J Autism Dev Disord (2014) 44:2734–2741
DOI 10.1007/s10803-014-2216-5
ORIGINAL PAPER
Autism Spectrum Disorder (ASD) and Unlawful Behaviour:
Where Do We Go from Here?
Marc Woodbury-Smith • Kalpana Dein
Published online: 26 August 2014
Ó Springer Science+Business Media New York 2014
Abstract There exists now a body of research that
describes case studies of individuals with autism spectrum
disorder (ASD) who have engaged, or are alleged to have
engaged, in a range of illegal behaviours, and that attempts
to estimate the prevalence of ASD at different stages of the
criminal justice process. Taken together, this research does
suggest that some individuals with ASD will come into
contact with the criminal justice system, but many ques-
tions regarding this apparent association remain unan-
swered. The purpose of this review is to propose a direction
for research to address some of these unanswered questions
and potentially inform the development of treatments and
service provision.
Keywords Autism spectrum disorder (ASD)

Adulthood
Outcome
Criminal behaviour
The lives of adults with autism spectrum disorder (ASD)
vary significantly in terms of such things as independence,
employment, mental health and relationships (Howlin
2005). Though in general terms ‘outcome’ has improved for
adults with ASD, there remains much variation, with very
little available evidence to indicate which factors impact
most significantly on determining a ‘good’ versus a ‘poor’
outcome (Farley et al. 2009). The risk of someone having
contact with the criminal justice system as an alleged per-
petrator of a crime is one example of a poor outcome that has
M. Woodbury-Smith (&)
Department of Psychiatry and Behavioural Neurosciences,
McMaster Children’s Hospital, McMaster University, Chedoke
Campus (Evel Building, Room 457), Hamilton, ON, Canada
e-mail: woodbur@mcmaster.ca
K. Dein
Cygnet Hospital, Stevenage, Herts, UK
123
received attention in the scientific literature (extant literature
discussed in Dein and Woodbury-Smith 2010; see also
Archer and Hurley 2013; Allen et al. 2008), and for which
our understanding of the relevant risk factors remains poor.
Fortunately this outcome happens only relatively rarely,
although it does demand special consideration for several
important reasons. First, negotiating the criminal justice
process may be difficult for a person with ASD, compounded
by their relative verbal strengths that may mask their
underlying socio-communicative vulnerabilities (Allen et al.
2008). As such, if not recognized, a person with ASD may be
deemed competent during the interview and court proceed-
ings. In reality, such individuals may be acquiescent or
suggestible during interview (Maras and Bowler 2012a, b),
or have difficulty constructing a narrative of their own
account of events (Maras and Bowler 2012a, b). They may
inadvertently come across as arrogant or disinterested, which
may influence how they are treated by criminal justice sys-
tem (Archer and Hurley 2013), or judged during the court
proceedings.
A second reason to put particular weight on this topic is
that there is no clear pathway of disposition for those who
are convicted (Murrie et al. 2002). According to the nature
of their offence, some may end up in prison, others may be
diverted to forensic secure facilities whilst others may
receive a community disposal. The crucial point here is that
the nature of their disability may not be factored into dis-
position decisions. Moreover, even if deemed vulnerable,
or if it is determined that forensic mental health services
are best placed to meet their needs, it is not entirely clear
that generic mental health services do, in fact, have the
expertise to rehabilitate (or in many cases habilitate) such
individuals. In the UK specialist services are being devel-
oped, but in the absence of a literature-base guiding, for
example, what the risk factors are and what types of service
J Autism Dev Disord (2014) 44:2734–2741
are needed, such services may not be truly ‘evidence
based’.
A third important issue is in relation to criminal
responsibility. For more serious offences, it is only when a
person is deemed criminally responsible for their actions
that they can be convicted, having been deemed to have the
mens rea in connection with the act or omission. In other
words, a person is responsible if they both committed the
offence and had underlying intent. Arguably, some indi-
viduals with ASD, by the nature of their underlying socio-
emotional impairments, may lack the attributes that are
available to ‘moral agents’ making everyday decisions
(Freckelton Sc and List 2009). Without, for example, the
ability to empathize and recognize moral versus conven-
tional transgressions, a person may not have the necessary
cognitive structure to inhibit inappropriate behavior (Blair
2001). The issue of criminal responsibility often arises in
the context of psychopathy (Fine and Kennett 2004), and
whilst the case law in relation to ASD is scanty, it is
expected that this issue will arise from time to time.
