Corrections and connection to the community: A diagnostic and service program for incarcerated adult men with FASD

Brintnell, E. Sharon; Sawhney, Anjili S.; Bailey, Patricia G.; Nelson, Monty; Pike, Ashley; Wielandt, Patricia

doi:10.1016/j.ijlp.2018.12.005

Cited by 19 publications

(32 citation statements)

References 42 publications

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“…Similar to a prevalence study of incarcerated WA youth with FASD, most participants had impairments in 3 to 4 central nervous system domains (Bower et al, 2018; Brintnell et al, 2019). The same study also found that most offenders had impaired academic achievement with the next 2 most commonly influenced domains being executive functioning and attention.…”

Section: Discussionmentioning

confidence: 66%

The Demographic and Neurocognitive Profile of Clients Diagnosed With Fetal Alcohol Spectrum Disorder in PATCHES Paediatrics Clinics Across Western Australia and the Northern Territory

Connor

Tan

Pestell

et al. 2020

Alcoholism Clin & Exp Res

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Background: Fetal alcohol spectrum disorder (FASD) is a diagnosis relating to neurocognitive impairments associated with prenatal alcohol exposure. A key aspect of improving FASD diagnostic processes and management is understanding the demographic and neurocognitive profile of those living with FASD. The aim of this study was to describe the demographic and neurocognitive profile of the first 199 individuals diagnosed with FASD in PATCHES Paediatrics clinics.Methods: A retrospective cross-sectional descriptive study design was conducted with individuals diagnosed with FASD between 2013 and 2018 through a multidisciplinary team according to the Australian FASD Diagnostic Guidelines.Results: Participants were primarily male 133 (66.8%) and Aboriginal Australian 147 (73.9%), aged 2 to 31 (mean 10.5), with 94 (47.3%) from remote or very remote parts of Western Australia. Participants came from low 119 (59.8%), medium 48 (24.1%), and high 32 (16.1%) socioeconomic (SE) backgrounds. Low SE background was found to be a predictor of number of sentinel facial features (Wald v 2 (1) = 4.03, p < 0.05). Most received a diagnosis of FASD with <3 sentinel features 165 (82.9%). Participants either had 6 or more 46 (23.1%), 5 44 (22.1%), 4 55 (27.6%), or 3 (27.1%) neurodevelopmental domains impaired. Executive functioning was the most commonly impaired neurodevelopmental domain 158 (79.4%), and 31 (61%) reported sleep disturbance. ADHD was the most observed comorbid condition (41.7%).Conclusions: This study improves our current understanding of neurocognitive and demographic profiles in individuals with FASD that have been clinically referred for diagnosis within Western Australia and the Northern Territory, and highlights the importance of prevention and early assessment/diagnosis as well as guidance regarding more targeted interventions. FASD affects individuals from all cultural and SE backgrounds. Individuals from middle to higher SE groups are at risk of FASD with prevention efforts needing to target these sectors of society. Suggestions for future research directions are also provided.

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Section: Discussionmentioning

confidence: 66%

The Demographic and Neurocognitive Profile of Clients Diagnosed With Fetal Alcohol Spectrum Disorder in PATCHES Paediatrics Clinics Across Western Australia and the Northern Territory

Connor

Tan

Pestell

et al. 2020

Alcoholism Clin & Exp Res

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“…As part of a larger study aimed at developing services and supports for individuals with FASD involved with the justice system, Brintnell and colleagues (2019) delivered the holistic Mind, Body, Spirit (MBS) program to incarcerated adult males with FASD. Although no analyses were conducted to examine the independent impacts of the MBS intervention, participants perceived that the overall program improved their self‐esteem and insight, emotional functioning, coping skills, relationships, and appreciation for the benefits of exercise.…”

Section: Resultsmentioning

confidence: 99%

“…Those who completed the intervention also had a greater sense of efficacy and family needs were better met at follow-up than those in the comparison group, although both groups reported an overall decline in needs met (Petrenko et al, 2019). Interestingly, caregivers in the comparison group reported significant improvements in parenting satisfaction at follow-up, but those in the treatment group 'Connor et al, 2016) • Home visitation model providing supportive mentorship, advocacy, and connection to community resources (Denys et al, 2011;Grant et al, 2004b;Kartin et al, 2002) • Group program in a correctional setting to promote social and emotional skills, communication, physical health, and spirituality (Brintnell et al, 2019) did not. Although all children showed continued improvements in disruptive behavior and negative affect at follow-up (no group differences), they also all showed significantly worsening self-esteem across time points, and the treatment group experienced diminishing gains in emotion regulation whereas the comparison group showed significant increases (Petrenko et al, 2019).…”

Section: Behaviormentioning

confidence: 99%

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Flannigan

Harding

Anderson

et al. 2020

Alcoholism Clin & Exp Res

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Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well-being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.

