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INDIVIDUALS WITH FASD AND

THE COURTS: What Social


Workers Need to Know
DAVID DEERE, MSW, MTH, LCSW
WILLIAM J. EDWARDS, JD
DAN DUBOVSKY, MSW
LEIGH TENKKU LEPPER, PHD

Any social worker employed in several characteristics, such as


a court or a criminal justice intellectual disabilities, learning
environment is almost certain to disabilities, and
encounter individuals with fetal neurodevelopmental
alcohol spectrum disorders disabilities. Individuals with an
(FASDs) regularly. This is FASD may have difficulty
especially true of individuals predicting the consequences of
who are repeatedly in mental their actions and controlling
health court, family court, drug impulses; they may be easily
court, delinquent court, criminal persuaded to take improper
court, and other justice settings. actions and find it hard to
One of the most common understand rules. Some persons
disabilities, FASD predisposes with an FASD also do not
sufferers to involvement in all recognize dangerous people
to taking things that don’t Often offenders with
types of courts because and situations. These
belong to them; FASD typically commit
prenatal alcohol exposure challenges make certain
• poor judgment (inability to unreasonable crimes—
alters brain function. individuals with an FASD more
reason and choose right that is, those with a high
likely to be involved in juvenile
from wrong); risk for little reward—engage in
An article in the Journal of the or adult court processes.
• overreacting to minor minor offenses with little to no
American Medical Association
estimates FASDs to affect 2 to 5 incidents due to an over- escalation, repeat the same
Due to the brain damage release of cortisol crime multiple times and are
percent of people in the United caused by prenatal alcohol (explosive behavior always surprised when they get
States, but less than 1 percent
exposure, some individuals episodes); in trouble, and commit crimes
of actual cases have been
diagnosed. (May et al, 2018).
with an FASD exhibit several • problems understanding the with little to no planning. They
social and behavioral consequences of behavior; struggle to follow probation
FASD is an umbrella term used
deficits that can result in • vulnerability to negative and parole and may have
to describe the range of effects
legal concerns: peer pressure and bullies; trouble linking unlawful
that can occur in an individual
• difficulty following verbal behavior to the punishment; this
who was exposed to alcohol
instructions, resulting in means that the unlawful
while in the womb. Diagnoses • impulsivity, which can lead
appearing not to care behavior generally continues
that fall under that umbrella to actions like shoplifting;
about what is being said; despite imprisonment, fines, or
include fetal alcohol syndrome, • social ineptness (trouble
• naïveté and gullibility, other punishments.
partial fetal alcohol syndrome, recognizing and
alcohol-related which can lead to
interpreting verbal and
becoming an accomplice; Many families enter the child
neurodevelopmental disability, nonverbal social cues and
• running from police out of welfare system through the
alcohol-related birth defects, difficulty learning social
fear; and dependency and delinquency
and neurobehavioral disability conventions);
• confessing to crimes that courts due to drug and alcohol
associated with prenatal • no understanding of rules
alcohol exposure. These they didn’t commit because abuse. Studies found that 16.9
and/or the concept of
they are saying what they percent of children in the child
conditions can cause one of ownership, which can lead
think is expected. welfare system have FASDs
(Lange, Shields, Rehm, & effects of prenatal alcohol Such children also show learning difficulties in some or
Popova, 2013) and that youths exposure and better assist deficits in communication, all academic areas as well as
with FASDs are 19 times more individuals with FASD” (ABA, daily living skills, and behavior challenges.
likely to be incarcerated than 2012, para 1). The resolution socialization. These deficits are
youths without FASDs (Popova, discusses why people with an not necessarily attributable to Unless they are diagnosed
Lange, Bekmuradov, Mihic, & FASD should receive services deficits in IQ and can last a (preferably early in life) and
Rehm, 2011). Children from developmental disability lifetime; therefore, it is crucial receive supportive services
entering those systems should organizations. On September that these children have early through special education,
be routinely screened for 19, 2012, a state law went into identification, diagnosis, and individuals with an FASD may
FASDs and evaluated when effect in Alaska that provides intervention, including services not succeed academically and
indicated, even if concerns are for the consideration of an from the state department of may be labeled as lazy, bad,
not easily apparent. FASD as a mitigating factor in developmental disabilities. or unmotivated. Once
criminal case sentencing. diagnosed with an FASD,
In 2012, the American Bar Without an understanding of individuals should be referred
Association passed a resolution Children who are prenatally the physically based cognitive for disability services; however,
advocating for “training to exposed to alcohol are more challenges faced by individuals many disability agencies do not
enhance awareness of FASD likely to experience a with an FASD, behaviors can recognize FASDs, especially in
and its impact on individuals in be misinterpreted as willful people with an IQ higher than
negative early environment,
the child welfare, juvenile misconduct, deliberate 70, a trait commonly found in
justice, and adult criminal
including: disobedience, or malicious those with an FASD. Attorneys
justice systems and the value of intent—when they are often just representing clients with an
collaboration with medical, • developmental delays; the opposite. Individuals with FASD should argue that they
mental health, and disability • abuse and neglect; an FASD can be impulsive. were born with a developmental
experts.” The resolution further • exposure to trauma; They may have information- disability and have permanent
urges “the passage of laws and • disrupted attachment; processing deficits that impair brain damage that often results
adoption of policies at all levels • parental loss; and learning, remembering, and in reduced adaptive behavioral
of government that • frequent hospitalizations, demonstrating skills. Individuals, skills. Without proper services,
acknowledge and treat the suicide attempts, and foster regardless of age, may have many people with an FASD will
care placements.