The purpose of this review is make suggestions for a
proposed research agenda exploring the interface between
ASD and the criminal justice system. The existing research
base will only be discussed in the simplest terms.
Throughout we use the term ASD in line with DSM-5
(APA 2013) nomenclature, although much of the literature
we quote is focussed on individuals described as having
Asperger Syndrome (AS). As such, if AS truly is a disorder
with its own external validity (a discussion of which is out
of the scope of this current paper), then much of what we
say subsequently may not correctly be true of the wider
ASD population. Throughout we will use the terms ‘illegal
behavior’ and ‘unlawful behavior’ interchangeably to
describe behaviors that are transgressive of the laws in the
jurisdiction in which they occur. Many of the transgres-
sions we are concerned with here are those related to
interpersonal assaultive or otherwise inappropriate physical
contact.
The literature base concerned with criminal behavior
among individuals with ASD represents a not unsubstantial
body of research, which, unfortunately, has collectively
only touched the surface in terms of advancing our
understanding of this topic area. This is not, of course, a
criticism of the researchers, but instead reflects the sig-
nificant difficulties faced when setting out to study this
population. The criminal justice population as a whole is
well known to be mobile, and tracing family in the forensic
population (a necessary prerequisite for ASD diagnosis) is
very challenging. Beyond the forensic population, studying
individuals with ASD more generally is not without its
challenges. Compounding this, (fortunately) only a very
small number of individuals with ASD are ever likely to be
in contact with the criminal justice system under
2735
circumstances of alleged perpetration of criminal activity.
It is unlikely, therefore, that more robust evidence will
emerge any time soon concerning such factors as the true
prevalence of unlawful behavior in this population, or the
likely factors mediating such behavior, whether related to
the core ASD phenotype or otherwise.
What Do We Know?
Asperger first drew our attention to the risk of aggressive
behavior in his case descriptions of four boys with inter-
personal difficulties who lacked social motivation towards
others (Asperger 1944 translated in Frith 1991). Subse-
quently, Wing (1981), in drawing our attention to Asper-
ger’s cases by describing her own series of cases, also
highlighted the risk of problematic behaviours, although
her subject were not necessarily aggressive, but instead
were interpersonally inappropriate. For example, she
describes how one individual ‘‘has no idea of how to
indicate his interest and attract a partner in a socially
acceptable fashion’’ (Wing 1981, p. 116). She later
expounded the topic of problematic behaviors, and
described a number of factors that may mediate the ten-
dency to unlawful or aggressive behavior in this popula-
tion, including the pursuit of a special interest, curiosity
and egocentricity (Wing 1997). The case studies published
since then have all highlighted the ways in which the core
ASD phenotype may mediate unlawful behavior through
several mechanism, including through the pursuit of a
special interest; through naı̈vety or otherwise inappropriate
attempts to engage with others, including on intimate
terms; and through egocentricity and a lack of perspective
taking.
Studies that have since attempted to investigate more
systematically the exact prevalence of unlawful behavior
among individuals with ASD (Hare et al. 1999; Robinson
et al. 2012), or to more fully realize empirically which of
the hypothesized risk factors are indeed associated with
risk, have been fraught with methodological issues. This
notwithstanding, it does seem reasonable to conclude that
the prevalence of unlawful behavior is not particularly high
(Mouridsen et al. 2008), and that among those who do
offend certain aspects of the core clinical and/or underlying
neuropsychological phenotypes may be of relevance in
determining risk. Whilst no one feature of the phenotype
stands out any more strikingly than another, most of the
transgressions observed from a community standpoint
include, for example, inappropriate attempts at forming
relationships (Clare and Woodbury-Smith 2009), threats to
kill or otherwise do harm in the context of perceived
wrongdoings (Woodbury-Smith et al. 2006), and illegal
behaviors that occur in fulfillment of a special interest
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2736
(such as stealing an item needed for the particular interest,
Woodbury-Smith et al. 2010). Of course, more severe
illegal behaviors are also seen among individuals with
ASD (Silva and Haskins 2006; Barry-Walsh and Mullen
2004), the etiology of which may be even more complex,
and include, to a variable degree, the factors known to be
associated with risk in the population at large (Farrington
1995).
The above research findings have trickled down into
clinical practice, as evidenced by the establishment of
specialist treatment facilities in the UK, which recognizes
that the needs of this population from both a habilitative
and rehabilitative point of view are very different from the
more generic forensic mental health population. This not-
withstanding, it is not unusual for individuals with ASD to
be detained in both prisons and generic forensic mental
health services. This reflects a lack of availability of spe-
cialist services; of course, in reality the exact treatment
needs of this population and the true number of individuals
requiring such specialist services is not fully understood.
