Fetal Alcohol Spectrum Disorder: Knowledge, Attitudes and Practice Within The Western Australian Justice System

Fetal Alcohol Spectrum Disorder:
Knowledge, attitudes and

practice within the
Western Australian
justice system
Lead Investigator: Dr Raewyn Mutch
Investigators: Dr Rochelle Watkins, Ms Heather Jones,

Winthrop Research Professor Carol Bower
Telethon Institute for Child Health Research
APRIL, 2013
Fetal Alcohol Spectrum
Disorder: Knowledge,
attitudes and practice
within the Western
Australian justice
system
Final Report
April 2013
Fetal Alcohol Spectrum Disorder: Knowledge, attitudes and
practice in the Western Australian justice system
Lead Investigator: Dr Raewyn Mutch
Investigators: Dr Rochelle Watkins, Heather Jones, Winthrop

Research Professor Carol Bower
Telethon Institute for Child Health Research, Centre for

Child Health Research, The University of Western
Australia, Perth, Australia
Contact Details:
Dr Raewyn Mutch Heather Jones
[email protected] [email protected]
April 2013
This project was undertaken with the financial assistance of the

Foundation for Alcohol Research and Education
Preface
The genesis of this research was an idea by Dr Raewyn Mutch who wrote to the Chief Justice of
Western Australia, the Hon. Wayne Martin AC in 2009. The Chief Justice invited Dr Mutch and
researchers from the Telethon Institute for Child Health Research to submit information on Fetal
Alcohol Spectrum Disorder for inclusion in the Western Australian Equality before the Law: Bench
Book. We acknowledge the support of the Chief Justice for this project and more generally for his
advocacy and instructional role on Fetal Alcohol Spectrum Disorder in the justice system.
“The first thing is I frequently have young lawyers say to me ‘It was inevitable that my client would
end up in the criminal justice system’, and when you look at the life and childhood of that person,
you know that’s right, it was inevitable that they would end up in the criminal justice system. If we
know it’s inevitable, why aren’t we doing more about it?”
Retired Chief Judge of the District Court of Western Australia, Justice Antoinette Kennedy,
Law Report Radio National, April 2012
i
Contents
Preface ..................................................................................................................................................... i
Contents .................................................................................................................................................. ii
List of Figures ......................................................................................................................................... iv
List of Tables .......................................................................................................................................... iv
Acknowledgements................................................................................................................................ vi
Executive Summary............................................................................................................................... vii
Introduction ...................................................................................................................................... vii
The Project ....................................................................................................................................... viii
Main Findings ................................................................................................................................... viii
Conclusions ........................................................................................................................................ ix
Glossary of Terms and Abbreviations ..................................................................................................... x
Background ............................................................................................................................................. 1
Fetal Alcohol Spectrum Disorder ........................................................................................................ 1
Criminal Justice and FASD ................................................................................................................... 1
Justice System in Western Australia ................................................................................................... 4
Methods .................................................................................................................................................. 6
Ethics ................................................................................................................................................... 7
Reference Group ................................................................................................................................. 7
Survey Development ........................................................................................................................... 8
Results ................................................................................................................................................... 11
Participation ...................................................................................................................................... 11
Awareness of FAS and FASD ............................................................................................................. 14
Knowledge and Beliefs about FASD .................................................................................................. 16
Requests for Information .................................................................................................................. 19
Experiences and Practices................................................................................................................. 21
Discussion.............................................................................................................................................. 34
Awareness and Knowledge ............................................................................................................... 34
Recognition of FASD.......................................................................................................................... 35
ii
Identification of FASD ....................................................................................................................... 37
Limitations ........................................................................................................................................ 38
Conclusions ........................................................................................................................................... 39
References ............................................................................................................................................ 40
Appendix 1: FASD and Justice Websites ............................................................................................... 47
Appendix 2A: Judicial Survey ................................................................................................................ 52
Appendix 2B: Legal Survey .................................................................................................................... 57
Appendix 2C: Corrections Survey.......................................................................................................... 68
Appendix 2D: Police Survey .................................................................................................................. 83
Appendix 3A: Justice Project Information for Judicial Officers............................................................. 92
Appendix 3B: Justice Project Information for Lawyers ......................................................................... 96
Appendix 3C: Justice Project Information for Department of Corrective Services Staff ...................... 99
Appendix 3D: Justice Project Information for Police Officers ............................................................. 102
