ROBIN LA DUE: FAS in the Criminal Justice System
FEN Conference in Madison, Wisconsin March 31, 2000
(notes taken by Teresa Kellerman)
On the plane, Robin was sitting next to a man who was eyeing her manuscript for one of the FAS books, and he commented on it, adding, "But FAS is not caused by wine, right?" Wrong! And she let him know exactly what causes FAS. Then she asked him if he was in the wine business. "Yes - but how did you know?" Lucky guess. He said his wife drank wine throughout her pregnancies with their three children, who were all okay. they talked some more about FAS and Robin explained some of the more subtle but troublesome symptoms, and after awhile the man began to rethink whether his kids might be somewhat affected after all.
Alcohol constricts the vascular system, and increases men's rate of sterility and impotence. One young man with FAS asked what impotence was. Robin explained that the more alcohol goes down, the less something else comes up.
The clients Robin treats are all "nonadjudicated" offenders, with Developmental Disabilities or Mental Illness. The two main legal issues with FAS are stealing and sex offenses. The charges do not always match up with the crime. They usually did something wrong, but usually not what they are charged with. One young man was charged with stealing beer. If a child with FAS is told to "go get a six-pack" and he goes and gets a six-pack, he doesn't realize he is stealing, he is just getting, like he was told. They are very concrete. On FAS Street there is so much concrete you could pave the world.
Another client was charged with 40 counts of auto theft in 30 days. He was used by a gang to hot-wire cars for them. Only he couldn't drive, and he racked up $200,000 worth of damage in one month. Robin suggested to the judge that the boy be given a job with a repossession firm. The judge suggested that Robin might need a vacation.
What are we teaching them by sending them to prison? We are teaching them how to be better criminals. If you live in a "three strikes" state, this works against FAS folks, because they don't learn from their mistakes. "One size fits all" justice does not do the job.
One young lady had full FAS but it was not recognized. She was jailed repeatedly for probation violations. She became pregnant and was incarcerated for most of her pregnancy. Her baby was born without alcohol effects. Most girls with FAS have baby after baby after baby. Both mother and babies are at high risk of being abused. An earlier presentation by a Madison doctor who diagnoses FAS revealed that possibly as many as 90% of women who give birth to babies with FAS have been victims of sexual abuse.
The people in Washington, DC drink twice as much liquor as the national average. Robin believes that those making laws and policies in our country should have mandatory two years of sobriety. And that all educators should have two years of sobriety. And all those in the field of social services as well. We need to be good role models for the persons we expect to stay sober.
Of the 20 clients Robin has had with FAS, 19 of them were sexual offenders and one was an arsonist. Of the sexual offenders, only one was a true sexual predator. The youngest sexually aggressive client was only four years old. Most or our kids are cuddly, affectionate and huggy - cute when they are young, but that is exactly what gets them into trouble when they are older. It's like we change the rules and forget to tell them. We can't reorient their sexuality. But we can provide a safe environment in which they can function. The younger they get into trouble and into the legal system, the better, because it is easier to get appropriate services for them earlier than later.
Instead of a prison sentence, they need therapy - with either working at a job or in school, with support and monitoring. What they need is one-on-one or two-to-one staffed supported living services. The best prevention will provide structure and supervision. The cost of services like this is only half the cost of incarceration. Talk therapy or insight therapy does not work for our kids. Don't send your kid to insight therapy with someone who doesn't have any insight. They need proper medications, and the best medications expert is Karen O'Malley at the Fetal Alcohol Drug Unit in Washington, (206) 543-7155. By the way, only three U.S. universities have a curriculum to teach FAS, and most of our doctors have only been given a one-page article on FAS.
We all know that short term memory is a common problem with FAS. One client was a man with FAS who had a wife and two little children. After an argument with his wife, in a fit of anger, the man drove their car into the canal, jumping out at the last moment. He forgot that his two little children were asleep in the back seat, and now he is charged with double homicide.
The four areas of forensics that Robin deals with are:
* Capacity: Under the age of twelve, a child is assumed t not have capacity, which is the ability to understand right and wrong and to understand the outcome at the time of the act.
* Competency: The ability to understand the charges, and the ability to help, in a reasonable manner, the attorney conduct an adequate defense, and to understand rights and what waving rights means. Some people with FAS think of waving rights in terms of waving hands, that's how concrete they are. If you ask them if they understand what waving their rights means, they will probably say yes, but you need to ask them to repeat back to you in their own words what they think it means.
* Decline: The decision to not try a child in the juvenile system and to decline to the adult justice system. This is more likely to happen to individuals with FAS who have not had a proper evaluation. (See section on tests.)
* Sentencing: Questions of extenuating circumstances that might contribute to a shorter/longer sentence.
Social Skills (abstract reasoning):
FIRO-B (control, inclusion, affection)
MMPI-2 and MMPI-A (addiction and personality)
Vineland Adaptive Behavior Scales (functional abilities)
MMPI-2 and MMPI-A
TAT Thematic Apperception Test (concrete responses to pictures)
Rorschach (to observe presence of perseveration)
WRAT-3 Wide Range Achievement Test
TORC Test of Reading Comprehension
WIAT Wechsler Individual Achievement Test
WAIS-R Wechsler adult version
WISC-III Wechsler children version
Organic Brain Dysfunction:
Bender (trace shapes) measures visual motor abilities
Self reports (lack of honesty makes this unreliable)
AUI Alcohol Use Inventory
Other issues are guardianship, residency, custody, and SSI eligibility. "If you look normal, then you must be normal." The biggest problem is that the legal system does not recognize FAS. This is why good assessments should be done. FAS is a diagnosis, it is not a label. FAS is permanent brain damage. It is like having a frontal lobotomy - before birth.