Understanding FASD, Employment and Involvement with the Justice System
In this section
What is FASD?
Fetal Alcohol Spectrum Disorder, or FASD, refers to a spectrum of lifelong and adverse effects that occur in an individual who has been exposed to alcohol before birth.
There is no ‘safe’ level of alcohol consumption during pregnancy. To prevent harm from alcohol to their unborn child, women who are pregnant or planning a pregnancy are advised not to drink alcohol.
If consumed during pregnancy, alcohol can readily pass through the placenta and enter the bloodstream of a fetus. Alcohol has the potential to damage the developing brain and to significantly interfere with development.
FASD has significant effects on individual persons, their families and society at large. These effects are particularly significant for health, education, disability and justice systems.
In Australia, FASD is under-recognised and often goes undiagnosed for the entirety of an individual’s life.
Most people with FASD do not display overt, physical symptoms of FASD and therefore, the disorder is often referred to as a ‘hidden disability’.
FASD can impact on an individual’s physiology by:
Impairments in neurodevelopmental domains
There are ten neurodevelopmental domains that are assessed when diagnosing FASD, with at least 3 of those needing to be met:
- Brain structure and neurology
- Motor skills including movement and actions of muscles
- General cognition and intelligence
- Academic achievement
- Memory and learning
- Executive function including impulse control and hyperactivity
- Regulation of mood and affect
- Adaptive behaviour, social skills and social communication
Atypical facial characteristics
Some people with FASD can have distinctive facial features, though most do not. When they occur, those facial features may present as small eye openings, thin upper lip, and smoothed groove between the nose and the upper lip.
Additional medical issues
Alcohol can cause serious physical and medical damage to the fetus. An individual exposed to alcohol in utero can be born with several medical issues including:
- Sensory problems: vision and/or hearing (at times involving permanent hearing loss)
- Chronic ear infections
- Skeletal defects
- Organ damage: brain, heart, liver and kidney
- Stunted growth
- Preterm birth
FASD can result in uneven and confusing maturity development. Strong abilities in some areas such as general intelligence can mask delays or challenges in other areas, such as language.
When interacting with someone with FASD, one is encouraged to think younger, as ‘dysmaturity’ can be a symptom of the condition.
FASD is a spectrum disorder, and the range and severity of cognitive and physical symptoms differs from one person to the next.
FASD is permanent, with impairments remaining apparent throughout the person’s life.
How Common is FASD?
The prevalence of FASD in Australia is unclear due to a lack of accurate research data for the Australian population.
Detection of FASD is also impacted by confusion around standard diagnostic criteria and definitions of FASD. A consistent approach for accurate diagnosis is still under development in Australia and internationally.
What we know about the prevalence of FASD:
FASD affects communities worldwide. According to recent estimates, 7.7 per 1,000 persons suffer from FASD and associated impairments worldwide.
In Australia, state and territory data have indicated that the rate of FASD may be 0.01 to 0.68 per 1,000 births in the general population.
It is considered that Australian estimates are largely underestimated and there will be an increase in diagnoses over time, as health professionals become more familiar with the diagnosis of FASD, and its implications.
FASD in Aboriginal and Torres Strait Islanders
FASD is diagnosed at higher rates in Aboriginal and Torres Strait Islander (Indigenous Australian) children, compared with non-Indigenous children in Australia. Such differences are also found in other Indigenous communities such as those in Canada.
Research suggests that between 2.0 to 9.3 per 1000 Indigenous Australians have FASD. Some estimates are much higher.
Research undertaken in the Fitzroy Valley, a remote Western Australian community, has provided some of the highest estimates of FASD worldwide, showing that persons with any diagnosis along the FASD spectrum may be up to 194.4 per 1000.
The reasons for the higher presence of FASD in Indigenous Australian populations compared to non-Indigenous populations are complex and reflect the interactions of psychosocial, political, historical, cultural and geographical factors.
Past policies such as the dispossession from land, community and culture, and the forceful removal of Indigenous children from their families known as the Stolen Generations, have left a legacy for many Indigenous Australians of disrupted families, disharmonious communities, mental health problems, poverty and disadvantage, marginalization, incarceration and drug and alcohol misuse.
Seeing FASD as an ‘Indigenous issue’ is a harmful misconception and can perpetuate disadvantages endured by Indigenous Australian people.
