Studies Investigating Fetal Alcohol Spectrum Disorders in the Criminal Justice System: A Systematic PRISMA Review

refer to a number of diagnostic categories including: Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neuro Developmental Disorder (ARND) and Alcohol-Related Birth Defects (ARBD) [1].Individuals with FASD often experience a number of childhood adversities such as neglect and abandonment and often become involved in the criminal justice system [2].The diagnostic criteria for FASD include: (a) three specific facial abnormalities (e.g., short palpebral fissures or eye openings, flat philtrum or groove below the nose, and small upper lip circumference); (b) prenatal or postnatal growth deficit (i.e., significant deficit in height and/ or weight); and (c) Central Nervous System (CNS) damage.Structural, neurological, or functional assessments provide three ways in which CNS damage is assessed [3].It has been estimated that individuals affected by FASD are between 19 and 40 times more likely to become involved in the Criminal Justice System [4].This can create a number of unique challenges and difficulties, for criminal justice professionals, given the nature of the disorder [5].Lack of adequate executive functioning e.g.understanding the consequences of inappropriate behaviors, and poor impulse control are often the primary reasons that bring individuals with FASD in contact with the Criminal Justice System [6,7].Such behavioral problems can present as unintentional rule breaking, confabulation and inappropriate sexual behavior.The latter becomes particularly evident during adolescence as the gap between cognitive and chronological age in these subjects increases [2].Furthermore, lack of understanding and appreciation of legal rights poses additional challenges to individuals with FASD.Fetal alcohol spectrum disorders are shown to cause poor linguistic and communication abilities, both from the expressive standpoint and the receptive one.In other words, individuals affected by FASD experience difficulties understanding and forming coherent communication patterns [8].Consequently, such individuals may be more easily coerced into improper interrogation procedures AbstractWithin correctional/confinement settings, screening in order to detect Fetal Alcohol Spectrum Disorders (FASD) or Alcohol-Related Neuro Developmental Disorder (ARND) is frequently lacking.The courts may not recognize FAS/ ARND which leads to inappropriate sentences for this vulnerable group.The primary objective of this systematic PRISMA review was to explore the peer reviewed literature which has investigated FASD in the criminal justice system.The present systematic PRISMA review explores the peer reviewed literature published since 1997 which has investigated using four databases in addition to separate searches conducted on 'Google Scholar' using specific search criteria.Only five studies were identified in this review which investigated the prevalence of FASD in an offender population.Only two studies were identified which investigated the psycho-legal abilities of offenders with FASD.Only three studies were identified which examined prenatal exposure to alcohol as potential risk factor for adverse outcomes.Only one study was identified which investigated the knowledge and attitudes of FASD in criminal justice professionals.Overall, the studies identified in this review highlight the urgent need for the development of screening tool(s) for FASD which have demonstrated validity and for the implementation of routine screening for FASD.In terms of the implication for further research and practice, the studies identified in this review highlight that training needs in relation to FASD in correction systems are substantial and require immediate attention.Important issues in formulating and implementing treatment programs for people with FASD in the corrections systems are also discussed.