ADULTS WITH FETAL ALCOHOL SPECTRUM DISORDER: FACTORS ASSOCIATED WITH POSITIVE OUTCOMES AND CONTACT WITH THE CRIMINAL JUSTICE SYSTEM
Main Article Content
Keywords
Fetal alcohol spectrum disorder, adults, criminal justice system, early diagnosis, intervention and support
Abstract
Background
Adults with FASD are at increased risk for contact with the criminal justice system (CJS). To date, there has been limited research devoted to development of supports for adults with FASD and it i s unclear what supports are required to improve outcomes and reduce CJS contact.
Objectives
To examine the services and supports experienced by a small group of adults with FASD living in both rural and urban locations in Ontario, and their contact with the CJS.
Methods
A sample of 14 individuals with FASD and 11 support persons participated in the study. Semi -structured interviews were conducted and coded according to key themes which were qualitatively analysed using quotations that supported each key theme. A reliabil ity analysis was conducted for the interview coding.
Results
Early diagnosis and lower substance use were found to be factors associated with reduced contact with the CJS. Participants reported on: knowledge of their diagnosis and caregiver training and e ducation about FASD; interdependence; routine, structure, and supervision; evidence of a strength- based approach; effective communication; and collaborative services. Few participants had received training and education around FASD and further research is needed to determine the training required for more successful interventions and outcomes.
Conclusion
As has been found previously, early diagnosis of FASD is associated with more positive outcomes including reduced amount of contact with the CJS. It is l ikely that early diagnosis leads to the receipt of more supports throughout childhood and contributes to a better understanding of FASD by family and caregivers.
References
2. Hoyme HE, May PA, Kalberg MA, et al. A practical clinical approach to diagnosis of Fetal alcohol spectrum disorder: Clarification of the 1996 In stitute of Medicine criteria. Pediatrics 2005;115: 39 47.
3. May PA. A multi -level comprehensive approach to the prevention of fetal alcohol syndrome (FAS) and other alcohol related birth defects (ARBD). International Journal of Addiction 1995;30:549– 602.
4. Col es C, Lynch ME, Kable JA, Johnson KC , Goldstein FC. Verbal and nonverbal memory in adults prenatally exposed to alcohol. Alcohol Clinical and Experimental Research 2012;34:897- 906.
5. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neuroscience and Biobehavioral Reviews 2007;31: 192– 201.
6. Streissguth A, Aase J , Clarren S, Randels S, LeDue R, Smith D. Fetal alcohol syndrome and in adolescents and adults. Journal of the American Medical Association 1 991;265: 961- 7.
7. Sphor HL, Willms J , Steinhausen HC. Fetal alcohol spectrum disorders in young adulthood. Journal of Pediatrics 2007;150:175- 179.
8. Chudley A, Kilgour A, Cranston M , Edwards M. Challenges of diagnosis in Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder in the adult. American Journal of Medical Genetics 2007;145C: 261– 272.
9. Streissguth A, Bookstein F, Barr H, et al. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. Developmental and Behavioral Pe diatrics 2004;25:228- 237.
10. Wheeler JA, Kenney KA , Temple VK. Fetal alcohol spectrum disorder: An exploratory investigation of services and interventions for adults. Journal on Developmental Disabilities 2013;19:64- 77.
11. Naumann D, Reynolds J , Smith H. An envi ronmental scan of programs available to residents of eastern Ontario affected by fetal alcohol spectrum disorder. Journal on Developmental Disabilities 2013;19:30 -47.
12. Fast D , Conry J. Fetal alcohol spectrum disorders and the criminal justice system. Develo pmental Disability Research and Reviews 2009;15:250- 7.
13. MacPherson & Chudley, AE. FASD in a Correctional Population: Preliminary Results from an Incidence Study . Ottawa, ON: Correctional Services Canada, 2007. Accessed on : August 24, 2015 http://events.onlinebroadcasting.com/fas/090707/ ppts/correctional.ppt
14. Brintnell ES, Bailey PG, Sawhney A , Kreftin L. Understanding FASD: Disability and social supports for adult offender. In: Riley EP, Clarren S, Weinberg J & Jonsson E, eds. Fetal Alcohol Spectrum Disorders -Management and Policy Perspectives of FASD. Toronto, ON: Wiley, 2011.
15. Institute of Health Economics. Consensus Statement on Legal Issues of Fetal Alcohol Spectrum Disorders. Edmonton, Alberta: Institute of Health Economics, 2013.
16. Cox L, Clarimont D, Cox S. Knowledge and attitudes of criminal justice professionals in relation to fetal alcohol spectrum disorder. Canadian Journal of Clinical Pharmacology 2008;15:e306- e313.
17. Mitten HR. Barriers to Implementing Holistic, Community -Based Treatments for Offenders with Fetal Alcohol Conditions. Saskatoon, S.K: University of Saskatchewan Department of Law, 2003.
18. Moore T , Green M. Fetal alcohol spectrum disorder (FASD): A need for closer examination by the criminal justice system . Criminal Rep orts 2004( 4);19:99- 108.
19. Boland F, Burrill R, Duwyn M, Karp J. Fetal Alcohol Syndrome: Implications for Correctional Service. Ottawa, ON: Correctional Services Canada, 1998.
20. Thanh NX , Jonsson E. Cost of FASD in Alberta, Canada. Canadian Journal of Clinical Pharmacology 2009;16:e80 -e90.
21. Popova S, Stade B, Bekmuradov D, Lange S, Rehm J. What do we know about the economic impact of fetal alcohol spectrum disorder? A systematic literature review. Alcohol and Alcoholism 2011;46:490- 7.
22. Hall N, Cunningham M , Jones S. Advancing effective service provider practices in fetal alcohol spectrum disorder. Fetal Alcohol Spectrum Disorders -Ontario Network of Ex pertise. (2010). Accessed on: August 31, 2015 http://www.fasdontario.ca/cms/wp - content/uploads/2014/01/Toward- a-Provincial -Strategy -Advancing -Effective -Service -Provider - Practices -2010.pdf
23. Malbin D. Fetal alcohol syndrome and fetal alcohol effects: Trying differently rather than harder. (2002). Accessed on: August 30, 2015 http://www.fascets.org/Bibliography.html