This makes planning services difficult. In the subsequent
paragraphs we propose a research agenda aimed to fill the
gaps in our knowledge, facilitating, we hope, a more
informed debate regarding the treatment needs and the
commissioning of services to meet these needs.
Where Do We Go from Here?
There is a need both to translate what we do know into
clinical practice, as well to develop a research agenda that
is driven by the clinical issues that need to be addressed.
We believe that there are a number of areas that demand
further research: pathways of care, modifiable risk factors,
criminal justice system, and women offenders with ASD.
Pathways of Care
The recently published document from the UK’s Royal
College of Psychiatrists, entitled Forensic Care Pathways
for Adults with Intellectual Disability Involved with the
Criminal Justice System (Royal College of Psychiatrists
2014) highlighted the core dilemma in the provision of care
for people with intellectual disability who offend. Briefly,
should such individuals be managed in the criminal justice
system, generic forensic mental health services or specialist
services? Of course, the argument involves many complex
issues, and there is a balance to be struck between ensuring
that those who are most vulnerable, or who have complex
mental health needs, are diverted from the criminal justice
system, while recognizing that there will be others for
whom prosecution and the criminal justice process is the
correct course of action. In order to fully realize a process
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J Autism Dev Disord (2014) 44:2734–2741
such as this, expertise is required that intersects all aspects
of the criminal justice and forensic process, perhaps in the
form of a specialist forensic intellectual disability liaison
team. Key to such a model is adequate training of indi-
viduals working in mental health, forensic and criminal
justice services in the recognition of intellectual disability,
as recommended in the Royal College document. More-
over, this model also demands that there are disposal
options, i.e. that adequately resourced inpatient (secure and
otherwise) and community services do exist.
The pathway for a person with ASD involves additional
layers of complexity. The numbers in absolute terms are
likely to be much lower, and hence the justification for
developing specialist treatment services is less clear. On
the other hand, the availability of a specialist triage service,
perhaps drawn from within existing forensic mental health,
intellectual disability or specialist community ASD teams,
does seem a reasonable suggestion. Crucially, such a team
will only function adequately, however, if criminal justice
workers in the Police, the legal profession and prisons are
able to recognize the red flags for ASD. Adequate training
is therefore needed, along with the availability of easy to
use and brief screening questionnaires. Of course, indi-
viduals with ASD, particularly those who are higher
functioning, may be more difficult to identify in the
criminal justice system than those with, say, intellectual
disability. Moreover, such individuals may have no history
of contact with specialist services, with diagnosis only
occurring after their initial contact with the criminal justice
system.
Currently in the UK there exist therapeutic prisons, such
as HMP Grendon that offer treatment to a wide variety of
offenders including those with psychopathic personality
disorders. Consideration should be given to developing
ASD specialist wings within centrally located prisons to
meet the specific needs of men with ASD. Sadly there is
little empirical evidence to guide the design of such ser-
vices. We would therefore suggest a number of research
programs.
Most fundamentally, a cohort study exploring the
pathways through the criminal justice system of people
with ASD who have been charged with a criminal offence
will allow the full realization of the many routes such
individuals take through the criminal justice process as
well as, perhaps, those that are most conducive to a good
outcome. It is anticipated that there will be much variation
in these pathways, generally being somewhat arbitrary but
also dictated by the availability of services. As numbers
identified will, of course, be small, such a study will need
to be multi-center: for example, State-wide in the U.S or
nationwide in the UK. Alternatively, the results of a
number of smaller studies could be combined using a
systematic review or meta-analysis.
J Autism Dev Disord (2014) 44:2734–2741
This research could also look at knowledge of ASD
among criminal justice workers, and health and social care
professionals working in generic community mental health
and forensic mental health services. It is anticipated that
there is likely to be a significant deficit in knowledge of
ASD, particularly among criminal justice workers. Con-
sequently, such individuals may not necessarily be expec-
ted to identify individuals with ASD, necessitating the need
for the development of training programs. Similarly,
existing screening tools may not be appropriate for use in
the criminal justice setting, and, as such, screening tools
may need to be developed and their psychometric proper-
ties determined for the use in this population. Additionally,
undertaking qualitative research would allow us to better
understand the experience of people with ASD who are
subject to different forensic care pathways (Paterson 2008).
