielded 52 sources, 11 FASD screening tools designed for or applied in criminal legal settings and 38 potential FASD indicators or characteristics relevant to identifying people who may have FASD in criminal legal settings, organised into six conceptually related domains. There was limited evidence supporting the psychometric properties of screening tools across populations or settings, though growing evidence highlights the promise of some instruments. Although few studies characterised potential considerations to be made when implementing a screening tool or approach, both system and individual level needs related to recognising and effectively responding to FASD in criminal legal contexts were identified, and findings revealed strong support among legal and clinical professionals regarding the need for FASD screening in these settings. CONCLUSIONS Findings of this review can be used to inform the development, selection, implementation and evaluation of FASD screening tools in criminal legal settings and underscore a continued need for enhanced resources, policy and cross-sectoral response to better support the needs of people with FASD in the criminal legal contexts.
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Affiliation(s)
- Emma Jewell
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
- Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Bianka Dunleavy
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Martina Faitakis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Jessica W Pun
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Sarah Moss
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | | | - Mansfield Mela
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | | | - Kaitlyn McLachlan
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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Brown J, Jonason A, Asp E, McGinn V, Carter MN, Spiller V, Jozan A. Fetal alcohol spectrum disorder and confabulation in psycholegal settings: A beginner's guide for criminal justice, forensic mental health, and legal interviewers. BEHAVIORAL SCIENCES & THE LAW 2022; 40:46-86. [PMID: 34689366 DOI: 10.1002/bsl.2540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
Fetal alcohol spectrum disorders (FASD) are neurodevelopmental/neurobehavioral conditions caused by prenatal alcohol exposure (PAE). Impairments caused by PAE contribute to the over-representation of individuals with FASD in the United States juvenile and adult criminal justice systems. These same impairments can equally impact on individuals with FASD who are witnesses to or victims of crime who also have to navigate the complexities of the criminal justice system. Difficulties include increased susceptibility to confabulation throughout the legal process that, in turn, can contribute to increased rates of poor outcomes including false confessions and wrongful convictions. Individuals with FASD are particularity at risk of confabulation when they are subjected to tactics, such as stressful and anxiety-provoking situations, threats, and leading, suggestive, or coercive questioning. Many professionals in the forensic context are unfamiliar with FASD or related confabulation risk and may unintentionally utilize tactics that intensify impacts of pre-existing impairment. This article serves as a beginner's guide for professionals working in criminal justice settings by (a) providing research-based overviews of FASD and confabulation, (b) describing how FASD may lead to confabulation, and (c) suggesting ways that professionals can modify protocols when interacting with individuals with FASD. Suggestions in this article hold the potential to decrease the risk of confabulation in the criminal justice system and decrease problematic outcomes, such as false confessions and wrongful convictions among individuals with FASD.
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Affiliation(s)
- Jerrod Brown
- Pathways Counseling Center, Inc., St. Paul, Minnesota, USA
- Concordia University, St. Paul, Minnesota, USA
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
| | - Alec Jonason
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
| | - Erik Asp
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
- Wesley & Lorene Artz Cognitive Neuroscience Research Center, Hamline University, St. Paul, Minnesota, USA
- Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Valerie McGinn
- The FASD Centre, Auckland, New Zealand
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Megan N Carter
- University of Washington, Seattle, Washington, USA
- Department of Social and Health Services, Special Commitment Center, Steilacoom, Washington, USA
| | | | - Amy Jozan
- American Institute for the Advancement of Forensic Studies, St. Paul, Minnesota, USA
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An invisible problem: stigma and FASD diagnosis in the health and justice professions. ADVANCES IN DUAL DIAGNOSIS 2020. [DOI: 10.1108/add-07-2020-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose
Fetal alcohol spectrum disorder (FASD) is a complex lifelong disorder impacting the brain and body. Individuals with FASD may require lifelong supports and are at a higher risk of experiencing adverse outcomes, including incarceration. Individuals with FASD face stigma related to FASD that impacts disclosure of the diagnosis and access to supports. The prevalence of FASD exceeds that of other developmental disabilities, yet it remains less visible and stigmatized.
Design/methodology/approach
Interviews conducted with health-care and justice professionals in a Canadian province explore their experiences attending to FASD and challenges of stigma.
Findings
While difficult to access, diagnosis provides a pathway to supports and is crucial in the criminal justice process. Visibility and invisibility in health and justice systems highlight the lack of understanding of FASD and surrounding stigma. When unaddressed, individuals with FASD face additional challenges stemming from a lack of information and strategies by professionals involved in their lives.
Originality/value
Stigma represents a significant and complex issue intertwined in understandings of FASD. This research explores this relationship and the mechanisms through which FASD stigma has impacts in health-care and justice settings.
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Passmore HM, Mutch RC, Watkins R, Burns S, Hall G, Urquhart J, Carapetis J, Bower C. Reframe the Behaviour: Evaluation of a training intervention to increase capacity in managing detained youth with fetal alcohol spectrum disorder and neurodevelopmental impairments. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2020; 28:382-407. [PMID: 35530127 PMCID: PMC9067986 DOI: 10.1080/13218719.2020.1780643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The first study to investigate the prevalence of fetal alcohol spectrum disorder (FASD) within an Australian juvenile detention centre has identified the highest known prevalence of FASD among a justice-involved population worldwide. However, there has been limited investigation into the capacity of the custodial workforce to identify and manage young people in Australian detention centres with FASD or other neurodevelopmental impairment (NDI), and no published interventions aiming to develop environments appropriate for those with FASD in justice settings. Using the Template for Intervention Description and Replication checklist, this study describes the conception, implementation and evaluation of a training intervention aiming to upskill the custodial workforce in the management of youth with FASD and NDI; 117 staff participated in the intervention, and 109 completed pre- and post-intervention surveys. Improvements were seen across almost all knowledge and attitude items, and the intervention was considered highly necessary, appropriate and valuable by the workforce.
