Evaluating the Psycholegal Abilities of Young Offenders with Fetal Alcohol Spectrum Disorder

Individuals with a diagnosis of fetal alcohol spectrum disorder (FASD) experience a range of physical, cognitive, and behavioral deficits thought to interfere with their ability to competently navigate the arrest, interrogation, and trial process. This study examined the psycholegal abilities of young offenders with FASD, including their understanding and appreciation of Miranda rights, and adjudication capacities (factual knowledge of criminal procedure, appreciation of the nature and object of the proceedings, ability to participate in a defense and communicate with counsel). Two groups of young offenders (50 with FASD and 50 without prenatal alcohol exposure) completed Grisso’s Instruments for Assessing Understanding and Appreciation of Miranda rights and the Fitness Interview Test-Revised in order to assess overall rates of impairment in youth with FASD, as well as differences between the groups. Potentially important predictors of psycholegal abilities were also evaluated. Results indicated the majority of young offenders with FASD (90%) showed impairment in at least one psycholegal ability, and rates of impairment were significantly higher than the comparison group. However, considerable within-group variability was observed. IQ and reading comprehension emerged as robust predictors of participants’ psycholegal abilities; while the FASD diagnosis differentiated participants’ scores on the FIT-R. These findings underscore the importance of individualized and comprehensive forensic assessments of psycholegal abilities in this population when warranted. Additional system level strains for this population are discussed, including problems in approaching competency remediation, and the potentially growing need for accommodation and forensic assessments in the face of limited financial and professional resources in legal settings

An Evaluation of the Predictive Validity of the SAVRY and YLS/CMI in Justice-Involved Youth with Fetal Alcohol Spectrum Disorder

Despite the high prevalence of fetal alcohol spectrum disorder (FASD) in youth criminal justice settings, there is currently no research supporting the use of violence risk assessment tools in this population. This study examined the predictive validity of total and domain scores on the Structured Assessment of Violence Risk in Youth (SAVRY) and the Youth Level of Service/Case Management Inventory (YLS/CMI) in justice-involved youth with FASD. Participants were 100 justice-involved youth (ages 12 to 23, 81% male), including 50 diagnosed with FASD and 50 without FASD or prenatal alcohol exposure. The SAVRY and YLS/CMI were prospectively coded based on interview and file review, with recidivism (both any and violent specifically) coded one-year post baseline assessment. Results provide preliminary support for the validity of the SAVRY and YLS/CMI in predicting recidivism in justice-involved youth with FASD. Higher ratings across SAVRY and YLS/CMI domains were found in youth with FASD, underscoring a critical need for assessments and interventions to buffer recidivism risk and address clinical needs

An examination of the abilities, risks, and needs of adolescents and young adults with Fetal Alcohol Spectrum Disorder (FASD) in the criminal justice system.

Fetal alcohol spectrum disorder (FASD) comprises the continuum of permanent deficits caused by alcohol consumption during pregnancy, which may include brain injury, neurobehavioural impairment, growth restriction, and physical birth defects. Individuals with FASD experience numerous adverse outcomes, including high rates of involvement with the criminal justice system. This dissertation examined the psycholegal abilities, justice-system experiences, and risks associated with prospective offending in 50 youth with FASD. The reliability and predictive validity of three commonly used youth risk assessment tools were also examined. Results were contrasted with a second group of 50 justice-involved youth without prenatal alcohol exposure (PAE). Participants included 100 justice-involved youth aged 12 to 23. Participants completed a battery of measures including Grisso’s Miranda Instruments, the Understanding Police Interrogation Questionnaire, the Fitness Interview Test-Revised, the Wechsler Abbreviated Scales of Intelligence, and the Wide Range Achievement Test-4th Ed. Rating scales including the Structured Assessment of Violence Risk in Youth, the Youth Level of Service/Case Management Inventory, and the Psychopathy Checklist—Youth Version, were also completed. Youth with FASD demonstrated substantially more impairment in psycholegal abilities relevant to police interrogation and adjudication than participants in the comparison group. Intellectual ability and reading comprehension emerged as robust independent predictors of psycholegal abilities, though the FASD diagnosis also served as an independent predictor of youths’ understanding and communication skills on the FIT-R. The two groups showed many similarities in legal experiences, including high rates of self-reported false confessions. Overall, the two groups demonstrated lengthy and serious offense histories. Youth with FASD showed earlier contact with the justice system and a higher volume of past offending, while comparison youth tended to be charged with fewer, but more serious offences. Youth with FASD recidivated earlier in the 3-month follow-up period and accrued more charges. They earned significantly higher continuous scores across risk assessment tools, and substantially more youth in the FASD group were rated as high or very high risk to reoffend. The risk assessment tools performed reasonably well in predicting general recidivism in youth with FASD. These findings are discussed in the context of current legal policy, clinical practice, and future intervention planning

Resilience and enculturation: Strengths among young offenders with Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder (FASD) is a lifelong disorder with no cure and is accompanied by neurological deficits. FASD is a health concern that is increasingly gaining attention within the justice system. Research has identified an association between delinquency and prenatal alcohol exposure. This study looked at resources of resilience for young offenders and addressed questions regarding the association between enculturation and resilience, and whether offence histories differed between youth with and without a diagnosis of FASD. Ninety-four young offenders between 13 and 23 years of age participated, 47 diagnosed with FASD and 47 without. While this study was not intended to be a study on Aboriginal adolescence, given the overrepresentation of FASD among Aboriginal youth involved in justice settings, the Multigroup Ethnic Identity Measure (MEIM) was included to assess levels of enculturation among youth. The Child and Youth Resilience Measure (CYRM) was used to assess resilience. Results showed a positive association between the resilience-enhancing resources and enculturation, indicating that the two are intricately connected. Neither group differed in their rates on the resilience-enhancing resources or the enculturation measure. While the resilience measure was not significantly associated with official conviction data, it did demonstrate significant associations with self-reported offending data. Finally, no significant results emerged to suggest that FASD had an influence on the association between the resilience measure and offence history or the enculturation measure and offence history. Findings suggest the importance of incorporating cultural components into services targeted to produce resilience and positive outcomes, and that different groups may have different service needs

