Therapeutic Recommendations in the Youth Justice System Cohort Diagnosed with Foetal Alcohol Spectrum Disorder

Youth Justice ◽  
2021 ◽  
pp. 147322542110361
Author(s):  
Natasha K. Russell ◽  
Kuen Yee Tan ◽  
Carmela F. Pestell ◽  
Sophia Connor ◽  
James P. Fitzpatrick
Keyword(s):  
Justice System ◽  
Community Integration ◽  
Spectrum Disorder ◽  
Clinical Population ◽  
Diagnostic Process ◽  
Future Research ◽  
Youth Justice ◽  
Clinical Recommendations ◽  
Therapeutic Recommendations ◽  
Education Support

Patches Paediatrics is a specialised private multidisciplinary service in Western Australia (WA), offering a range of developmental diagnostic assessments such as foetal alcohol spectrum disorder (FASD). Many FASD assessments occur in children and youth who are engaged with the justice system in WA and the Northern Territory (NT). There are currently no studies outlining the types of clinical recommendations and management strategies made or implemented by clinicians for this clinical population within Australia. This study outlines therapeutic recommendations made as part of the youth justice FASD diagnostic process within Patches Paediatrics to ultimately refine recommendations to inform therapeutic strategies. This was a retrospective cross-sectional descriptive study of those aged 10 years to 17 years 11 months (N = 64) who were diagnosed with FASD within Patches Paediatrics; and referred from the youth justice system in WA and the NT between January 2017 and February 2019. Information on FASD recommendations was gathered by reviewing participants’ source documents, such as FASD diagnostic reports. ‘FASD recommendations’ categories were divided into subdomains: medical, mental health, developmental, lifestyle, future goals and others. In the various categories of recommendations, the most prominent were referral for National Disability Insurance Scheme (NDIS) funding (75%) followed by education support (67.2%), occupational therapy (56.3%), and drug and alcohol services (45.3%). Significant correlations between impaired neurocognitive domains and recommendations were also observed. Similarly, there were significant correlations between comorbidities and recommendations. Our study highlighted gaps in recommendations for those with comorbid attention-deficit/hyperactivity disorder (ADHD), rural communities and access to NDIS, therapeutic rehabilitation programmes as well as community work programmes. Other gaps included making adequate recommendations for speech/language therapy, education support, life skills advice and staff/clinician education. This study was the first to describe therapeutic recommendations for the youth cohort assessed by Patches Paediatrics in WA and the NT. It also showed significant correlations between the neurocognitive/comorbidity profile and clinical recommendations. This highlights areas within the recommendations that can be individualised as well as ways to improve community integration. A discussion of limitations and suggestions for future research is also provided.

Net-Widening and the Diversion of Young People From Court: A Longitudinal Analysis With Implications for Restorative Justice

2010 ◽  
Vol 43 (1) ◽  
pp. 112-129 ◽  
Author(s):  
Jeremy Prichard
Keyword(s):  
Criminal Justice ◽  
Young People ◽  
Criminal Justice System ◽  
Restorative Justice ◽  
Justice System ◽  
Future Research ◽  
Youth Justice ◽  
System A ◽  
Police Records ◽  
Net Widening

Internationally, many youth justice systems aim to divert young people from court through informal mechanisms, such as police cautions and restorative conferences. Among other things, diversion avoids the potentially criminogenic effects of formal contact with the criminal justice system. However, in some instances, the sum of court appearances and diversionary procedures indicates an overall increase in the numbers of young people having contact (formal or informal) with the criminal justice system — a phenomenon known as net-widening. This article summarises previous debates about the risks of net-widening. It then presents results from analysis of over 50,000 police records pertaining to young people's contact with the Tasmanian criminal justice system between 1991 and 2002. Across that decade, court appearances markedly reduced, while a corresponding increase in diversions was recorded. There was no evidence of net-widening. However, there was a significant increase in detention orders. Implications for policy and future research are considered.

The Youth Justice System

2020 ◽  
Author(s):  
Nessa Lynch
Keyword(s):  
Justice System ◽  
Youth Justice

No description supplied

Oppositional Defiant Disorder and Related Disruptive Behaviors in Autism Spectrum Disorder

2020 ◽  
pp. 136-158
Author(s):  
Connor M. Kerns ◽  
Chandler Puhy ◽  
Chelsea M. Day ◽  
Steven J. Berkowitz
Keyword(s):  
Autism Spectrum Disorder ◽  
Oppositional Defiant Disorder ◽  
Challenging Behaviors ◽  
Disruptive Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Oppositional Defiant ◽  
Assessment And Treatment ◽  
Defiant Behavior

