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 Services ² Saskatoon Health Region and University of Saskatchewan, Saskatoon, SK

Scope of the Problem Few studies of FASD in Young Offender (YO) populations Conry et al Suggestions that FASD is a significant problem amongst YO in Saskatchewan Presently no universally accepted screen

Why Develop a Screen? Need for early identification Implementation of appropriate interventions Recognition of etiology of behaviors Potential for use of Alternative Measures Consideration for sentencing

FASD Screen Developed by: Garry Prediger, Director, Kilburn Hall Garry 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 youth Youth’s history Youth’s criminal history Observations of the youth Scoring Four point Likert scale Clinical override

RISK SCREENING TOOL FOR FETAL ALCOHOL SPECTRUM DISORDER GENERAL 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 Question 1. History of alcohol use by birth mother during pregnancy No 1 2 X no confirmed suspected confirmed insufficient history history history information

Family History of Youth History of alcohol use by birth mother during pregnancy If mother consumed alcohol, rate of consumption Rate 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 youth History of abusing substances Early onset of attentional problems History of academic problems in school History of behavioral problems at school History of mental health problems History of care/living arrangements

Youth’s Criminal History History of trouble with the Justice System but no convictions History of convictions History of non-violent convictions History of violent convictions Lack of continuity in criminal behavior Failure to abide by court ordered conditions

Observations of the Youth Impulsivity/poor problem solving skills Easily led by others Presents in an immature manner for corresponding age level Lack of continuity in life, tends to live minute to minute

Observations of the Youth Receptive language issues Expressive language issues Unusual responses to sensory stimuli Unusual responses to environmental stimuli

Ratings Low likelihood of FASD Scores less than 13 Moderate likelihood of FASD Scores between 13 and 26 High likelihood of FASD Scores between 26 and 52

Action Moderate likelihood of FASD Referral to a forensic psychologist for a generalized assessment High likelihood of FASD Referral to a physician and neuropsychologist for specific exploration of FASD

Important Considerations Consent from legal guardian Assent from youth Maternal alcohol history Cultural sensitivity Legal implications Linking diagnosis with services

Important Considerations Information gathering: YO Corrections and Public Safety file Interview with youth Interview with family members or collateral sources

Plan Pilot study Closed custody YO facility Discussions with stakeholders Training of raters

Future Plans Expansion to adult offenders Addition of question on history of employment problems Interest from Provincial and Federal Correctional facilities