iii
List of Figures
Figure 1: Justice Project flow chart ......................................................................................................... 6
Figure 2: Gender of survey participants (n=427) .................................................................................. 11
Figure 3: Age distribution of survey participants (n=427) .................................................................... 12
Figure 4: Proportion of participants who had heard of FAS and FASD ................................................. 14
Figure 5: Reported knowledge of FAS/FASD across the justice system (n=347) .................................. 15
Figure 6: Summary of participant responses to the question ‘What type of information would you
prefer?’.................................................................................................................................................. 20
List of Tables
Table 1: Survey response ...................................................................................................................... 11
Table 2.1: Age of survey participants .................................................................................................... 12
Table 2.2: Location of survey participants’ work .................................................................................. 13
Table 2.3: Length of time survey participants worked in the justice system ....................................... 13
Table 2.4: Year of graduation of survey participants ............................................................................ 13
Table 3: Reported source of FAS/FASD information............................................................................. 15
Table 4: Participant responses to the question ‘Which would best describe your knowledge of
FAS/FASD?’............................................................................................................................................ 16
Table 5.1: Participant agreement with the statement ‘FASD is a real syndrome’ ................................ 16
Table 5.2: Participant agreement with the statement ‘FASD is relevant to my work in the criminal
justice system’....................................................................................................................................... 17
Table 5.3: Participant agreement with the statement ‘Alcohol’s negative effect on fetal
development has been proven’ ............................................................................................................ 17
Table 5.4: Participant agreement with the statement ‘FASD is only an issue for children and youth
not adults’ ............................................................................................................................................. 17
Table 5.5: Participant agreement with the statement ‘Assessment and diagnosis of FASD would
improve possibilities of appropriate consequences for unacceptable behaviour’............................... 17
Table 5.6: Participant agreement with the statement ‘People grow out of FASD’ .............................. 18
Table 5.7: Participant agreement with the statement ‘FASD occurs primarily in Indigenous families’18
Table 6: Participant identification of key features of FASD .................................................................. 18
Table 7.1: Participant responses to the question ‘Would you like more information about FASD?’ ... 19
iv
Table 7.2: Participant responses to the question ‘Would it be helpful to have a forum with other
professionals within the justice system to discuss the development of a co-ordinated approach to
FASD in WA?’......................................................................................................................................... 19
Table 7.3: Participant responses to the question ‘What type of information would you prefer?’ ...... 20
Table 7.4: Participant responses to the question ‘How would you prefer the information on FASD
was delivered?’ ..................................................................................................................................... 21
Table 8.1: Participant responses to the question ‘Have you have ever dealt with a person who you
suspect had a FASD?’ ............................................................................................................................ 21
Table 8.2: Participant responses to the question ‘What factors made you suspect a person had a
FASD?’ ................................................................................................................................................... 22
Table 9: Participant responses to the question ‘Have you ever been informed that a person had a
FASD?’ ................................................................................................................................................... 23
Table 10.1: Participant responses to the question ‘Have you ever dealt with a person who you
know had a FASD?’................................................................................................................................ 24
Table 10.2: Participant responses to the question ‘How did you know that a person had a FASD?’... 24
Table 11: Participant responses to the question ‘Have you ever recommended, required or sent a
person for diagnosis for FASD where you suspected FASD may be relevant? ..................................... 25
Table 12.1: Participant responses to the question ‘Have you ever used a trained person to
communicate with a person that you knew had a FASD?’ ................................................................... 26
Table 12.2: Participant explanations for not using a trained person to communicate with a client
or offender they knew had a FASD ....................................................................................................... 26
Table 13.1: Participant responses to the question ‘Do you think it would be helpful to have
alternative/diversionary sentencing options?’ ..................................................................................... 28
Table 13.2: Lawyer and police officer agreement with statements on sentencing options ................ 28
Table 14: Judicial officer responses to statements on changes or modifications to practice .............. 29
Table 15: Lawyer, DCS staff and police officer responses to the question ‘Do you think a more
detailed knowledge of FASD would assist in your work in the criminal justice system?’ .................... 29
v
Acknowledgements
We are indebted to members of the Western Australian justice system: judges, magistrates,
registrars, lawyers, Corrective Services staff and police officers, who completed the survey. Their
contribution to this project will enable an improved understanding of how Fetal Alcohol Spectrum
Disorder impacts on their decision making, and what challenges they face in their work within the
justice system.
The project benefited from the generous time commitment and involvement of individuals within
the justice sector. We would like to acknowledge the exceptional contributions of the following
people:
 Dr Monica Cass: Senior Evaluation and Research Officer, Policy and Aboriginal Services
Directorate, Department of the Attorney General
 Ms Dakota Gregory: Administrative Support Officer, Policy and Aboriginal Services Directorate,
Department of the Attorney General
 Magistrate Andre Horrigan: Children’s Court of Western Australia, Department of the Attorney
General
 Dr Shona Hyde: Team Leader Research and Evaluation, Strategic Planning and Review Strategic
and Executive Services, Department of Corrective Services
 Ms Jenny Kingsley: A/Assistant Director, Academic Development, Western Australia Police
 Ms Michaela Miller: Research Coordinator, Western Australia Police Academic Research
Administration Unit
We wish to acknowledge the assistance of the Reference Group for their contributions to the project
and development of this report.
 Ms Fay Alford: Director, Foster Care Association of Western Australia