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition characterizes oppositional defiant disorder (ODD) as reflecting pervasive patterns of irritable mood, defiant behavior, and/or vindictiveness. Youth with autism spectrum disorder (ASD) exhibit high rates of disruptive behaviors commonly associated with ODD, such as noncompliance, irritability, temper tantrums, and mood dysregulation. This chapter reviews the presentation of ODD in individuals with ASD, including current prevalence estimates, proposed etiology, validated assessment methods, and emerging best practices designed to treat challenging behaviors. Although there is a robust literature describing assessment and treatment procedures for disruptive behaviors in individuals with ASD, conceptualizing these hallmark behaviors within the framework of ODD is relatively novel and not without controversy. Discussion thus includes challenges around the applicability of the diagnostic criteria in this population and future research directions that may provide clarity on this issue.

scholarly journals Equality in the Youth Court: Meaning, Perceptions and Implications of the Principle of Equality in Youth Justice

Youth Justice ◽  
2021 ◽  
pp. 147322542110134
Author(s):  
Yannick van den Brink
Keyword(s):  
Conceptual Model ◽  
Ethnic Minorities ◽  
Fundamental Principle ◽  
Future Research ◽  
Youth Justice ◽  
Specific Context ◽  
Youth Court ◽  
Low Socioeconomic ◽  
Policy Practice ◽  
Theoretical Perspectives

Equality is a fundamental principle, also in youth justice. Nevertheless, children from ethnic minorities, children with disabilities and children from low socioeconomic backgrounds are vastly overrepresented in youth detention populations across the globe. This article combines interdisciplinary theoretical perspectives and empirical findings from interviews with practitioners from two English youth courts to explore the meaning, perceptions and implications of the principle of equality in the specific context of the youth court. Ultimately, this article presents the first contours of a conceptual model of equality in the youth court, which aims to inform policy, practice and future research.

Exploring Growth in Expressive Communication of Infants and Toddlers With Autism Spectrum Disorder

2021 ◽  
pp. 105381512199557
Author(s):  
Jay Buzhardt ◽  
Anna Wallisch ◽  
Dwight Irvin ◽  
Brian Boyd ◽  
Brenda Salley ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Progress Monitoring ◽  
Autism Spectrum ◽  
Growth Patterns ◽  
Spectrum Disorder ◽  
Future Research ◽  
Infants And Toddlers ◽  
Early Communication ◽  
Children With Asd ◽  
Language Growth

One of the earliest indicators of autism spectrum disorder (ASD) is delay in language and social communication. Despite consensus on the benefits of earlier diagnosis and intervention, our understanding of the language growth of children with ASD during the first years of life remains limited. Therefore, this study compared communication growth patterns of infants and toddlers with ASD to growth benchmarks of a standardized language assessment. We conducted a retrospective analysis of growth on the Early Communication Indicator (ECI) of 23 infants and toddlers who received an ASD diagnosis in the future. At 42 months of age, children with ASD had significantly lower rates of gestures, single words, and multiple words, but significantly higher rates of nonword vocalizations. Children with ASD had significantly slower growth of single and multiple words, but their rate of vocalization growth was significantly greater than benchmark. Although more research is needed with larger samples, because the ECI was designed for practitioners to monitor children’s response to intervention over time, these findings show promise for the ECI’s use as a progress monitoring measure for young children with ASD. Limitations and the need for future research are discussed.

scholarly journals Diagnosis despite clinical ambiguity: physicians’ perspectives on the rise in Autism Spectrum disorder incidence

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Davidovitch ◽  
Dorit Shmueli ◽  
Ran Shmuel Rotem ◽  
Aviva Mimouni Bloch
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Mental Illnesses ◽  
Spectrum Disorder ◽  
Medical Community ◽  
Categorical Variables ◽  
Diagnostic Process ◽  
Child Neurology ◽  
Chi Square ◽  
Child Psychiatrists

Abstract Background To provide insight on physicians’ perspectives concerning recent changes in the incidence and diagnostic process of Autism Spectrum Disorder (ASD) compared to other mental and neurodevelopmental disorders. Method A questionnaire was sent to 191 specialists in child neurology and child development, and 200 child psychiatrists in Israel. Information was collected on professional background, as well as on physicians’ opinions concerning the accuracy and rate of ASD diagnosis compared to that of cerebral palsy (CP), mental illness, and Attention Deficit Hyperactivity Disorder (ADHD). For each closed-ended question, a global chi-square test for categorical variables was performed. Results 115 (60.2%) of specialists in child neurology and development, and 59 (29.5%) of child psychiatrists responded. Most physicians (67.2%) indicated that there was a moderate/significant increase in the incidence of ASD, which was higher than similar responses provided for CP (2.9%, p < 0.01) and mental illnesses (14.4%, p < 0.01), and similar to responses provided for ADHD (70.1%, p = 0.56). 52.8% of physicians believed that in more than 10% of clinical assessments, an ASD diagnosis was given despite an inconclusive evaluation (CP: 8.6%, p < 0.01; mental illnesses: 25.8%, p = 0.03; ADHD: 68.4%, p = 0.03). Conclusion The clinicians perceive both ASD and ADHD as over-diagnosed disorders. The shared symptomology between ASD and other disorders, coupled with heightened awareness and public de-stigmatization of ASD and with the availability of ASD-specific services that are not accessible to children diagnosed with other conditions, might lead clinicians to over-diagnose ASD. It is advisable to adopt an approach in which eligibility for treatments is conditional on function, rather than solely on a diagnosis. The medical community should strive for accurate diagnoses and a continuous review of diagnostic criteria.

