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

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Individuals with FASD are overrepresented in criminal justice settings, but there is currently little evidence to describe prevalence rates. The study summarized below estimated the prevalence of FASD in a Northern Canadian correctional context.

Main Findings

  • Of 80 individuals assessed, 14 received a diagnosis of FASD, equating to a 17.5% prevalence rate
  • Among those who received a diagnosis, only two had been previously diagnosed with FASD
  • In 11 individuals, a reliable diagnosis could not be made, therefore the prevalence rate could have been 31.2%
  • Prenatal alcohol exposure was confirmed in 20 individuals (25%)
  • More than half of the participants had ‘moderate’ neurodevelopmental dysfunction, and 1/3rd had ‘severe’ dysfunction


Additional findings
Many individuals also described their experience with the following:

  • Sleep problems
  • Loss of consciousness as a result of head injury
  • BMI considered to be ‘obese’
  • Taking medication such as antidepressants, melatonin, antipsychotics, anti-epileptic or ADHD medication
  • Experiencing episode(s) of abuse or neglect
  • Rate of suicide attempts among the population was 41.2%

Recommendations

  • Screening and assessment should focus on the neurocognitive abilities of the individual given the low rate of characteristic facial features in this sample
  • Future research should involve understanding the needs of those with FASD who are involved in the criminal justice system, to improve intervention strategies
  • There is need for the correctional system to improve awareness and consideration of those with FASD in the context of comprehensive mental and physical health assessments

Take-home message

The findings of this study emphasize the vulnerability of those with FASD, and considers whether the overrepresentation in the criminal justice system could be avoided or lessened with early diagnosis/intervention and proper education. Additionally, taking a prevention approach is critical in supporting those with FASD and their families, and avoiding involvement in the criminal justice system. Evaluating FASD in a timely manner is important for issuing appropriate sentencing and other conditions that will facilitate a positive rehabilitation outcome for the individual.

 

Authors: K. McLachlan, A. McNeil, J. Pei, U. Brian, G. Andrew, T. F. Oberlander

Journal:  BMC Public Health

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