 Mr David Davidson: Law Society of Western Australia, Criminal Law Committee
 Mr Warren Harvey: WA Representative, National Organisation for Fetal Alcohol Syndrome and
Related Disorders
 Ms Sue Renshaw: A/Assistant Commissioner, Youth Justice Community and Youth Justice
Divisions Department of Corrective Services
 Ms Claire Rossi: Senior Solicitor, Youth Law Team Legal Aid Western Australia
 Assistant Commissioner: Judicial Services Western Australia Police (Mr Wayne Gregson APM, Mr
Jon Tuttle, Mr Kim Porter)
We thank the Foundation for Alcohol Research and Education for the funding to conduct this
project.
Winthrop Research Professor Carol Bower is supported by a National Health and Medical Research
Council (NHMRC) Research Fellowship (No 634341)
vi
Executive Summary
Introduction
Fetal Alcohol Spectrum Disorder (FASD) is a non-diagnostic term used to refer collectively to a range
of conditions caused by prenatal exposure to alcohol, including Fetal Alcohol Syndrome (FAS), Partial
Fetal Alcohol Syndrome (PFAS), and related neurodevelopmental disorders. These conditions are
characterised by severe structural or functional central nervous system dysfunction leading to a
range of learning, developmental and behavioural problems including: problems with memory, the
inability to complete complex tasks that involve planning and judgement, difficulty self-managing
behaviour, and problems with social interaction. These primary disabilities have been associated
with the occurrence of secondary disabilities including school failure, unemployment, substance
abuse, mental health disorders, and engagement with the criminal justice system.
Early intervention with children with FASD has been recognised to improve children’s social, health
and educational outcomes and decrease the risk of secondary disabilities. However, there is
evidence to indicate that FASD are under-diagnosed in Australia and there are no FASD-specific
diagnostic and management services in the country. Most individuals who have FASD do not have
the characteristic FAS facial features, and in general only those with more severely affected are
identified during infancy. Studies from North America document a high prevalence of individuals
with FASD among incarcerated youth and adults. Problems experienced by individuals within the
criminal justice sector may not be recognised as symptoms associated with FASD, and FASD has been
recognised to potentially affect the ability to understand and respond appropriately to interviewing,
to be a reliable and credible witness, to understand the charges and the court proceedings, and to
comply with court orders or the requirements of imprisonment.
Both the Canadian Bar Association and the American Bar Association have passed resolutions to urge
governments to avoid ongoing criminalisation of people with FASD and prevent persistent over-
representation of individuals affected with FASD within the justice system. These resolutions
recommend: the allocation of additional resources to improve awareness of FASD and its impact on
individuals within justice systems; collaboration with other professionals, including health and
disability experts, to develop policies that acknowledge and treat the effects of prenatal alcohol
exposure; better support for individuals with FASD; and amended criminal sentencing laws to
accommodate the neurocognitive disabilities of those with FASD.
While there are no reliable data on the prevalence of FASD within the Australian justice system,
similar issues to those described in North America are likely to also exist within the Australian justice
system. Several studies in North America have found poor awareness of the impact of FASD on an
individual among justice system professionals, and identified the need for action to improve their
ability to identify and work with people with FASD. A study of judges and lawyers in Queensland
suggests similar challenges may be faced by the justice system in Australia. Through this project we
sought to investigate the knowledge, attitudes and practice of justice professionals in Western
Australia (WA) and identify implications for training, policy and practice.
vii
The Project
The aims of the project were to: assess justice professionals’ awareness and knowledge of FASD;
assess the perceived impact of FASD on practice within the justice system; and identify the
information needs relating to FASD for the justice system in WA. A Reference Group was established
to provide advice on study design and facilitate participant recruitment. A review of the literature
was conducted to identify existing surveys or questionnaires that assessed FASD knowledge,
attitudes and practice within justice systems that could be used as a basis for survey development.