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Affiliation(s)
- Hayley M. Passmore
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Raewyn C. Mutch
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
- Department of Health Western Australia, Child and Adolescent Health Service, Perth, WA, Australia
| | - Rochelle Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Sharyn Burns
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Guy Hall
- School of Law, Murdoch University, Perth, WA, Australia
| | | | - Jonathan Carapetis
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
- Perth Children’s Hospital, Perth, WA, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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Smele S, Quinlan A, Fogel C. Sexual Assault Policing and Justice for People With Developmental Disabilities. VIOLENCE AND VICTIMS 2019; 34:818-837. [PMID: 31575817 DOI: 10.1891/0886-6708.vv-d-18-00041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Services and Supports to Promote Social Inclusion of Persons With Developmental Disabilities Act that passed in 2008 was intended to improve services and supports for persons with developmental disabilities in Ontario, Canada. This legislation introduced a new mandatory police reporting policy for any suspected abuse, including sexual assault. While heralded as a significant advancement, questions remain about the policy and the Canadian criminal justice system's capacity to effectively respond to abuse of people with developmental disabilities. Drawing on qualitative interview data with police investigators and Victim Crisis Services employees in Ontario, this article examines how police respond to these reports. The findings highlight the need for more clearly defined protocols and training on these types of sexual assault investigations and increased provision and coordination of appropriate support for victims/survivors with developmental disabilities.
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Affiliation(s)
- Sandra Smele
- Department of Sociology, York University, Toronto, Ontario, Canada
| | - Andrea Quinlan
- Department of Sociology and Legal Studies, University of Waterloo, Waterloo, Canada
| | - Curtis Fogel
- Department of Sport Management & Social Justice and Equity Studies, Brock University, St. Catharines, Canada
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Passmore HM, Mutch RC, Burns S, Watkins R, Carapetis J, Hall G, Bower C. Fetal Alcohol Spectrum Disorder (FASD): Knowledge, attitudes, experiences and practices of the Western Australian youth custodial workforce. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 59:44-52. [PMID: 29996987 DOI: 10.1016/j.ijlp.2018.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/14/2018] [Accepted: 05/30/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorder (FASD) is a condition caused by prenatal alcohol exposure and characterised by lifelong physical, behavioural and cognitive abnormalities. Primary disabilities, such as impairment in memory, attention, cognition, language, executive function, and adaptive function, can lead to young people with FASD becoming engaged with the justice system. Little is known about the extent of FASD in youth detention in Australia, or of the capacity custodial staff have to manage and support young people with FASD. In tandem with a study assessing the prevalence of FASD among youth in detention in Western Australia (WA), this study aims to establish the current knowledge, attitudes, experiences and practices regarding FASD and other neurodevelopmental impairments among youth custodial officers in order to develop training resources for this workforce. METHODS We invited youth custodial officers in the only youth detention centre in WA to participate in an online or hardcopy survey. The survey was developed following extensive consultation with the workforce and investigated their knowledge, attitudes, experiences and practices relating to FASD and other neurodevelopmental impairments. This included experience working with young people with FASD and other impairments, and attitudes towards relevant training. RESULTS 112 youth custodial officers (51% of the youth custodial workforce) completed the survey. While many respondents had heard of FASD (77%) and understood it is relevant to the justice system (74%), limited in-depth FASD knowledge existed. Many respondents were unsure or unaware that FASD is permanent brain damage (53%) and cannot be outgrown (57%). Respondents were infrequently informed if a young person in detention had a diagnosis of FASD. Almost all custodial officers indicated motivation to complete training to further understand FASD (92%) and other neurodevelopmental impairments (94%), with particular interest in the application of management strategies appropriate for affected young people. CONCLUSIONS A lack of specific knowledge, inadequate training to recognise and manage young people with neurodevelopmental impairments, and inconsistent information-sharing processes reduce the ability of the custodial workforce to care for young people with FASD and other neurodevelopmental impairments. These findings have supported the development and evaluation of training resources targeting the specific needs and requests of the WA youth custodial workforce, and this is now underway.
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Affiliation(s)
- Hayley M Passmore
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
| | - Raewyn C Mutch
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia; Child and Adolescent Health Service, Department of Health Western Australia, Perth, Australia
| | - Sharyn Burns
- School of Public Health, Curtin University, Perth, Australia
| | - Rochelle Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Jonathan Carapetis
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; Perth Children's Hospital, Perth, Australia
| | - Guy Hall
- School of Law, Murdoch University, Perth, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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Flannigan K, Pei J, Stewart M, Johnson A. Fetal Alcohol Spectrum Disorder and the criminal justice system: A systematic literature review. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 57:42-52. [PMID: 29548503 DOI: 10.1016/j.ijlp.2017.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 05/24/2023]
Affiliation(s)
- Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver, BC V5R 0A4, Canada.
| | - Jacqueline Pei
- Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver, BC V5R 0A4, Canada; Department of Educational Psychology, University of Alberta, 6-102 Education North, Edmonton, AB T6G 2G5, Canada
| | - Michelle Stewart
- Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver, BC V5R 0A4, Canada; Department of Justice Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Alexandra Johnson
- Canada Fetal Alcohol Spectrum Disorder Research Network, PO Box 11364 Wessex PO, Vancouver, BC V5R 0A4, Canada; Department of Justice Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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