Interventions
The treatment and rehabilitation of convicted individuals
will be dictated by which service they are managed within.
Forensic mental health services, both inpatient and com-
munity, tend to focus on the management of any co-mor-
bidity, as well as offering specialist group based and
individual psychotherapeutic interventions aimed at par-
ticular subgroups, such as sex offenders or individuals with
anger management issues. Specialist groups are also
available in prisons. A critical question, however, is whe-
ther individuals with ASD are able to benefit therapeutically
from these services, or, alternatively, whether modification
to therapeutic programs is needed that takes into consider-
ation the socio-communicative vulnerabilities and behav-
ioral and cognitive rigidity that characterize the disorder.
For instance, sex offender treatments using a CBT model
have been found to be effective by a number of studies
(Aytes et al. 2001; Lösel and Schmucker 2005). There is a
need for further research to investigate the effectiveness of
psychological interventions in this population.
Moreover, individuals with ASD may also require
therapeutic approaches that are currently not offered in
such services, such as fundamental social skills develop-
ment, more general ‘habilitation’ as well as treatments that
improve empathy. For example, ‘Mind Reading’, an
interactive guide to emotions, was found to improve sig-
nificantly the ability of adults with Asperger syndrome to
recognize a variety of complex emotions and mental states
over a period of 10–15 weeks (Golan and Baron-Cohen
2006). More recently there have been attempts to formulate
treatments specific to the autistic population within foren-
sic psychiatric services (Kelbrick and Radley 2013;
Langdon et al. 2013). These suggestions require further
evaluation using a larger number of people of normal
intellectual functioning.
2737
Intuition and our own experience working with the
ASD population, as well as our knowledge of available
services, tells us that, beside some notable exceptions
(such as, for example, the specialist service at Broadmoor
Special Hospital in the UK, a maximum secure psychi-
atric hospital, and specialist services in the UK’s private
sector), people with ASD who have offended are not
necessarily receiving a service ‘tuned’ to their collective
and individualized needs. These programs need to be
evaluated for cost-effectiveness and effectiveness in
improving the quality of care, the length of hospital stay,
or recidivism of ASD offenders admitted to specialist
units; in comparison to those admitted to generic secure
services.
Whilst the ‘pathways research’ discussed above would
be able to provide more data on the distribution of treat-
ments being delivered, other research needs to focus on the
evaluation of different treatment approaches on outcomes
(such as quality of life, skill acquisition or rates of recid-
ivism) among individuals with ASD. A controlled trial
design would allow the evaluation of treatment approaches
comparing, for example (1) individuals with and without
ASD in response to a certain therapeutic approach and (2)
individuals with ASD who have received a treatment ver-
sus those who have not. Patients in secure hospitals are
invariably prescribed psychotropic medication. Future
studies could look at the usefulness of psychotropic med-
ication in reducing self-harm, violence and fixation with
dangerous circumscribed interests.
In terms of outcome, a number of studies have looked at
recidivism following discharge from secure psychiatric
care (Coid et al. 2007) and prisons (Langan and Levin
2002). However, no studies to our knowledge have looked
at the factors affecting recidivism amongst ASD offenders
who complete prison sentences, or those who are dis-
charged from secure psychiatric care
Criminal Justice Research
The process of negotiating the criminal justice system is
associated with many hurdles, which are challenging even
to individuals with ASD who are intellectually able. The
challenges are numerous, and summarized in Box 1 below.
High functioning individuals with ASD may not be
immediately recognizable to the Police and allied criminal
justice workers who may be the first with whom they have
contact following arrest, or, of course, if they have been a
victim of crime. If they have not previously been diag-
nosed, or do not make others aware of their diagnosis, the
interview is likely to proceed unmodified. However, a
person with ASD may be vulnerable during the police
interview for a number of reasons, some of which have
been highlighted in Box 1. In particular, any peculiarities
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of speech or behavior, particularly if it carries negative
valence, may be simply interpreted as purposeful or willful.
Similarly, difficulties understanding questions or state-
ments made by others, particularly if they involve the use
of irony, sarcasm or otherwise include a somewhat shrou-
ded meaning, may leave the person with ASD confused or
anxious.
A person with ASD may also be suggestible or acqui-
escent. Acquiescence refers to a tendency to agree to what
is being asked or said because the person thinks that this is
expected of them. Acquiescence is characterized by a wish
to please others by saying what they think the other person
wants to hear, whether or not it is a true account of reality.