To enable the investigation of issues specific to each sector of the WA justice system, separate
surveys were developed for people working in all four sectors of the justice system: judicial, legal,
corrections and police. Each survey assessed socio-demographic characteristics, knowledge of FASD,
sources of information about FASD, and information and training needs. Additional sector specific
questionnaire items assessed participant experiences and practices using language particular to each
sector. Surveys were pilot tested within each sector to ensure the questions were clear and easily
understandable. The surveys were administered to 133 judicial officers, 90 lawyers, 650 Department
of Corrective Services (DCS) staff and 1000 police officers. Results were summarised using
descriptive statistics and qualitative content analysis.
Main Findings
Response to the survey was low (23%) and relatively consistent across sectors. Over 90% of judicial
officers, lawyers and DCS staff, and almost 75% of police officers were aware of FAS. Awareness of
FASD was lower than for FAS across all sectors. Almost 80% of participants agreed that FASD is real,
and that the negative effect of alcohol on fetal development has been proven. When participants
were asked to describe their understanding of FASD, we found few differences in response between
the judicial, legal and corrections sectors in the frequency of identification of the following four key
aspects of FASD: identification of the cause as alcohol consumption during pregnancy, identification
of potential impacts on physical and psychological development, and recognition that the damage is
permanent. Across all four sectors of the justice system most participants reported only a basic
understanding of FASD and how it affects individuals. Participants were most knowledgeable about
the cause of FASD, and factors therefore important for prevention. Notably, some participants
described FASD as caused by excessive alcohol use, alcohol abuse or dependence.
More than 75% of judicial officers, 85% of lawyers and DCS staff, and almost 50% of police officers
perceived FASD as relevant to their work. Consistent with the importance of formal training or
professional development as a source of information on FASD among DCS staff, knowledge about
FASD was highest among DCS staff, who were more likely to report a good understanding of how
FASD affects children and adults (44%) than participants from the other sectors. Few DCS staff
reported not being aware of how FASD affects children and adults (5%) compared with 30% or more
among participants from other sectors.
Participants across all sectors frequently reported recognition of suspected FASD among individuals
they dealt with, and raised concerns about the management of these individuals within the justice
system. Approximately 60% of participants from the judicial and legal sectors, 67% of staff from the
corrections sector, and 43% from the police sector reported ever dealing with a person who may
viii
have been affected by FASD. Suspicion of FASD was most commonly based on identification of a
poor attention span, low intelligence quotient (IQ), maternal history of alcoholism and physical
appearance. We found widespread agreement among judicial officers (79%), lawyers (92%) and DCS
staff (84%) that the assessment and diagnosis of FASD would improve the possibilities of appropriate
consequences for unacceptable behaviour. Most participants (72%) also indicated a need for more
information about FASD, including information to improve the identification of individuals in need of
specialist assessment, and guidelines on how to deal with people with FASD. We also found strong
support across all sectors for the development of appropriate alternative or diversionary sentencing
options for people with FASD.
Conclusions
Despite some differences in perceptions and practice between professionals working in different
sectors of the justice system, participants generally indicated a limited capacity to formally identify
and respond to the needs of people with FASD, and supported the need for a coordinated approach
to the development of policies to improve the management of people with FASD within the WA
justice system. Our findings indicate the need for training and education to improve awareness and
management of the specific impairments associated with FASD within the WA justice system. They
also point to the importance of access to services and programs for the appropriate diagnosis and
management of these individuals both within the justice system and the wider community to
prevent their continued engagement with the justice system.
ix
Glossary of Terms and Abbreviations
Acronym Full Text

