Navigating complexity to support justice-involved youth with FASD and other neurodevelopmental disabilities: needs and challenges of a regional workforce

Abstract

Background Young people with Fetal Alcohol Spectrum Disorder (FASD) can face significant challenges in their lives, including overrepresentation in the justice system from a young age. Police questioning and court proceedings can be difficult for these young people to navigate. Practice and policy responses are necessary to identify these individuals, provide appropriate support/rehabilitation, and upskill the justice workforce. The aim of this research was to determine the unmet workforce development needs of a regional workforce providing care and support to youth involved with the justice system. Interviews were conducted with 29 participants from 14 organisations to understand the support provided to youth, existence and uptake of referral pathways, and unmet needs. Results Results revealed a workforce that wants to see improvements to outcomes for young people with FASD and other neurodevelopmental disabilities who enter the youth justice system. However more support is required through training, ongoing funding, and assistance to develop FASD informed work practices. Conclusions The workforce supporting youth to navigate the justice system requires practical interventions to achieve best practice so that young people with FASD and other neurodevelopmental disabilities receive the support that they need. Following the interviews a model of care tool was developed and piloted in the sector. The tool includes current pathways through the justice system and provides resources to assist staff in achieving best practice care for young people with FASD and other neurodevelopmental disabilities.

Adverse childhood experiences, associated stressors and comorbidities in children and youth with fetal alcohol spectrum disorder across the justice and child protection settings in Western Australia

“…These studies revealed high rates of early life adversity in individuals with FASD. Additionally, it was also documented that childhood trauma is associated with child protection or justice system involvement, especially among children with FASD [ 11 , 26 ]. However, little to no research has examined the ACEs profiles of those with FASD who have been in contact with these government systems.…”

Toward Effective Identification of FASD

“…11,12,[19][20][21] Identification of FASD via screening has been proposed as an important system-level intervention that may improve early and accurate recognition, and in doing so, improve outcomes and reduce costs associated with misaligned services and later difficulties. 8,10,[22][23][24][25][26] To date, many FASD screening tools and practices have been developed with the overall goal of improving identification of FASD. 24,25,27 This work has been led by both community agencies and researchers, highlighting the development of screening tools and processes as a priority for many stakeholders.…”

Diminished culpability in fetal alcohol spectrum disorders (FASD)

“…Just as executive dysfunction impairs behavior in important adaptive domains throughout life for those with FASD, such dysfunction also can explain the high rate of violence and other adverse outcomes in this population (Khoury et al, 2015;Streissguth et al, 1996Streissguth et al, , 2004. While environmental structure (sometimes referred to in FASD as the "external brain") can compensate for EF deficits to reduce risk of violence (Doctor, 2000;Kapasi et al, 2021;Novick Brown, in press;Novick Brown & Connor, 2014;Pedruzzi et al, 2021), it has been our experience in capital cases that violent acts in people with FASD often reflect a breakdown in baseline executive capacity due to contextual complexity. In other words, those with FASD have the ability to plan, form intentions, and make choices, but the quality of their planning, intentionality, and choosing in fraught social situations is likely to reflect impaired executive control due directly to brain damage.…”