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“…The prevalence in the legal context seems to be higher in both juvenile and adult offender samples (e.g., Fast et al, 1999;MacPherson et al, 2011;Brintnell, Sawhney, Bailey, Nelson, Pike, & Wielandt, 2019). It is important to emphasise that most individuals with FASD never become involved with the criminal justice system.…”

mentioning

confidence: 99%

“…Another important finding which has emerged from active case ascertainment studies is that a significant proportion of individuals identified as having a FASD only became aware of this when they are in the criminal justice system. This is despite the fact that they had previously been diagnosed with other psychiatric mental health conditions (e.g., Popova, Lange, Bekmuradov, Mihic, & Rehm, 2011;Bower et al, 2018;Brintnell et al, 2019). In a systematic review on prevalence, Popova and colleagues estimated that youth with FASD are 19 times more likely to be incarcerated when compared to youth with no diagnosis of FASD (Popova et al, 2011).…”

mentioning

confidence: 99%

Suggestibility, false confessions and competency to stand trial in individuals with fetal alcohol spectrum disorders: current concerns and recommendations

Allely

Mukherjee

2019

JCP

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Suggestibility, false confessions and competency to stand trial in individuals with fetal alcohol spectrum disorders: current concerns and recommendations Fetal alcohol spectrum disorder (FASD) is a lifelong disorder which is the result of prenatal exposure to alcohol (PAE) (Charness et al., 2016;Rangmar et al., 2015). Alcohol crosses the placenta which may result in cell damage and have an impact on developing organs (including the brain and the spinal cord). There are numerous organs which are sensitive to alcohol exposure across all stages of pregnancy ( Jonsson, 2019). FASD, previously considered an umbrella term for a range of accepted diagnoses including: fetal alcohol syndrome (FAS), partial FAS, alcohol-related neurodevelopmental disorder (ND) and alcohol-related birth defects. Increasingly these terms are being replaced by the FASD with and without dysmorphic features in the UK (SIGN, 2018). Individuals with FASD exhibit a variety of symptoms including cognitive (e.g. intelligence, executive control, and memory), social (e.g. communication skills and suggestibility) and adaptive (e.g. decision making ability and capacity to solve problems) impairments (Brown et al., 2011;BoS, BMA, 2016). One of the misconceptions regarding FASD is that individual will exhibit facial features that would suggest PAE. However, this is rarely the case. The majority of individuals who experience the negative effects of PAE lack any physical symptoms. It has been estimated that less than 10 per cent of individuals with FASD exhibit the physical features which have been found to be associated with PAE (Astley, 2010). Moreover, individuals who do exhibit the physical symptoms of PAE, typically diagnosed as FAS (i.e. short palpebral fissures, thin vermilion border, smooth philtrum and growth deficits), tend to become less marked or pronounced as the individual gets older (Streissguth et al., 1991). Individuals with FASD often present with a range of other physical and mental health problems. A review identified 428 comorbid conditions linked to FASD. They suggest rather than being referred for FASD, these comorbid conditions are how individuals may present to services (Popova et al., 2016).Currently, there are no guidelines which are developed to inform and support mental health professionals in the detection and identification of PAE in mental health professionals amongst their patient population (Mela et al., 2019). In order to make the diagnostic process more accessible to mental health professionals (as well as address some of the key diagnostic complexities surrounding FASD), "the Diagnostic and Statistical Manual -Fifth Edition" (DSM-5; American Psychiatric Association, 2013) included ND associated with prenatal alcohol exposure (ND-PAE) as an example under the diagnosis "Other Specified Neurodevelopmental Disorder". Therefore, DSM-5 allows for a clinical diagnosis of "Other Specified Neurodevelopmental Disorder -Neurodevelopmental Disorder Associated with Prenatal Alcohol Disorder". The diagnostic criteria are included in ...

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Corrections and connection to the community: A diagnostic and service program for incarcerated adult men with FASD

Cited by 19 publications

References 42 publications

The Demographic and Neurocognitive Profile of Clients Diagnosed With Fetal Alcohol Spectrum Disorder in PATCHES Paediatrics Clinics Across Western Australia and the Northern Territory

The Demographic and Neurocognitive Profile of Clients Diagnosed With Fetal Alcohol Spectrum Disorder in PATCHES Paediatrics Clinics Across Western Australia and the Northern Territory

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Suggestibility, false confessions and competency to stand trial in individuals with fetal alcohol spectrum disorders: current concerns and recommendations

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