ABA American Bar Association
ACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
ALSWA Aboriginal Legal Service of Western Australia
CBA Canadian Bar Association
CCWA Children’s Court of Western Australia
CBO Community Based Order
CIA Criminal Investigations Act 2006
DCP Department for Child Protection
DCS Department of Corrective Services
DotAG Department of the Attorney General
FARE Foundation for Alcohol Research and Education Ltd
FAS Fetal Alcohol Syndrome
FASD Fetal Alcohol Spectrum Disorder
FASD ONE FASD Ontario Network of Expertise
HREC Human Research Ethics Committee
IDD Intellectual Disability Diversion
IQ Intelligence Quotient
NGO Non-Government Organisation
NHMRC National Health and Medical Research Council
NOFASARD National Organisation for Fetal Alcohol Syndrome and Related Disorders
NSW New South Wales
PFAS Partial Fetal Alcohol Syndrome
QLD Queensland
WA Western Australia
WAP WA Police Policy
Fetus/Foetus and Fetal/Foetal

The word 'fetus' is from Latin origins and means offspring, bringing forth or hatching of young. Fetus is now the
Standard English spelling throughout the world in medical journals. Where the alternate spelling of foetus is
used in a published report, resource, website or journal article the spelling has not been changed. This also
applies to the use of fetal or foetal.
Fetal Alcohol Spectrum Disorder (FASD)

In this report we use the term FASD to refer collectively to the three diagnoses (Fetal Alcohol Syndrome,
Partial Fetal Alcohol Syndrome and Neurodevelopmental Disorders – Alcohol Exposed) which comprise FASD.
x
Background
Fetal Alcohol Spectrum Disorder
Alcohol is a teratogen.1 Exposure to alcohol in pregnancy may cause irreversible damage to the brain
and other organs of the unborn child,2, 3 with devastating lifelong consequences.4-6 Fetal Alcohol
Spectrum Disorder (FASD) is a non-diagnostic term encompassing a range of disabilities caused by
prenatal exposure to alcohol, including Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome
(PFAS), and related neurodevelopmental disorders.
The effects of fetal alcohol exposure are life-long and may not be seen at birth.7 Only a minority of
children will have FAS, or PFAS, which are characterised by key facial features, poor growth and
abnormalities of brain structure and/or function. Most children with FASD will not have the key
facial features but will have a range of learning, developmental and behavioural problems.
Additional developmental problems can specifically include: poor hand-eye coordination and fine
motor function, inability to complete complex tasks that involve planning and judgement, and
problems with social interaction. People with FASD commonly have cognitive impairment on
standardised testing, but their intelligence quotient (IQ) is not often below 70 and so does not meet
the definition of an intellectual disability.8, 9 These primary effects or disabilities are the direct result
of brain damage from alcohol exposure to the fetus.3 Secondary effects or disabilities are those
disabilities that a child develops as a result of the primary disabilities associated with FASD and
include: problems at school, mental health problems, problems with alcohol and other drugs,
unemployment and trouble with the law.10
Early diagnosis of children with FASD allows early intervention11 and improves children’s social,
health and educational outcomes12 through understanding and accommodating their strengths and
weaknesses, thus reducing the possibility of secondary disabilities. Without early diagnosis, the life
trajectory of children with FASD is significantly affected, with common experiences of school
failure,13 reduced self-esteem and depression,14 early addiction15 and risk behaviours,16 and early
engagement with criminal justice.17, 18, 19, 20 Unfortunately, FASD are under-diagnosed in Australia21-24
and there are no dedicated FASD-specific diagnostic and management services in the country.
Criminal Justice and FASD