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end up in the criminal justice • Some other activities that
system or in psychiatric can increase the likelihood
institutions. Social workers with of success in working with
clients who have an FASD persons with an FASD
might also apply for include the following.
Supplemental Security Income, • Advocate for legislation
(SSI) to help clients with their that includes FASD as a
financial needs. developmental disability so
that children and adults will
The socio-emotional and qualify for state services.
communication development • Collaborate with medical,
of those with an FASD is mental health, and
disability experts to
often delayed; therefore,
promote appropriate legal
when questioning and
representation and
giving instructions, it is advocacy for individuals
important to adjust with an FASD.
expectations to match those • Convey to the judicial and
of persons who are much larger community the need
younger. Individuals with an for screening, diagnosis,
FASD often have expressive and treatment for FASDs.
• Educate families on how Dan Dubovsky, MSW, is a private communities. Journal
language skills that are far
best to support their loved consultant on FASDs. For 14 years, he of the American
more developed than their ones with an FASD. was the FASD Specialist for the Medical Association,
receptive language, causing • Become informed on Substance Abuse and Mental Health 319(5), 474-
others to assume they existing resources and Services Administration FASD Center 482.doi:10.1001/
understand more than they advocate for resources to for Excellence. He can be contacted at jama.2017.21896
do. Because of this unusual fill in the gaps within the ddubovksy@verizon.net.
communication profile, it context of judicial ethics. Popova, S., Lange, S.,
may be useful to: • Identify those who have Leigh Tenkku Lepper, PhD, is an Bekmuradov, D., Mihic, A.,
interests and abilities to associate research professor in the & Rehm, J. (2011). Fetal
lead both in the courtroom Master in Public Health program at alcohol spectrum disorders
• use simple, short sentences
and in the community on the University of Missouri. She can be
and clear, literal terms; prevalence estimates in
FASD issues. contacted at tenkkul@missouri.edu.
• keep questions short and correctional systems: A
• Advocate for legislation systemic literature review.
calmly prompt for answers;
like that in Alaska, which REFERENCES Canadian Journal of Public
• provide one instruction
recognizes FASD as a American Bar Association. Health, 102(5), 336-340.
at a time;
mitigating factor for (2012). ABA resolution
• speak slowly and repeat
juveniles and adults during 112B. [Online]. Retrieved RESOURCES
often;
sentencing. from www.americanbar. Alaska Statues Title 12. Code
• avoid legalese and
• Docket for a one-family- org/content/dam/aba/admi of Criminal Procedures §
acronyms;
one-judge model across nistrative/mental_physical_di 12.55.155. Factors in
• use visual aids wherever
case types, which will sability/Resolution_112B.aut aggravation and mitigation
possible;
provide consistency for hcheckdam.pdf.
• confirm personally that
persons with an FASD. Resources for social workers
the individual understands
Lange, S., Shields, K., Rehm, in court settings
key concepts and his or
David Deere, MSW, MTh, LCSW, is J., & Popova, S. (2013).
her rights;
the director of Partners for Inclusive Prevalence of fetal alcohol • Substance Abuse and Mental
• be attentive to the fact that
Communities at the University of spectrum disorders in child
individuals affected by an Health Services Administration
Arkansas. He can be contacted at care settings. Pediatrics,
FASD have a desire to treatment locator Web site:
deere@uark.edu. 132, e980-e995.
please and fit in and may https://findtreatment.
pretend to understand samhsa.gov/
William J. Edwards, JD, is deputy May, P., Chambers, C.,
when they don’t; and public defender III in the Office of Kalbert, W., Zellner, J., • National Organization for
• be attentive to nonverbal the Public Defender, Los Angeles Haruna, F., Buckley, D.,,… Fetal Alcohol Syndrome
cues as well as cues that County Mental Health Court. He Hoyme, H. E. (2018). Web site: www.nofas.org
you, as a social worker, can be contacted at Prevalence of fetal alcohol
may be giving, such as WEdwards@pubdef.lacounty.gov. spectrum disorders in 4 US
frustration.