scholarly journals Application of electronic trigger tools to identify targets for improving diagnostic safety

2018 ◽  
Vol 28 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Daniel R Murphy ◽  
Ashley ND Meyer ◽  
Dean F Sittig ◽  
Derek W Meeks ◽  
Eric J Thomas ◽  
...  
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
High Risk ◽  
Health Systems ◽  
Language Processing ◽  
Diagnostic Errors ◽  
Diagnostic Process ◽  
Future Research ◽  
Implementation Challenges ◽  
Preventable Harm

Progress in reducing diagnostic errors remains slow partly due to poorly defined methods to identify errors, high-risk situations, and adverse events. Electronic trigger (e-trigger) tools, which mine vast amounts of patient data to identify signals indicative of a likely error or adverse event, offer a promising method to efficiently identify errors. The increasing amounts of longitudinal electronic data and maturing data warehousing techniques and infrastructure offer an unprecedented opportunity to implement new types of e-trigger tools that use algorithms to identify risks and events related to the diagnostic process. We present a knowledge discovery framework, the Safer Dx Trigger Tools Framework, that enables health systems to develop and implement e-trigger tools to identify and measure diagnostic errors using comprehensive electronic health record (EHR) data. Safer Dx e-trigger tools detect potential diagnostic events, allowing health systems to monitor event rates, study contributory factors and identify targets for improving diagnostic safety. In addition to promoting organisational learning, some e-triggers can monitor data prospectively and help identify patients at high-risk for a future adverse event, enabling clinicians, patients or safety personnel to take preventive actions proactively. Successful application of electronic algorithms requires health systems to invest in clinical informaticists, information technology professionals, patient safety professionals and clinicians, all of who work closely together to overcome development and implementation challenges. We outline key future research, including advances in natural language processing and machine learning, needed to improve effectiveness of e-triggers. Integrating diagnostic safety e-triggers in institutional patient safety strategies can accelerate progress in reducing preventable harm from diagnostic errors.

scholarly journals Parental evaluation of a revised autism spectrum disorder diagnostic process for children under 36 months of age

2021 ◽  
Author(s):  
Jean-François Lemay ◽  
Shauna Langenberger ◽  
Scott McLeod
Keyword(s):  
Autism Spectrum Disorder ◽  
Early Intervention ◽  
Parent Education ◽  
Positive Impact ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
High Level

Abstract Background The Alberta Children’s Hospital-Autism Spectrum Disorder Diagnostic Clinic (ACH-ASDC) was restructured due to long wait times and unsustainable clinic workflow. Major changes included the initiation of pre- and post-ASD parent education sessions and distinct ASD screening appointments before the ASD diagnostic appointment. Methods We conducted a parental program evaluation in summer 2018 of the ACH-ASDC. We used a cross-sectional survey to evaluate key outcomes including parental satisfaction, and the percentage of families obtaining access to government supports and early intervention programs. Results For the 101 eligible patients diagnosed with ASD under 36 months of age 70 (69.3%) parents agreed to participate. The mean diagnostic age of the children diagnosed with ASD was 30.6 months (SD=4.1 months). There were no statistically significant age differences between biological sexes. Ninety-three per cent of parents felt that ASD educational sessions were useful, and 92% of parents were satisfied to very satisfied with the overall ASD diagnostic process. Ninety per cent of parents had access to at least one of the key resources available for ASD early intervention in our province following diagnosis. Parents reported a positive impact on intervention provided to their child in the areas of communication, social interaction, and behaviour. Conclusion Parents of children diagnosed with ASD expressed a high level of satisfaction with the restructured ACH-ASDC process. Implementing parent education sessions was well received and met parents’ needs. Parents were able to access intervention services following diagnosis and reported positive impacts for their child. Re-envisioning program approaches to incorporate novel strategies to support families should be encouraged.

scholarly journals A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

2018 ◽  
Vol 8 (1) ◽  
pp. 58-79 ◽  
Author(s):  
Clare S. Allely
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Care ◽  
Psychiatric Hospitals ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Bibliographic Databases ◽  
Future Research ◽  
Content Type ◽  
Secure Psychiatric Care

Purpose Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings. Design/methodology/approach Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Findings A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed. Originality/value To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

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