This may occur if the interviewee wishes the interview to
be over as quickly as possible, or may be motivated by a
wish simply to be liked by the interviewer. Suggestibility
on the other hand is the term generally employed to
describe the uncritical acceptance of information being
offered or a susceptibility to misleading information, and
may have a more complex origin. For example, the ques-
tioning style of the interviewer (who may use leading or
closed questions) may influence the responses given.
Additionally, poor problem solving capacity when thinking
on one’s feet, characteristic of executive dysfunction, has
been hypothesized to result in a greater tendency to rely on
immediate linguistic and social cues rather than the actual
recall of events.
There is a body of research on the suggestibility and
acquiescence among people with ASD, and, surprisingly,
the research has tended to indicate that such individuals are
no more suggestible than their general population coun-
terparts (Maras and Bowler 2012a, b). On the other hand,
some research does suggest, perhaps unsurprisingly, a
tendency to acquiesce among individuals with ASD (North
et al. 2008). This notwithstanding, it is not entirely clear as
to the impact of different interviewing styles on a person
with ASD’s recall. In particular, it has been shown that
traditional interviewing styles may not be conducive to
active recall among this population. Similarly, some people
with ASD have difficulty remembering the temporal order
Box 1 Vulnerability in the criminal justice system
Police interview
Understanding miranda rights
Communication vulnerability
Social vulnerability
Suggestibility and acquiescence
Court proceedings
Fitness to stand trial
Fitness to plead
Criminal responsibility
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of events, i.e. whilst their recall may be intact, their ability
to remember the temporal sequence of events and the
relationship between different events may be impaired.
Whilst recall has been empirically examined in this pop-
ulation, how well they remember complex sequences of
elements of events has not. Importantly, if there are vul-
nerabilities with the recall of events, then interviewing
strategies may be able to overcome these difficulties and
improve the accuracy of the information obtained. It is also
important to note that much of the research concerning
police interviews of people with ASD has focussed on
individuals as witnesses but not those who have been
accused. Unlike being a witness, in which events are typ-
ically described as by an ‘onlooker’, an accused person
needs to integrate themselves into their recall of events.
This may place demands on cognitive capacities, such as
theory of mind, known to be generally impaired among
individuals with ASD, and their ability to recount events
may be thus compromised.
Criminal Responsibility
The court proceedings present their own challenges in
connection with individuals with ASD as defendants, par-
ticularly in relation to decisions regarding criminal
responsibility. On many occasions decisions in the Court
have involved deliberation as a direct result of a diagnosis
of Asperger’s. Examples are given in Freckelton (2011),
and include, for example, the case of Gary McKinnon,
accused of gaining access to U.S. Military computers, but
whose extradition was blocked on the grounds that his
Asperger Syndrome made him vulnerable if incarcerated in
the U.S. awaiting trial. In other cases (Freckelton 2011),
the introduction of the diagnosis into evidence resulted in
the order for a retrial (Sultan v The Queen, 2008), dis-
charge without conviction (R v Walker, 2008) and a finding
of guilt in connection with alleged indecent assault being
quashed (Parish v DPP, 2007). The introduction of an ASD
diagnosis may be raised in connection with mitigation or
culpability, and it is the latter of these two that will be the
most problematic for the Courts. Fundamentally, whether a
person with ASD does or does not have the capacity to
form criminal intent is a complex issue, which requires
careful consideration along criminological, philosophical
and biological grounds, in the same way that similar
arguments of responsibility has been approached among
individuals with psychopathy. Unlike psychopathy, how-
ever, ASD has nosological status, and, by definition, is
associated with significant socio-emotional impairments,
that may, arguably, affect the ability to form intent. Rec-
ognizing the potential importance of this, we will present
some of the more significant lines of evidence in the
paragraphs that follow.
J Autism Dev Disord (2014) 44:2734–2741
The defence of ‘not guilty by reason of insanity’
(M’Naghten Rules) sometimes arises in connection with a
defendant charged with murder. However, in relation to
ASD, it is of little relevance (except for those who may
have an additional diagnosis of a mental illness). What the
Rules do raise, however, is the important consideration of
the difference between understanding what is legally
‘right’ and ‘wrong’, versus understanding ‘right’ from
‘wrong’ from a moral standpoint. A legal understanding
simply requires that the individual knows what is right and
wrong according to the legislation in the jurisdiction in
which they are living. In contrast, a moral understanding
requires the person to recognize that certain behavior is
wrong because it results in a victim, i.e. not simply con-
trary to law.