People engaging with the criminal justice system may exhibit problems with learning, poor memory,
difficulty self-managing their behaviour, and difficulty communicating.18, 25, 26 These neurocognitive
problems may not be recognised or understood as symptoms associated with FASD.17, 20 The
challenges within the justice sector for people with FASD were outlined by Professor Heather
Douglas, Law Professor at the University of Queensland Beirne School of Law, in her presentation to
the National Judicial College of Australia Sentencing 2010 Conference.27 Professor Douglas charted
the range of concerns facing people with FASD who become involved with criminal justice, such as
their inability to be credible witnesses, their disadvantage through the processes related to police
questioning, their vulnerability to suggestion and acquiescence, and their ability for confabulation;
which together suggest a diminished capacity of fitness to plead. Professor Douglas went on to
1
advocate: “It may be appropriate, considering the apparent under-diagnosis of FASD, to require
sentencing report writers to address the possibility of FASD in preparation of their reports in
circumstances where there has been a history of breaches of court orders or where there are other
matters that suggest the possibility of FASD (for example impulsive offending or known history of
maternal drinking). While more resources directed towards therapy are needed, the first step is
awareness.”
International
Evidence from North America documents a high prevalence of individuals with FASD among
incarcerated youth and adults.25, 26, 28 A Canadian study18 where all youth remanded to a Canadian
psychiatric inpatient assessment unit over a one-year period were evaluated for FASD found that, of
the 287 youth: 67 (23%) had an alcohol-related diagnosis, 3 (1%) had a diagnosis of FAS and 64 (22%)
had a diagnosis within FASD. A United States of America (United States) longitudinal study of
individuals diagnosed with FASD found approximately 60% had had some contact with the law.29 A
systematic literature review of FASD prevalence in correctional systems28 estimated that there was a
19 times greater risk for individuals with FASD to be incarcerated.
Courts in both Canada and the United States acknowledged that an accused/victim/witness with
FASD involved with the criminal justice system may not understand the arrest and court process.
Some of the issues identified include: reduced competency and capacity, diminished legal
responsibility, false confessions, unreliable testimony, sentencing; as well as the victimisation of
persons with FASD while in custody.20 A person with FASD may not be able to fully grasp the severity
of the situation. United States and Canadian courts have identified the following broad areas of
difficulty for persons with FASD related to their neurocognitive impairment and disability:
 difficulty translating information from one sense or modality into appropriate behaviour
 difficulty generalising information
 difficulty perceiving similarities and differences
Without the ability to generalise and make associations, judgment is affected. The court summed up
these deficits as “gaps” and considered them significant in a legal context.20
In 2010 the Canadian Bar Association (CBA) passed a resolution concerning FASD in the criminal
justice system30 that urged governments to avoid ongoing criminalisation of people with FASD. It
also urged them to allocate additional resources to develop policies and solutions relating to FASD as
an access to justice issue. In 2012 the American Bar Association (ABA) followed the CBA lead and
unanimously passed a resolution31 that, like the CBA resolution, urged all members of the judicial
system, including judges, lawyers and policy makers to improve awareness of FASD and its impact on
individuals within justice systems. The resolutions recommend collaboration with other
professionals, including health and disability experts, to develop policies that acknowledge and treat
the effects of prenatal alcohol exposure and better assist individuals with FASD. The resolutions also
urge governments to prevent persistent over-representation of individuals affected with FASD
within the justice system and consider amending criminal sentencing laws to accommodate the
neurocognitive impairment and disability of those with FASD.
With funding from the Public Health Agency of Canada and the Department of Justice Canada, Youth