Research shows that a higher proportion of Indigenous Australian women drink at high-risk levels than non-Indigenous Australian women including during pregnancy.
However, the data also shows that Indigenous Australian women are far more likely to abstain from alcohol compared to non-Indigenous Australian women.
FASD is a universal disorder. Alcohol consumption is ubiquitous in Australia and is common in Australian women of childbearing age regardless of cultural background.
FASD occurs across the community, irrespective of socioeconomic, ethnic or other demographic factors.
FASD and Involvement in the Justice System
People with FASD are more likely to be involved with the justice system.
The risk of contact with the justice system is approximately 30 times greater for a person with FASD compared to a person without FASD.
In a youth Detention Centre in Western Australia, it was found that 36% of detainees had a diagnosis of FASD; the highest rate of FASD documented in a justice setting in the world. Seventy-Five percent of participants were Indigenous Australians.
The over-representation of Indigenous Australians within the justice system is evident in that Indigenous youth are over 20 times more likely to end up in the justice system, than non-Indigenous youth.
The rate of FASD in Indigenous youth in the justice system is currently estimated to be more than double the rate of FASD in non-Indigenous incarcerated youth.
The link between having FASD and being involved with the justice system is complex.
A suite of impairments that are inherent to FASD has been found to increase the person’s vulnerability to engage in unlawful behaviour and therefore engage with the justice system.
These factors can greatly affect the person with FASD at every stage of the justice system, from their initial interactions with Police, giving evidence in Court, during incarceration and adhering to bail conditions on release.
Factors that can pre-dispose a person with FASD to engage in criminal behaviour are:
People with FASD often, but not always, have been exposed to tumultuous living situations such as a dysfunctional family setting, several foster home placements or experiences of negative role modelling in the home, which may predispose them to engaging in criminal behaviour later in life. Poor parental support, guidance and supervision can also result in youth with FASD becoming exposed to negative peer influences and being manipulated into engaging in risky and unlawful behavior. Due to their interpersonal difficulties, people with FASD may also struggle to maintain appropriate social and interpersonal boundaries.
People with FASD can be very chatty and engaging. Others, including police, lawyers and judges may overestimate their level of understanding of complex verbal processes and their competency to stand trial. Combined with other cognitive problems, language difficulties can increase suggestibility and cause the individual to admit to crimes they did not commit. Difficulties comprehending and appreciating information relating to the legal process, including their legal rights, factual knowledge regarding the legal procedure and the nature of the charges can lead to difficulties participating in defence and communicating with legal teams.
People with FASD do not simply choose to forget. They may be truly unable to recall what happened and this can make them particularly suggestible and vulnerable during a police investigation. They may recount a story omitting details, adding inaccurate details or in a non-cohesive manner. To others, this may seem as though the individual is distorting the truth or not complying. They may also poorly recall sentencing conditions or bail conditions and demonstrate poor adherence to them.
People with FASD may struggle in several aspects of their thinking such as:
- linking actions and consequences: cause and effect
- integrating knowledge and previously-learnt information (acceptable and nonacceptable behaviour) and making smart choices that are focused on long-term goals
- grasping abstract concepts such as time, money and math and more importantly, laws and rules (which are abstract) as well as the future consequences of current poor behaviour.
People with FASD may be unable to understand the connection between separate events. For instance, they may understand that they will go to jail for committing an illegal act, but they may not understand that they may also go to jail for being an accomplice to an illegal act.
People with FASD may have difficulties with planning and envisioning the flow on effects of their behavior (an abstract process) and following a series of complex steps. This can lead to poorly considered and impulsive behaviour.
A disrupted educational experience, which is common in people with FASD, is associated with criminal behaviour and recidivism.
FASD often goes unrecognised and undiagnosed until later in life and sometimes for a whole life. As a result, the individual may develop secondary problem behaviours to cope with their daily life difficulties and mental health issues such as depression, trauma and anxiety. Some of those problem behaviours include self-medicating with alcohol and illicit substances, which can lead to contact with the justice system.
In many cases, people with FASD may engage in criminal behaviour as they may not have a full understanding of the long-term impact of their actions.
People with FASD are 30 times more likely to be in contact with the justice system than people without FASD.