In relation to psychopathy, there are many threads of
evidence from biologically based research that suggest that
many categorized with this label do not have moral
capacity (i.e. a moral understanding) to determine ‘right’
from ‘wrong’ (Fine and Kennett 2004). For example, def-
icits in emotion recognition have been recorded, as has an
attenuated autonomic response to the distress cues of others
(Blair 2001). Moreover, individuals with psychopathy fail
to make a moral/conventional distinction, incorrectly
judging moral transgressions (e.g. hitting another) as no
less dependent on authority jurisdiction that conventional
transgressions (e.g. talking in the classroom, Blair 2001).
Of course, there is no reason to believe that psychopathy
and ASD are in any way related. However, individuals with
ASD have their own pattern of vulnerabilities in the
affective-cognitive domain, some of which bring into
question, therefore, their ability to form intent. Most
characteristically, individuals with ASD have difficulty
interpreting verbal and non-verbal cues that carry emo-
tional valence, although the pattern is somewhat different
to that which is described in the psychopathy literature. For
example, people with ASD have difficulties in theory of
mind and various aspects of emotion recognition, but have
been shown to have an intact ability to make a moral/
conventional distinction (Blair 2008).
ASD is, of course, a spectrum, and in this respect there
is much variation in different aspects of the phenotype,
both clinical and cognitive. It is quite possible, therefore,
that different cognitive strengths and vulnerabilities char-
acterize individuals with ASD who have engaged in
unlawful behavior in comparison to their non-offending
counterparts. This needs more detailed exploration, but in
our own research we did indeed find such differences
(Woodbury-Smith et al. 2005). Most strikingly, the ASD
offenders showed a specific impairment in the ability to
identify fearful expressions, whereas their theory of mind
and executive function were relatively preserved. Perhaps,
2739
therefore, decisions regarding culpability need to be based
on cognitive strengths and vulnerabilities rather than
diagnosis, and this does make to case for including detailed
cognitive ‘profiles’ as part of a forensic evaluation.
Women Offenders with ASD
A study within the female population (n = 51) of Broad-
moor Hospital by Crocombe et al. (2006) suggested that
over 10 % met the diagnosis of ASD (n = 6) or ‘‘probable
ASD’’ (n = 5). None of these patients were diagnosed with
the condition prior to their admission. In a large case
control study (Mouridsen et al. 2007), women with per-
vasive developmental disorders were shown to have a
similar risk of being convicted of criminal offences as men.
However men from the comparison sample (without ASD)
had much higher rates of convictions than women. Indeed,
according to Bennett and colleagues studies have consis-
tently shown higher rates of offending for males in com-
parison to females (Bennett et al. 2005). The scant
empirical evidence available in this area suggests that the
needs of women with ASD within secure settings are in
urgent need of scientific exploration. Future research can
look into the prevalence of ASD within this population in
different settings, their pathways into care, factors associ-
ated with criminal offending, the effectiveness of thera-
peutic interventions, their experience of the criminal justice
system, and their recidivism rates.
Research Challenges
There are many challenges with any of the programs of
research proposed above. For example, numbers of indi-
viduals with ASD in the criminal justice system will be
small, and this will impact on the statistical power of any
study undertaken. It goes without saying that sample size
determination should be based on a power calculation, but
recognizing that this may lead to an impractically large
number, collaboration rather than small, underpowered
studies is the required solution. Another challenge is the
robustness of diagnosis, particularly among those who are
not in contact with families or do not wish their families to
be contacted. In our experience this is much less of a
problem among those with ASD than in the forensic and
prison populations more generally, but for those among
whom developmental information is unavailable, we do not
advocate diagnosis based on cross-sectional information.
This runs a high risk of capturing an etiologically and
phenomenologically heterogeneous group of individuals
whose treatment needs and care pathways are likely to be
significantly different.
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Conclusions
In summary, slow progress is being made in terms of our
understanding of the interface between ASD and the
criminal justice system. It does appear that that a number of
individuals with ASD will come into contact with the
criminal justice system as alleged perpetrators of illegal
behavior, and that for some the core characteristics may be
etiologically relevant. Planning treatment programs and
specialist services, however, demands a new collaborative
phase of research that asks more clinically focussed ques-
tions and ultimately facilitates a clear pathway of care for
people with ASD negotiating the criminal justice system.
Acknowledgments MWS acknowledges the support of the Cana-
dian Institute for Health Research (CIHR) and Scottish Rite Chari-
table Foundation during the preparation of this manuscript.
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