FAS Screening for Young Offenders

Patricia M. Blakley, MD, PhD¹ and Garry Perry²

Alvin Buckwold Child Development Program, Department of Pediatrics,¹ and Child and Youth Services, Mental Health

Services²Saskatoon Health Region and University of Saskatchewan,

Saskatoon, SK

Scope of the ProblemFew studies of FASD in Young Offender (YO) populationsConry et alSuggestions that FASD is a significant problem amongst YO in SaskatchewanPresently no universally accepted screen

Why Develop a Screen?Need for early identification

Implementation of appropriate interventionsRecognition of etiology of behaviorsPotential for use of Alternative MeasuresConsideration for sentencing

FASD ScreenDeveloped by:

Garry Prediger, Director, Kilburn HallGarry Perry, Psychologist, Young Offenders Unit, Child and Youth Services Dr. Pat Blakley, Medical Director, Alvin Buckwold Child Development Program

Version 3.0

FASD Screen Four sections

Family history of youthYouth’s historyYouth’s criminal historyObservations of the youth

ScoringFour point Likert scaleClinical override

RISK SCREENING TOOL FORFETAL ALCOHOL SPECTRUM

DISORDERGENERAL INFORMATION: CLIENT’S NAME:______________________________________________ DATE OF BIRTH: ________________________ GENDER:_____________ ASSESSED BY: __________________________ DATE: ______________AGENCY: ___________________________________________________ETHNIC ORIGIN: ____________________________________________ SOURCES OF INFORMATION: (Please Identify)

1. ______________________________________________________________ 2. ______________________________________________________________ 3. ______________________________________________________________ 4. ______________________________________________________________ 5. ______________________________________________________________

6. ______________________________________________________________

Sample Question1. History of alcohol use by birth

mother during pregnancy

No 1 2 X no confirmed suspected confirmed

insufficienthistory history history

information

Family History of YouthHistory of alcohol use by birth mother during pregnancyIf mother consumed alcohol, rate of consumptionRate of consumption of other drugs used during pregnancy by birth mother Any previous indications or diagnoses of FASD of the youth’s siblings

Youth’s History Any previous indications or diagnosis of FASD of the youthHistory of abusing substancesEarly onset of attentional problemsHistory of academic problems in schoolHistory of behavioral problems at schoolHistory of mental health problemsHistory of care/living arrangements

Youth’s Criminal HistoryHistory of trouble with the Justice System but no convictionsHistory of convictionsHistory of non-violent convictionsHistory of violent convictionsLack of continuity in criminal behaviorFailure to abide by court ordered conditions

Observations of the YouthImpulsivity/poor problem solving skillsEasily led by othersPresents in an immature manner for corresponding age levelLack of continuity in life, tends to live minute to minute

Observations of the YouthReceptive language issuesExpressive language issuesUnusual responses to sensory stimuliUnusual responses to environmental stimuli

RatingsLow likelihood of FASD

Scores less than 13

Moderate likelihood of FASDScores between 13 and 26

High likelihood of FASDScores between 26 and 52

ActionModerate likelihood of FASD

Referral to a forensic psychologist for a generalized assessment

High likelihood of FASDReferral to a physician and neuropsychologist for specific exploration of FASD

Important ConsiderationsConsent from legal guardianAssent from youthMaternal alcohol historyCultural sensitivityLegal implicationsLinking diagnosis with services

Important ConsiderationsInformation gathering:

YO Corrections and Public Safety fileInterview with youthInterview with family members or collateral sources

PlanPilot studyClosed custody YO facilityDiscussions with stakeholdersTraining of raters

Future PlansExpansion to adult offenders

Addition of question on history of employment problems

Interest from Provincial and Federal Correctional facilities