Assessing violence risk and psychopathy in juvenile and adult offenders: a survey of clinical practices

This study surveyed 199 forensic clinicians about the practices that they use in assessing violence risk in juvenile and adult offenders. Results indicated that the use of risk assessment and psychopathy tools was common. Although clinicians reported more routine use of psychopathy measures in adult risk assessments compared with juvenile risks assessments, 79% of clinicians reported using psychopathy measures at least once in a while in juvenile risk assessments. Extremely few clinicians, however, believe that juveniles should be labeled or referred to as psychopaths. Juvenile risk reports were more likely than adult reports to routinely discuss treatment and protective factors, and provide recommendations to reevaluate risk. The implications of these findings are discussed

Balancing the story of fetal alcohol spectrum disorder: a narrative review of the literature on strengths.

For many years, researchers have explored the complex challenges experienced by individuals with fetal alcohol spectrum disorder (FASD). This research has been important for documenting the brain- and body-based impacts of prenatal alcohol exposure and the psychosocial vulnerabilities and environmental adversities frequently associated with FASD. It has also supported advocacy efforts and highlighted the necessity of providing FASD services and supports. However, with the focus on deficits and needs, there is a considerable gap in the literature on the strengths and successes of individuals with FASD. The lack of strengths-based FASD research has likely perpetuated the stress and stigma experienced by individuals with FASD and their families. Thus, there is a critical need to shift the direction of the field. Here we provide a narrative review of the literature on strengths in FASD. Our goals are to: (1) understand the state of strengths-based research related to individuals with FASD across the lifespan, and (2) describe positive characteristics, talents, and abilities of individuals with FASD that may be cultivated to promote their fulfillment and well-being. We identified a total of 19 studies, most of which were conducted to explore the lived experiences of adults with FASD. This preliminary but critical body of evidence highlights the intrinsic strengths of individuals with FASD, including strong self-awareness, receptiveness to support, capacity for human connection, perseverance through challenges, and hope for the future. Despite the importance of this emerging evidence, appraisal of the literature indicates a need for more intentional, methodologically rigorous, participatory, and theory-driven research in this area. Findings from this study, including the identified gaps in the literature, can be used to inform research, practice, and policy to meaningfully advance the field of FASD and promote positive outcomes in this population

Deficits in Reward Decision-Making on the Iowa Gambling Task in Justice-Involved Adults

Deficits in reward decision-making are thought to contribute to criminal offending. These impairments have been measured in laboratory studies using the Iowa Gambling Task (IGT) which assesses implicit learning of different reward/punishment contingencies. This study compared IGT performance between a sample of justice-involved individuals and community-based individuals without an offending history. Participants included 100 adults from two Canadian federal correctional institutions (34% female, Mage = 39.14 ± 9.74) and a comparison group of 89 community adults with no history of offending (39% female, Mage = 37.04 ± 10.79). Responses on the IGT were analyzed for overall net score, learning across the task, and deck switching patterns. Associations between IGT performance and sentence characteristics and static factors assessment of recidivism risk were examined for the justice-involved group. The justice-involved group performed significantly worse than community adults in terms of net score. While the community group learned the advantageous strategy across the task, justice-involved participants exhibited minimal learning. This effect was moderated by recidivism risk within the justice-involved group, with individuals at low risk, but not medium/high risk, showing improvement over the blocks of the task. Finally, the justice-involved group also made greater use of an ineffective “win-stay/lose-shift” strategy. These results suggest that, compared with community participants without history of offending, incarcerated adults tend to employ maladaptive decision-making strategies that yield worse overall outcomes and the extent of impairment is associated with recidivism risk

Latent classes of neurodevelopmental profiles and needs in children and adolescents with prenatal alcohol exposure.

BACKGROUND: Fetal alcohol spectrum disorder (FASD) resulting from prenatal alcohol exposure (PAE) is a common neurodevelopmental disorder, but substantial interindividual heterogeneity complicates timely and accurate assessment, diagnosis, and intervention. The current study aimed to identify classes of children and adolescents with PAE assessed for FASD according to their pattern of significant neurodevelopmental functioning across 10 domains using latent class analysis (LCA), and to characterize these subgroups across clinical features. METHODS: Data from the Canadian National FASD Database, a large ongoing repository of anonymized clinical data received from diagnostic clinics across Canada, was analyzed using a retrospective cross-sectional cohort design. The sample included 1440 children and adolescents ages 6 to 17 years (M = 11.0, SD = 3.5, 41.7% female) with confirmed PAE assessed for FASD between 2016 and 2020. RESULTS: Results revealed an optimal four-class solution. The Global needs group was characterized by high overall neurodevelopmental impairment considered severe in nature. The Regulation and Cognitive needs groups presented with moderate but substantively distinguishable patterns of significant neurodevelopmental impairment. The Attention needs group was characterized by relatively low probabilities of significant neurodevelopmental impairment. Both the Global and Regulation needs groups also presented with the highest probabilities of clinical needs, further signifying potential substantive differences in assessment and intervention needs across classes. CONCLUSIONS: Four relatively distinct subgroups were present in a large heterogeneous sample of children and adolescents with PAE assessed for FASD in Canada. These findings may inform clinical services by guiding clinicians to identify distinct service pathways for these subgroups, potentially increasing access to a more personalized treatment approach and improving outcomes