Abilities associated with adjudicative competence were assessed among 927 adolescents in juvenile detention facilities and community settings. Adolescents' abilities were compared to those of 466 young adults in jails and in the community. Participants at 4 locations across the United States completed a standardized measure of abilities relevant for competence to stand trial (the MacArthur Competence Assessment Tool-Criminal Adjudication) as well as a new procedure for assessing psychosocial influences on legal decisions often required of defendants (MacArthur Judgment Evaluation). Youths aged 15 and younger performed more poorly than young adults, with a greater proportion manifesting a level of impairment consistent with that of persons found incompetent to stand trial. Adolescents also tended more often than young adults to make choices (e.g., about plea agreements) that reflected compliance with authority, as well as influences of psychosocial immaturity. Implications of these results for policy and practice are discussed, with an emphasis on the development of legal standards that recognize immaturity as a potential predicate of incompetence to stand trial.

The authors use a developmental perspective to examine questions about the criminal culpability of juveniles and the juvenile death penalty. Under principles of criminal law, culpability is mitigated when the actor's decision-making capacity is diminished, when the criminal act was coerced, or when the act was out of character. The authors argue that juveniles should not be held to the same standards of criminal responsibility as adults, because adolescents' decision-making capacity is diminished, they are less able to resist coercive influence, and their character is still undergoing change. The uniqueness of immaturity as a mitigating condition argues for a commitment to a legal environment under which most youths are dealt with in a separate justice system and none are eligible for capital punishment.

An individual is typically considered an adult at age 18, although the age of adulthood varies for different legal and social policies. A key question is how cognitive capacities relevant to these policies change with development. The current study used an emotional go/no-go paradigm and functional neuroimaging to assess cognitive control under sustained states of negative and positive arousal in a community sample of one hundred ten 13- to 25-year-olds from New York City and Los Angeles. The results showed diminished cognitive performance under brief and prolonged negative emotional arousal in 18- to 21-year-olds relative to adults over 21. This reduction in performance was paralleled by decreased activity in fronto-parietal circuitry, implicated in cognitive control, and increased sustained activity in the ventromedial prefrontal cortex, involved in emotional processes. The findings suggest a developmental shift in cognitive capacity in emotional situations that coincides with dynamic changes in prefrontal circuitry. These findings may inform age-related social policies.

Research Summary:Accurately gauging the public's support for alternative responses to juvenile offending is important, because policy makers often justify expenditures for punitive juvenile justice reforms on the basis of popular demand for tougher policies. In this study, we assess public support for both punitively and nonpunitively oriented juvenile justice policies by measuring respondents' willingness to pay for various policy proposals. We employ a methodology known as "contingent valuation" (CV) that permits the comparison of respondents' willingness to pay (WTP) for competing policy alternatives. Specifically, we compare CVbased estimates for the public's WTP for two distinctively different responses to serious juvenile crime: incarceration and rehabilitation. An additional focus of our analysis is an examination of the public's WTP for an early childhood prevention program. The analysis indicates that the public is at least as willing to pay for rehabilitation as punishment for juvenile offenders and that WTP for early childhood prevention is also substantial. Implications and future research directions are outlined.

Challenges the use by policy researchers of a model for comparing adolescent and adult decision making that is based on informed consent standards. An expanded decision-making framework designed to evaluate "judgment" in adults and adolescents can better test the empirical basis of paternalistic legal policies. The theoretical and empirical literature on the informed consent framework is critiqued and an alternative framework incorporating judgment factors is proposed. Three judgment factors--temporal perspective, attitude toward risk, and peer and parental influence--and their effects on decision making are explored. Finally, implications for future research are analyzed in several decision-making contexts.Adolescents pose a dilemma for legal policymakers. Traditionally they have been classified with younger children as minors, and been denied legal fights and privileges accorded to adults. However, most would agree that presumptions of vulnerability, dependence, and incompetence that justify paternalistic legal policies seem less valid when applied to adolescents (Zimring, 1982). Some observers (e.g., Melton, 1983aMelton, , 1983b have argued that adolescents' legal treatment is unduly restrictive and that they should be given more of the fights and privileges * Several of the ideas in this article were originally presented by the fh'st author and were published as part of a symposium on competence (see Scott, 1992). The current article expands and refines these ideas, provides a more substantial research base, and suggests several future research directions. We thank

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Both authors gratefully acknowledge the John D. and Catherine T. MacArthur Foundation for its support of this project. This paper was presented at the Symposium on New Directions in Juvenile Justice at the University of Pennsylvania Law School in May 1997. We thank participants at that symposium for comments. We also thankJohn Monahan, Dick Reppucci, and Frank Zimring for comments.

Objectives Older adults with serious illness are increasingly becoming homebound. By nature of their homebound status they lack access to basic services including dental care. We conducted a study to assess the oral health status, dental utilization and dental needs of the homebound elderly and to determine whether medical diagnoses or demographic factors influenced perceived oral health. Design Cross-sectional analysis Methods A total of 125 homebound patients received a comprehensive clinical examination in their home by a trained dental research team and completed a dental utilization and needs survey as well as the Geriatric Oral Health Assessment Index (GOHAI). Results Patients who reported a high level of unmet oral health needs were more likely to be non-white, although this effect was not significant in multivariate analysis. Individual medical diagnoses and the presence of multiple comorbidities were not associated with unmet oral health needs. Conclusions The oral health status of the homebound elderly regardless of their medical diagnoses was poor. High unmet oral health needs combined with strong desire to receive dental care suggests there is an imperative need to improve access to dental care for this growing population. In addition to improving awareness among geriatricians and primary care providers who care for the homebound, the medical community must partner with the dental community to develop home-based programs for older adults.