Understanding Criminal Behaviour in Fetal Alcohol Spectrum Disorders

199 Pages·2014·1.38 MB·English

by  Katelyn Harker

Understanding Criminal Behaviour in Fetal Alcohol Spectrum Disorders: Neurocognitive
Deficits and Social Factors

A Thesis Submitted to the College of
Graduate Studies and Research
in Partial Fulfillment of the Requirements
for the Degree of Doctor of Philosophy
in the Department of Psychology

University of Saskatchewan

Saskatoon, Saskatchewan

By
Katelyn A. Harker

Copyright Katelyn A. Harker, March, 2014. All rights reserved.
PERMISSION TO USE

In presenting this thesis/dissertation in partial fulfillment of the requirements for a Postgraduate
degree from the University of Saskatchewan, I agree that the Libraries of this University may
make it freely available for inspection. I further agree that permission for copying of this
thesis/dissertation in any manner, in whole or in part, for scholarly purposes may be granted by
the professor or professors who supervised my thesis/dissertation work or, in their absence, by
the Head of the Department or the Dean of the College in which my thesis work was done. It is
understood that any copying or publication or use of this thesis/dissertation or parts thereof for

financial gain shall not be allowed without my written permission. It is also understood that due

recognition shall be given to me and to the University of Saskatchewan in any scholarly use
which may be made of any material in my thesis/dissertation.

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ABSTRACT

Individuals with fetal alcohol spectrum disorder (FASD) are more likely to be involved in the
criminal justice system than individuals without FASD. Research shows that individuals with
FASD are unable to learn from standard methods of punishment, such as incarceration. The
objective of this research was to determine how young offenders with an FASD diagnosis differ
from young offenders without a diagnosis in order to inform sentencing and treatment options for
FASD offenders. Using a pre-existing database of court-referred young offenders, the data of
197 youths were compared. Eighty-six young offenders in this sample were diagnosed with
FASD. Information was available on a number of neurocognitive variables, such as cognition,
memory, attention, achievement, and language, as well as social data, such as substance use,

assistance in school, home stability, and criminal charges. Profile analysis was run on the
neurocognitive data for young offenders with and without FASD. The social data were analyzed
using a combination of correlation and one-way ANOVAs. Young offenders with FASD differed
from young offenders without FASD on severity of impairment on the neurocognitive measures,
with individuals with FASD scoring lower that the comparison group. There was no difference in
the profile of neurocognitive deficiency between the groups, suggesting that young offenders
with FASD have the same profile of impairments as other young offenders but to a more severe
degree. There were not found to be any strong or moderate associations between the types of
charges accrued and any neurocognitive measure, indicating that deficits likely do not directly
lead to offending. Home stability between birth and age seven was particularly important as a
protective factor for future crime, and having ever been in foster care was strongly related to
number of charges. Current substance use of all kinds was associated with a higher number of
charges. Youth with FASD are likely more at risk for criminal behaviour due to lower overall
neurocognitive functioning, poor environmental stability, and an interaction of the two. Programs
for people with FASD will be required throughout the life span and current correctional
programs have yet to be developed for offenders with FASD.

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ACKNOWLEDGEMENTS

I would like to thank my primary supervisor, Dr. Jo Nanson, most sincerely for her
encouragement, support, and dedication to this project. Her knowledge and guidance were
integral to the completion of this document and her investment in both this study and my overall
development as a psychologist could not be appreciated more. In addition, I am thankful for
access to her research database of young offenders, which made this research possible.
I am also incredibly grateful for the thoughtful and beneficial direction of my other
committee members, Dr. Steve Wormith, Dr. Megan O’Connell, Dr. Mark Olver, and Glen

Luther; a particular thanks to Dr. O’Connell for her additional assistance with statistical analyses

and formatting. My committee was instrumental in my success. I would like to thank my external
examiner, Dr. Carmen Rasmussen, for her observant and challenging questions.
I would like to extend my gratitude to Dr. Pat Blakely for her role in diagnosing the youth
referred for an FASD assessment. As well, many thanks to Rand Harker for his willingness to
proofread drafts and provide feedback.

Finally, I would like to thank the participants of this study for permitting the inclusion of
their information for research purposes. I understand and appreciate their vulnerable position in
this process and am grateful they were open to sharing their hardships, deficits, and strengths.

