Determining whether someone has a Fetal Alcohol Spectrum Disorder – which in itself is not diagnosable – has proven to be difficult, at best. Fetal Alcohol Spectrum Disorders, or FASDs, is the umbrella term describing the range of adverse effects that can occur in an individual due to prenatal alcohol exposure (PAE). The diagnoses, per the American Academy of Pediatrics, are the following: Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE), Alcohol-Related Neurodevelopmental Disorder (ARND), Fetal Alcohol Syndrome (FAS) and Partial Fetal Alcohol Syndrome (PFAS), and Alcohol-Related Birth Defects (ARBD).
Determining whether someone in corrections has an FASD seems to be even harder than determining the same in the general population…and determining whether someone in corrections in the US has an FASD…whew! Don’t even bother trying! Canada has done a better job with data about FASD overall and data about FASD in corrections, particularly, but the data isn’t exactly robust there, either.
A Canadian study from 2019 indicates that of 80 participants, the majority of whom identified as Indigenous (62 or 77.5%), 17.5% or 14 individuals, were diagnosed with PFAS or ARND, and 11 more individuals were deferred due to a lack of reliable information regarding PAE, which means that nearly one-third of the population (31.2%) that is incarcerated could be diagnosed with an FASD if there were always sufficient PAE information available. Even more disturbing is that only TWO of the individuals had been previously diagnosed with an FASD (McLachlan, K., McNeil, A., Pei, J. et al.).
In “Fetal Alcohol Spectrum Disorder in Confinement Settings: A Review for Correctional Professionals,” authors Jerrod Brown, Mario L. Hesse, Anthony Wartnik, et al, indicate that
“Surprisingly, only a small number of studies have been published on FASD and the correctional system (Bisgard, Fisher, Adubato, & Louis, 2010; Conry & Fast, 2000). Of the studies conducted, two separate samples found that 10% and 24% of inmate participants had been exposed to alcohol prenatally (Conry & Loock, 1999; MacPherson & Chudly, 2007). […] In a recent review of Canadian records, the authors found that individuals with FASD were 19 times more likely to be incarcerated” (Popova, Lange, Bekmuradov, Mihic, & Rehm, 2011).”
But there is some good news, too: the above-named document includes training and an intervention – DEAR – for those in confinement who may or may not be diagnosed with one of the FASDs. DEAR stands for Direct Language, Engage Support System, Accommodate Needs, and Remain Calm, and it was adapted from “Fetal Alcohol Spectrum Disorders and Offender Reentry: A Review for Criminal Justice and Mental Health Professionals” by Jerrod Brown, Sarah Herrick, and Jeffrey Long-McGie. The strategies outlined won’t negatively affect someone who doesn’t have an FASD, but they will help those who do. And, more importantly, not using the strategies with those who do have an “FASD may contribute to secondary disabilities and possibly result in recidivism and even suicidal ideation or self-harm” (Brown, Hesse, Wartnik, et al).
We don’t know what we don’t know, but we can still help. And isn’t that a step in the right direction?
References
American Academy of Pediatrics. Common Fetal Alcohol Spectrum Disorder Definitions. https://www.aap.org/en/patient-care/fetal-alcohol-spectrum-disorders/common-definitions/
Brown, J., Herrick, S., and Long-McGie, J., Fetal Alcohol Spectrum Disorders and Offender Reentry: A Review for Criminal Justice and Mental Health Professionals. https://www.researchgate.net/publication/265293697_Fetal_Alcohol_Spectrum_Disorders_and_Offender_Reentry_A_Review_for_Criminal_Justice_and_Mental_Health_Professionals
Brown, J., Hesse, M., Wartnik, A., et al. Fetal Alcohol Spectrum Disorder in Confinement Settings: A Review for Correctional Professionals. https://rffada.org/wp-content/uploads/2012/09/documents_article-Fetal_Alcohol_Spectrum_Disorder_in_Confinement_Settings.pdf
McLachlan, K., McNeil, A., Pei, J. et al. Prevalence and characteristics of adults with fetal alcohol spectrum disorder in corrections: a Canadian case ascertainment study. BMC Public Health 19, 43 (2019). https://doi.org/10.1186/s12889-018-6292-x
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