Justice Policy, the FASD Ontario Network of Expertise (FASD ONE) developed a website on FASD and
the justice system specifically for individuals working in the justice system. The website provides
2
information and resources about FASD, including background information, case law, legal resources
and strategies for effective intervention.32 A comprehensive list of FASD and justice websites can be
found in Appendix 1. Several Canadian and American judges have also documented their
experiences and the issues faced when adapting the operations of their court or evaluating the
impairment of the person before them who has or may have FASD.33, 34
Australia
The Australian Institute for Health and Welfare (AIHW) report, Juvenile Justice in Australia 2010-
2011,35 indicates that while rates of involvement remain low, youth were increasingly presenting at
an early age to juvenile justice, and Indigenous youth were overrepresented. The 2010-2011 data
estimated that on an average day 7,265 young people were under juvenile justice supervision in
Australia with 86% supervised in the community and 14% in detention. As part of the National
Assessment of Australia’s Children’s Courts, data show that WA has the highest representation of
juveniles appearing in the Children’s Court of WA (CCWA) relative to the proportion of juveniles in
the WA population.36 Other key findings of this research show an over-representation of Aboriginal
children appearing in the CCWA; there is an absence of appropriate services and programs for
children and their families; a lack of integrated approaches within the Department for Child
Protection (DCP), Youth Justice and WA Police; and that there is a requirement for specific
professional development and inter-agency training.36 Whilst there are no figures on FASD in the
AIHW or National Assessment of Australia’s Children’s Court data, a disproportionately large number
of youth and adults with FASD are likely to be engaged with the legal system. In her submission to
the House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs
(Doing Time – Time for Doing, Indigenous youth in the criminal justice system)37 Professor Douglas
estimated that 60% of adolescents with FASD have been in trouble with the law.
The New South Wales (NSW) Law Reform Commission consultation paper published in 2010
presented an overview of youth with cognitive and mental health impairments in the criminal justice
system of NSW.38 The consultation paper examined the applications of bail, apprehended violence
orders, diversion, fitness and defence of mental illness and sentencing. The estimated rates of youth
with a cognitive impairment and involved with the law may potentially include youth with as yet
undiagnosed FASD.38
In Western Australia (WA) the Equality before the Law: Bench Book includes specific reference to
FASD.39 The purpose of the Bench Book is to ensure equal treatment for those who come into
contact with the justice system by attempting to remove disadvantage and inequality without
causing prejudice to other participants in the process. The Bench Book , which contains a chapter on
‘People with Disabilities’, also highlights the need to “….determine accurately and appropriately
whether a person with a disability requires any form of adjustment to be made, and if so, what type
and level of adjustment”.39
The House of Representatives Standing Committee on Social Policy and Legal Affairs Inquiry into
FASD received 92 written submissions and held 13 public hearings around Australia. The Aboriginal
Disability Justice Campaign submission stated “Too many children and young people living with
undetected/undiagnosed FASD will have early entry into the criminal justice system and without
intervention, will become our ‘revolving door’ prisoners.”40 The submission from Legal Aid NSW and
Aboriginal Legal Service NSW/ACT also highlighted the criminal justice perspective and focused on
issues of pathways of people with disabilities in the criminal justice system, consequences of
3
increasing ‘criminalisation of care’ and the need to look at policing policies in relation to people with
FASD.41 In his address to the WA Legislative Assembly Education and Health Standing Committee
Inquiry into FASD42 the Chief Justice the Hon. Wayne Martin stated “… symptoms of FASD will place a
person at a significant disadvantage when they enter the criminal justice system.”
Justice System in Western Australia