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DEDICATION

To my parents, Rand and Cathy Harker, who always instilled in me that my abilities were
only limited by my imagination and have provided endless support and encouragement in my
pursuit of this dream. And for enduring numerous rants about the ineffectiveness of “tough on
crime” policy with great humour. I would not be who I am without you, nor could I have
accomplished all I have.
To my sister, Jessica Harker, who believes in me more than I believe in myself and shows
her grace and kindness with every thoughtful gesture. I love and am so proud of you.
To Neil, A.K.A. The Master of Patience, A.K.A. my rock. You provided perspective and
joy and laughter to carry me through the hard periods and you delighted in my successes. We did
it. Thank you for everything you do.

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TABLE OF CONTENTS
PERMISSION TO USE ………………………………………………………………………….. i
ABSTRACT ...…………………………………………………………………………………... ii
ACKNOWLEDGEMENTS …………………………………………………………………….. iii
DEDICATION ………………………………………………………………………………….. iv
TABLE OF CONTENTS ………………………………………………………………………... v
LIST OF TABLES ……………………………………………………………………………… ix
LIST OF FIGURES ……………………………………………………………………………... x
LIST OF ABBREVIATIONS ……………………………………………………………………xi
1. INTRODUCTION…………………………………………………………………………….. 1
1.1. Diagnostic Considerations ………………………………………………………….. 1
1.1.1. FASD diagnostic criteria ………………………………………………….. 6

1.1.2. Fetal Alcohol Spectrum Disorder: Canadian Guidelines for Diagnosis .…. 9
1.1.3. FASD and CNS dysfunction …………………………………………….. 11
1.1.3.1. Neurological signs …………………………………………….. 11
1.1.3.2. Brain structure ………………………………………………… 13
1.1.3.3. Cognition ……………………………………………………… 15
1.1.3.4. Communication: receptive and expressive ……………………. 17
1.1.3.5. Academic achievement ………….…………………………….. 18
1.1.3.6. Memory ………………………………………………………... 19
1.1.3.7. Executive functioning and abstract reasoning ………………… 22
1.1.3.8. Attention ………………………………………………………. 25
1.1.3.9. Adaptive behaviour, social skills, and social communication … 26
1.1.4. CNS dysfunction defined ….…………………………………………….. 30
1.1.5. The low exposure consideration…………………………………………. 31
1.2. FASD and the Legal System …….………………………………………………… 33
1.2.1. The youth justice system ………………………………………………… 40
1.2.2. Executive function and offending ……………………………………….. 41
1.2.3. Home stability and delinquency ………………………………………..... 42
1.2.4. Educational opportunities and delinquency ……………………………... 45
1.2.5. Substance use and delinquency ………………………………………….. 47
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1.3. Summary …………………………………………………………………………... 49
2. HYPOTHESES…..………………………………………………………………………….. 52
2.1. Hypothesis 1: Neurocognitive Profile..…………………………………………….. 52
2.1.1. Hypothesis 1a ………………………………………………..…………... 52
2.1.2. Hypothesis 1b ……………………………………………………………. 52
2.2. Hypothesis 2: Neurocognitive Scores and Offending..…………………………….. 52
2.2.1. Hypothesis 2a ……………………………………………………………. 52
2.2.2. Hypothesis 2b ……………………………………………………………. 52
2.2.3. Hypothesis 2c ……………………………………………………………. 52
2.2.4. Hypothesis 2d ……………………………………………………………. 52

2.3. Hypothesis 3: Home Stability and Offending..…………………………………….. 53

2.3.1. Hypothesis 3a ……………………………………………………………. 53
2.3.1.1. Hypothesis 3.a.1………………………………………………... 53
2.3.1.2. Hypothesis 3.a.2………………………………………………... 53
2.3.1.3. Hypothesis 3.a.3………………………………………………... 53
2.3.2. Hypothesis 3b ……………………………………………………………. 53

