Trainee Series: FASD and the Criminal Legal System

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Written by Patrick Okonji, member of the 2025 CanFASD Trainee Program.


Hi, I’m Patrick Okonji, Research Coordinator in the Department of Psychiatry at the University of Saskatchewan, where I support Professor Mansfield Mela’s multidisciplinary work on Fetal Alcohol Spectrum Disorder (FASD) and related neurocognitive needs. With a background in Public Health and over ten years of experience in academic research, I facilitate ethics approvals, oversee research implementation, monitor progress, and lead knowledge translation activities. Although I had a general understanding of FASD before joining this team, working with Professor Mela deepened my awareness of the daily challenges faced by individuals with FASD, particularly within the criminal justice system. I have long been passionate about social justice, inclusion, and equitable healthcare access for people with differing functional capacities.  

Background and rationale

Individuals with neurocognitive differences, including FASD, often experience challenges with skills like executive functioning, decision-making, impulse control, language comprehension, and memory, which can hinder their capacity to navigate legal processes. These challenges can heighten vulnerability of people with FASD to misunderstandings during legal proceedings, increasing the risk of false confessions, wrongful convictions, and repeated justice system involvement. Despite the significant socioeconomic and personal costs associated with these criminal legal involvement, Saskatchewan currently lacks systematic, evidence-based interventions and educational resources tailored to the legal needs of people with FASD and other neurodiverse conditions. Recurrent justice-related offenses, many stemming from unaddressed cognitive and social challenges, underscore the urgent need to develop strategies that foster equitable treatment and safeguard both individual rights and public safety. 

Study objectives and methods

Our research titled “Leave no one behind: Stimulating Access to Justice for Individuals with FASD” aims to bridge these gaps by collaborating with community stakeholders, legal professionals, and justice system personnel to create targeted educational tools and policy recommendations. We are employing community-engaged, mixed-methods approach in three phases: 

  1. Systematic Review and Legal Analysis
    We first conducted a comprehensive review of scholarly literature and case law (2014–2024) from Canada, the United Kingdom, the United States, and Australia/New Zealand to identify themes in how individuals with FASD are treated within the justice system. This analysis highlights existing barriers and potential facilitators, informing the design of subsequent data collection tools. 
  2. Surveys and Focus Groups
    Based on the findings from the review we will develop surveys and focus-group protocols to be administered to (a) individuals with FASD who have experienced the justice system, (b) their caregivers or advocates, and (c) justice professionals (lawyers, police officers, judges). These qualitative and quantitative data will help us understand firsthand challenges, knowledge gaps, and opportunities for intervention. 
  3. Data Analysis and Recommendations
    Drawing on insights from the literature review, surveys, and focus groups, we will identify specific barriers experienced by people with FASD, such as comprehension of legal processes and inadequate legal representation, and craft recommendations for adapting justice services. Proposed interventions may include specialized advocacy programs, courtroom modifications, and enhanced training for legal practitioners to accommodate cognitive differences. 

Preliminary findings and next steps

Although surveys and interviews are pending, our systematic review has already surfaced key themes: misunderstandings of legal procedures among people with FASD, lack of specialized FASD-informed support in correctional settings, heightened vulnerability of people with FASD to coercion, and inflexible policy frameworks. Conversely, promising facilitators of access to justice include court process modifications, targeted advocacy initiatives, and increased FASD awareness among justice professionals. These findings underscore the necessity of a holistic approach that integrates screening protocols, tailored education, and ongoing support for individuals with FASD throughout the justice journey. 

Since joining the FASD research field, I have gained a nuanced appreciation for how FASD often goes unrecognized, leading to misconceptions about individuals’ abilities, especially in high-stress forensic environments. I am actively collaborating with Professor Mela and a practicum student to develop knowledge translation strategies that raise public awareness, promote early diagnosis, and foster understanding among diverse audiences. As this research progresses, my goal remains to translate evidence into practice, ensuring that people with FASD receive the fair, informed, and compassionate treatment they deserve. 


Patrick Okonji is the Research Coordinator for the “Leave No One Behind” project, bringing a strong academic foundation in public health to his role. He works closely with multidisciplinary teams at the Department of Psychiatry, University of Saskatchewan; liaising between investigators, community partners, and knowledge translation specialists, to ensure seamless study implementation, timely dissemination of results, and maximized research impact. Patrick oversees project logistics, supports responsible conduct of research, and research dissemination (including Knowledge Translation).

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