FASD & the Justice System

Most accused, victims, and witnesses with FASD, show little or no physical evidence of having FASD. “The only symptoms seen in most children and adults with this disorder are behavioural. The wide range of these behavioural symptoms reflects the timing, dose, duration, and types of drug used, as well as the age of the mother, genetics, stress and nutrition.” (Malbin. 2004).

Fetal Alcohol Syndrome (FAS) is the most severe and clinically recognizable form of damage caused by prenatal exposure to alcohol. It was first reported by Lemoine (1968) in France and then independently identified by American researchers, Jones and Smith (1973) who coined the term, “Fetal Alcohol Syndrome”. 

The diagnosis of FAS depends on the presence of:

  • characteristic facial features (evident in the shape of the eyes, mid-face and upper lip),
  • evidence of brain dysfunction, and
  • prenatal and postnatal growth deficiency in the presence of prenatal alcohol exposure (Clarren and Smith, 1978).

Only individuals with full-blown FAS have the visible physical characteristics of the syndrome, though elements such as characteristic facial features may become less evident as the person ages. A variety of other birth defects associated with FAS have been described, including malformations of the brain, heart, kidneys, palate, and musculoskeletal system (Chudley, 2006).

It is important to keep in mind, that FAS is the least common form of FASD. Estimates of the prevalence of FAS vary from 0.5 to 3 per 1,000 live births (Malbin, 2004; Abel E.L., 1995; CDC, 2002).

The majority of people with FASD do not have FAS nor do they have easily identifiable physical characteristics.  “However, even with no visible characteristics, a person with FASD may have brain dysfunction as severe as those with full FAS.  Identification of this larger group with FASD is crucial since they are at greater risk for failure due to the greater invisibility of their disability.” (Malbin, 2004).

If FASD is diagnosed early, interventions may be able to lessen its impact. For example, an effective management plan for ongoing supports can help prevent people with FASD from developing secondary disabilities and can help them lead more productive lives. Research shows that individuals exposed to alcohol before birth, who began participating in developmental programs between birth and age five, have experienced positive results. Employment coaching and supported living can also help the person with FASD find and keep a job and become independent with ongoing supports. Despite their disabilities, people with FASD have many positive qualities and can enjoy very successful lives (PHAC. 2008). Sadly, however, most cases of FASD go undiagnosed.

The primary disabilities of FASD are those that reflect most directly the underlying brain and central nervous system damage caused by prenatal exposure to alcohol. They include abnormal facial features, growth retardation, and impaired mental functioning; poor executive functioning, memory problems, impaired judgment and other effects.

Secondary disabilities are those disabilities that an individual is not born with, and that could be ameliorated through better understanding and appropriate interventions (Streissguth, A. 1996). 

Primary disabilities are linked to behaviours such as:

Impulsive actions

Resistant to change

Poor judgment

Makes same errors again

Does not "learn a lesson"

Poor memory

Talks "a blue streak"

Doesn't understand

Misses spoken words

Money and time problems

Future planning poor

Cannot generalize

Slow thinker

Confabulates stories

Dismaturity 

Secondary disabilities could include but are not limited to:

Poor social relationships

Irritability, fatigue

Resistance

Sexual inappropriateness

Addiction issues

Anger, aggressiveness

Mental health issues

Other psychiatric diagnoses

Recidivism

Self-destructiveness

Suicidal tendencies