2.4. Hypothesis 4: Educational Assistance and Offending.…………………………….. 53
2.4.1. Hypothesis 4a ……………………………………………………………. 53
2.4.2. Hypothesis 4b ……………………………………………………………. 53
2.5. Hypothesis 5: Substance Use and Offending...…………………………………….. 54
2.5.1. Hypothesis 5a ……………………………………………………………. 54
2.5.2. Hypothesis 5b ……………………………………………………………. 54
2.5.3. Hypothesis 5c ……………………………………………………………. 54
2.5.4. Hypothesis 5d ……………………………………………………………. 54
3. METHOD……………………………………………………………………………………. 55
3.1. Participants ………………………………………………………………………… 55
3.2. Materials .………………………………………………………………………….. 56
3.2.1. Achievement …………………………………………………………….. 58
3.2.2. Cognition ………………………………………………………………... 60
3.2.3. Executive functioning …………………………………………………… 62
3.2.4. Attention ………………………………………………………………… 65
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3.2.5. Memory ………………………………………………………………….. 70
3.2.6. Language ………………………………………………………………… 75
3.2.7. Psychosocial data ………………………………………………………... 79
3.3. Procedure and Analysis …………………….…………………………..………….. 79
4. RESULTS …………………………………………………………………………………… 82
4.1. Missing data ……………………………………………………………………….. 82
4.2. Outliers …………………………………………………………………………….. 83
4.3. Demographic information …………………………………………………………. 83
4.4. Hypothesis 1: Neurocognitive Profile..…………………………………………….. 84
4.4.1. Post hoc analyses ………………………………………………………... 91

4.5. Hypothesis 2: Neurocognitive Scores and Offending……………………………….96

4.5.1. Hypothesis 2a ..……………………………………………………………96
4.5.2. Hypothesis 2b …………………………………………………………... 99
4.5.2.1. Post-hoc analyses 2b …………………………………………. 101
4.5.3. Hypothesis 2c …………………………………………………………... 103
4.5.4. Hypothesis 2d …………………………………………………………... 103

4.5.5. Post-hoc analyses ………………………………………………………. 104
4.6. Hypothesis 3: Home Stability and Offending..………………………………….... 106
4.6.1. Hypothesis 3a …………………………………………………………... 108
4.6.1.1. Hypothesis 3.a.1………………………………………………. 108
4.6.1.2. Hypothesis 3.a.2………………………………………………. 109
4.6.1.3. Hypothesis 3.a.3………………………………………………. 109
4.6.2. Hypothesis 3b …………………………………………………………... 110
4.7. Hypothesis 4: Educational Assistance and Offending.…………………………… 111
4.7.1. Hypothesis 4a …………………………………………………………... 111
4.7.2. Hypothesis 4b …………………………………………………………... 112
4.8. Hypothesis 5: Substance Use and Offending...…………………………………… 113
4.8.1. Hypothesis 5a …………………………………………………………... 113
4.8.2. Hypothesis 5b …………………………………………………………... 114
4.8.3. Hypothesis 5c …………………………………………………………... 115
4.8.4. Hypothesis 5d …………………………………………………………... 115
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5. DISCUSSION ……………………………………………………………………………… 117
5.1. Recommendations………………………………………………………………… 139
5.2. Limitations ……………………………………………………………………….. 144
5.3. Future Research ………………………………………………………………….. 147
6. CONCLUSION …………………………………………………………………………….. 151
7. REFERENCES …………………………………………………………………………….. 155

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LIST OF TABLES

TABLE 1: Review of Findings Regarding the Relationship Between the D-KEFS and the
WCST…………………………………………………………………………………………….66
TABLE 2: Participant Demographic Information ……………………………………………... 84
TABLE 3: Participant Demographic Information by Diagnosis ………………………………. 85
TABLE 4: Measures and Means for the Total Sample ………………………………………… 86
TABLE 5: Domain Mean Z Scores by Diagnosis ……………………………………………... 88
TABLE 6: Domain Mean Standard Scores by Diagnosis ……………………………………… 90
TABLE 7: Domain Mean Z Score by Subdiagnosis …………………………………………… 93
TABLE 8: Domain Mean Z Score, Participants Who Completed the WCST…………………... 95
TABLE 9: Domain Mean Z Score, Participants Who Discontinued the WCST……………...… 98

TABLE 10: Correlation Between Memory Scores and Systemic Charges …………………... 101
TABLE 11: Correlation Between Executive Functioning Scores and Sexual Charges ………. 102
TABLE 12: Correlation Between Executive Functioning Scores and Violent Charges ……... 104
TABLE 13: Difference in Correlation Between Type of Crime and Neurological Impairment by
Diagnostic Group ………………………………………………………………… 105
TABLE 14: Correlation Between Neurocognitive Scores and Charges Accumulated ……….. 107
TABLE 15: Difference in Correlation Between Home Stability and Charges Accrued by
Diagnostic Group ………………………………………………………………... 111
TABLE 16: Difference in Correlation Between Substance Use and Charges Accrued by
Diagnostic Group ………………………………………………………………... 116

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