Prevalence and characteristics of adults with fetal alcohol spectrum disorder in corrections: a Canadian case ascertainment study

Abstract

BackgroundIndividuals with fetal alcohol spectrum disorder (FASD) experience a range of cognitive, affective, and physical deficits following prenatal alcohol exposure. They are thought to be overrepresented in criminal justice settings. However, limited evidence is available to inform prevalence. We sought to estimate the prevalence of FASD in a Northern Canadian correctional population.MethodsUsing an active case ascertainment approach we recruited a representative sample of 80 justice-involved adults (ages 18–40, 85% male) over an 18-month period from 2013 to 2015. Participants completed interdisciplinary clinical assessments comprising medical and psychological evaluations that adhered to the 2005 Canadian FASD Diagnostic Guidelines.ResultsWe identified a high rate of FASD (17.5, 95% CI [9.2, 25.8%]) in this sample, and this rate could have been as high as 31.2% with confirmation of prenatal alcohol exposure. Most participants in this study presented with significant neurodevelopmental and cognitive deficits in at least two domains of functioning, irrespective of diagnosis, with only five of 80 participants (6.3%) demonstrating no cognitive impairment.ConclusionsFindings showed disproportionately high estimated FASD prevalence in this representative sample compared to general population estimates in both Canada and the U.S. (2–5%), underscoring the need for improved FASD screening and diagnosis in correctional settings, and education for clinicians working in the justice context. Strengthened health prevention and intervention efforts to support the needs of individuals with FASD outside the criminal justice context are needed.

Performance Validity Testing in Justice-Involved Adults with Fetal Alcohol Spectrum Disorder

“…Data for this study were drawn from a larger project (McLachlan et al, 2019). Participants included 80 justiceinvolved adults from a Northern Canadian correctional jurisdiction.…”

Alcohol use in pregnancy and its impact on the mother and child

“…type and quantities of alcohol), sociodemographic, environmental and personal differences. These groups include Indigenous communities (up to 25 times) [75,76], children in out of home care (up to 68 times) [77], incarcerated persons (up to 30 times) [78], people from lower socioeconomic groups (23.7 times) [79] and people requiring psychiatric care (up to 18.5 times) [80].…”

Oral and written communication skills of adolescents with prenatal alcohol exposure (PAE) compared with those with no/low PAE: A systematic review

“…Weak communication skills also have implications for forensic contexts, compromising psycho-legal abilities and, potentially, success in rehabilitation and educational programmes (McLachlan et al 2014, Rost andMcGregor 2012). Adolescents and adults who have either or both FASD and language deficits are over-represented, yet often under-identified, in justice settings (Kippin et al 2018, McLachlan et al 2019. Therefore, it is critical that the communication demands of forensic contexts are understood by the justice workforce, and that policies and practices are introduced that better enable the identification and response to an individual's communication needs (Kippin et al 2018, Rost andMcGregor 2012).…”