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1When Someone with an FASDis Arrested:
What You Need to KnowPaul Connor, Ph.D.
Private Practice Des Moines, WAFetal Alcohol and Drug Unit,
University of Washington
[email protected]
www.FASDExperts.com
NOFAS Webinar SeriesApril 15, 2015
Prevalence of FASD Around the World
General Populations Seattle: 1/100 (FAS and ARND) Russia:
7.9/100 (FAS only) South Africa: 4.6/100 (FAS only)
US and Western Europe Estimate for FASD 2-5%
Sampson, et al., Teratology, 1997Riley et al., ACER, 2003May et
al., Am J Public Health, 2000May et al., Dev Dis Res Rev 2009
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2PREVALENCEWhy Is FASD Relevant in a Forensic Context?
Secondary Disabilities100
90
80
70
60
50
40
30
20
10
Ages 6-51 (n=408-415)Ages 21-51 (n=89-90)
%
Mental HealthProblems
Disrupted SchoolExperience
Trouble Withthe Law
Confinement
Inappropriate SexualBehavior
Alcohol & DrugProblems
DependentLiving
Problems withEmployment
Ages 6 - 51 Ages 21 - 51
Arrested 44%Charged 41%
Convicted 30%
Arrested 44%Charged 41%
Convicted 30%
Lifespan Prevalence of Secondary Disabilities &
SequelaeFAS/FAE ages 1251 yrs (n=253)
Lifespan Prevalence of Secondary Disabilities &
SequelaeFAS/FAE ages 1251 yrs (n=253)
Trouble with the Law 60%Trouble with the Law 60%
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3Lifespan Prevalence ofTypes of Trouble with The Law
FAS/FAE ages 1251 yrs (n=253)
Lifespan Prevalence ofTypes of Trouble with The Law
FAS/FAE ages 1251 yrs (n=253)
Persons (not sex-related) 45%Property 24%Possession / selling
19%Persons (sex-related ) 14%Driving violations 10%Legal system
processes 10%Other (runaway, lying to police, etc.) 6%
Persons (not sex-related) 45%Property 24%Possession / selling
19%Persons (sex-related ) 14%Driving violations 10%Legal system
processes 10%Other (runaway, lying to police, etc.) 6%
* Rape, molestation, incest, prostitution* Rape, molestation,
incest, prostitution
**
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4Prevalence of FASD in Forensic Settings
Juvenile Justice: 23% (FAS and ARND)
Youth Probation ~4.5% diagnosed with FASD 26% identified to be
at risk but not formally diagnosed at that
time Adult Prison
Incidence of FASD in Canadian prison was 10x higher thanin
general population.
Fast, Conry, Loock, 1999Canadian DOJ, 2005MacPherson, 2007
Why is FASDRelevant in Court?
FASD = brain damage that may affect executivefunctioning
Executive functioning = judgment, decisionmaking, impulse
control
Judgment, decision making, impulse controlimpact all aspects of
behavior in the legalcontext
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5SUGGESTIBILITY
COMPARISON OF FASD FORENSIC, FASDNON-FORENSIC AND US
CONTROLS
GSS2 Subscale
ForensicFASD Sample
(n=7) Mean/SD
Trowbridge Non-Forensic
FASD Sample(n = 8) Mean/SD
TrowbridgeControls(n =72)
Mean/SD
Immediate Recall 7.8/6.6 10.8/4.7 18.9/5.2
Delayed Recall 6.1/5.3 --- ---Yield 1 7.9/4.2 7.0/2.7
3.4/2.5
Yield 2 9.3/2.0 --- ---
Shift 9.9/3.2 8.5/3.6 4.0/3.2Total Suggestibility 17.7/4.9
15.5/5.2 7.4/5.1
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6Neuropsychological Assessment:
BUT
Important for documenting pattern of strengthsand weaknesses
Establishing the basis for an ultimate diagnosis Discussing how
the impairments can impact the
persons daily life
Forensic Assessment MustAddress The Nexus
(i.e. Link FASD to Offense Conduct):prenatal exposure
brain damage in fetus
lifelong cognitive-behavioral deficits
specific deficits in judgment, decision-making, cause-and-effect
awareness, and impulse control
instant offense behavior
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7NEXUS
How did Clients FASD affect his behaviorduring the instant
offense?
A PRIORI:Impulsive, illogical offense behaviors that
dont make sense.
What To Do if Someone withFASD Gets In Trouble with the
Law:
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8The Attorney
Finding an attorney familiar with FASD Several around the
countryOR
Finding an attorney willing to learn about FASD An attorney
familiar with FASD and can
recommend colleagues in other parts of the country
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9http://www.fasdcenter.samhsa.gov/
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10
Wallet Cards
Juneau Police were informed aboutthe cards and were
receptive
If No Formal Diagnosis Get a formal assessment that involves at
leastNeuropsychological Assessment that is
focused on tests sensitive to impacts of prenatalalcohol
exposure.
Medical Assessment that measures physicalfeatures, takes into
account other possible etiologiesand renders formal medical
diagnosis
Historical/Psychosocial Assessment thatassesses behavior history
consistent with FASD andestablishes the NEXUS between the diagnosis
andthe criminal behaviors
www.FASDExperts.com
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If There Has Been a Diagnosis
Get all the records about the diagnosis If no recent
neuropsychological evaluation
Consider updated testing Find a psychologist who can address the
Nexus.
The Important Message:
FASD doesnt excuse Clients behavior, it explainshis/her behavior
in the context of his brain
damage.
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However FASD should be considered as a mitigating factor
Alternatives to incarcerations should be considered
MH or Drug Courts Court ordered MH/Substance treatment programs
Half way houses Group homes Electronic monitoring DDA involvement
24/7 line of sight monitoring
Resources NOFAS www.nofas.org/criminal-justice American Bar
Association www.americanbar.org (search
FASD) MOFAS www.mofas.org UW FADU Legal Issues Resources -
http://depts.washington.edu/fadu/resources/fas-and-the-law
Forensic Diagnosis
FASDExperts (team I work with) www.FASDExperts.com Dr. Ira
Chasnoff (IL)- http://www.childrensresearchtriangle.org/ira-j-
chasnoff-president/ Dr. George Woods (CA) -
[email protected]
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Resources Referrals to attorneys in your area
Contact Kay Kelly [email protected] at UWsFetal Alcohol and
Drug Unit
Contact members of diagnostic teams to get namesof attorneys
that they have worked with on priorcases
Contact attorneys who themselves are experts onFASD for
recommendations William Edwards (CA) [email protected]
Karen Steele (OR) [email protected]
Check NOFAS.org resources page for providers inyour state