Challenges Transitioning out of Prison and into Employment
People with both FASD and a criminal record often seek employment as part of their transition and social reintegration to support a productive and meaningful life.
There are a number of challenges for people with FASD seeking employment.
Many have patterns of behaviour that are difficult to change. They may have challenges with reintegrating themselves into community life following incarceration, particularly if they have been in prison for a long period of time or have continually cycled in and out of prison.
Such barriers exist for non-Indigenous Australians but are compounded for Indigenous Australians with FASD.
These barriers can be considered either tangible or intangible in nature.
Tangible barriers to employment can include:
Housing that is alcohol and drug free with supportive family members that limit the risk of illegal behaviours.
Lack of clean and appropriate clothing for presenting at interviews and for work, including protective equipment such a safety standard footwear.
Challenges getting to a workplace due to lack of drivers license, poor knowledge of public transport or not being able to afford to pay for transportation.
Lack of knowledge of how to manage personal budgets or family finances while living on reduced incomes. Challenges in accessing or opening a bank account. Lack of knowledge of Taxation and Superannuation requirements.
Loss of birth certificate, drivers license or photo identification to enable access to many services, such as bank accounts or housing applications.
Access to, or lack of skills to use a computer to access online job searches, preparing job applications and responding to potential employment opportunities as well as internet banking, housing applications and payment of bills.
Intangible barriers to employment can include:
Workplaces may not have a Human Resource policy around employing someone with a criminal record. Recruitment could then be very subjective. Employers may see people who have FASD as well as past involvement of the justice system, as presenting a double risk to the workplace. Employers may also feel ill-equipped to mitigate this perceived risk.
When released from prison, people often face the pressure of transitioning from prison life, which is highly-structured and routine to suddenly being left to their own devices and making their own decisions as to where to live, how to access healthcare, manage their own appointments, establish and re-establish relationships, manage their own finances, look for employment and possibly manage the demands of parole, all on their own. In addition, people with FASD contend with the challenges that their cognitive problems may present. Poor coordination amongst service providers can also compound these issues.
Upon entering the justice system, some may lose or disconnect from family, friends and support systems. They may often lack positive role models who could lead them away from criminogenic behaviours.
Drug and alcohol use is common in people who have justice system involvement. Challenges with addiction coupled with negative peer influences, result in a return to substance abuse. Alcohol and drug use may inhibit motivation to seek employment or may impact on an employer’s hiring decision.
A person with FASD and who has had involvement with the justice system often has a disjointed or incomplete education resulting in poor literacy and numeracy. In addition, social skills such as working in groups and maintaining social interactions as well as job skills such as task prioritisation, time management and written reporting may be lacking.
Returning to family and social networks who continue to engage in unlawful behaviour can predispose a person with FASD to re-engage with the justice system.
Let’s hear about Adrian’s experience leaving prison
Adrian Edwards: Lived experience mentor and single father
Finding Work To Facilitate Reintegration
Returning to work can be an important goal to support transition and social reintegration following incarceration.
People who are exiting the justice system have talents and skills that are underutilised and are increasingly becoming recognised as a valuable human resource opportunity.
Employing people who are exiting the justice system and who have a disability, makes good business sense for many reasons.
People with disabilities are:
They tend to take fewer days off, request sick leave less often and stay working for the same employer for longer than their colleagues without a disability.
Once they have found the right job, they tend to perform to the same standard as their colleagues.
Recruiting, covering insurance and compensation costs are lower for employers with disability. People with disabilities also tend to have fewer accidents whilst at work relative to other colleagues.
They foster strong and warm relationships with customers, boost staff morale and model loyalty. They also bring a diversity of skills, backgrounds and life experiences to the team enhancing cohesion and teamwork.
They enhance the overall image of the company amongst its staff members, the community and customers and lift the company’s brand.
Let’s hear what a person with disability brings to the workplace
Marina Chalmers: APM: Disability Employment Provider
Benefits of Employment for People with FASD
While employers certainly benefit from including people with disability into the workforce, the latter also receive a range of positive outcomes from undertaking meaningful employment.
Work promotes health and well-being in all people, including those who have a disability.
Disability can often lead to the individual becoming socially isolated. Work promotes meaningful social interaction and social inclusion.
Work can improve independence, reducing the likelihood of poverty and dependence in persons with a disability by providing them with a steady and regular source of income