The criminal justice system in Australia has three stages through which a case proceeds.43 The first
stage is the investigative component which involves police (state, federal and National Crime
Authority); the second stage is the adjudicative component which involves courts (judicial officers,
lawyers, barristers, solicitors); and the third stage is the correctional component (prisons or other
correctional facilities).
Investigation
The principal duties of police are the prevention and detection of crime, protection of life and
property, and the enforcement of law to maintain peace and good order. In WA there were 5,768
sworn police officers, inclusive of all ranks from senior police to probationary constables at the time
of the project. WA Police are responsible for the world’s largest single police jurisdiction covering 2.5
million square kilometres, with 3 regions, 14 districts and 157 police stations.44 The Judicial Services
section of WA Police has wide ranging responsibilities including community engagement, youth
policy, custodial services and prosecution. With respect to juvenile justice, the Young Offenders Act
of 1994 gives police officers discretionary powers to use diversionary options when dealing with a
young person who commits an offence.
Adjudication
Courts in WA are administered by the Department of the Attorney General (DotAG). The judiciary
includes judges (56), magistrates (65) and registrars (16) who control and arbitrate the functions of
the courts. There are different levels of courts operating throughout WA.45
In WA the statutory minimum age of criminal responsibility is 10 years. The CCWA deals with
offences alleged to have been committed by young people aged 10 - 17 years.46 In this report the
terms youth, adolescent and juvenile refer to a person under the age of 18 years.
Access to legal representation is an important part of the investigative and adjudication stages of the
justice system. Where offenders are unable to afford to pay their own legal costs, access is provided
through Legal Aid WA or the Aboriginal Legal Service of WA (ALSWA).
Corrections
The Department of Corrective Services (DCS) is responsible for offenders in WA’s prisons and
detention centres as well as people on probation, parole and other community orders.47 The
Community and Youth Justice Division has responsibility for two juvenile detention centres and 34
youth justice service centres in metropolitan, regional and rural WA. There are 400 staff within the
Youth Justice System and 250 in the Youth Custodial Service.
4
Justice Project
Given the high proportion of individuals with FASD having contact with the justice system in North
America and the concern about their understanding and competency in the system, there have been
several studies in North America and one in Australia to ascertain the knowledge, attitudes and
practice of justice professionals. The survey of judges and crown prosecutors in the Canadian
province of New Brunswick was conducted to specifically determine their attitudes, knowledge,
behaviours and training needs related to FASD.20 Alaskan service professionals, including physicians,
educators, correctional staff, social workers, public health nurses and substance abuse counsellors,
were surveyed with the aim of exploring differences in FASD knowledge, attitudes and behaviours.48
In parallel with the WA research, the University of Queensland (QLD) conducted a survey of
members of the QLD judiciary (judges and magistrates) and lawyers about their understanding of
FASD and how they deal with FASD in their role.49, 50 This project was also funded by FARE.
In order to assess the knowledge, attitudes and practices of people working in each stage of the
judicial system in WA – investigation, adjudication and corrections – we undertook a survey of
professionals in the judicial, legal, corrections and police sectors in WA.
5
Methods
The aims of the ‘Fetal Alcohol Spectrum Disorder: Knowledge, attitudes and practice within the
Western Australian Justice System’ project (Justice Project) were to: assess justice professionals’
awareness and knowledge of FASD, assess the perceived impact of FASD on practice within the
justice system, and identify the information needs relating to FASD for the justice system in WA. The
Justice Project sought to involve people working in all sectors of the justice system including: 1.
judicial (judicial officers); 2. legal (lawyers); 3. corrections (DCS staff); and 4. police (police officers).
Throughout this report these four target groups are referred to as sectors of the justice system.
The Justice Project was conducted between July 2011 and November 2012. The study investigators
consulted professional organisations and WA government departments during the project
development phase to ensure stakeholder views were addressed and incorporated into the study
design. The study process is summarised in Figure 1.
Project Reference Group

Project plan
Advice on survey questions
Review of final report
Judicial Legal Corrections Police

Survey development Survey development Survey development Survey development

Survey pre-testing Survey pre-testing Survey pre-testing Survey pre-testing

Survey completed Survey completed Survey completed Survey completed
Data analysis and draft report

Analysis of data from each sector
and comparison across sectors
Feedback to stakeholders
Review of draft report by sector
stakeholders and meetings to
discuss outcomes
Final Report
Draft report revised following
consultation
Final report submitted to FARE
Figure 1: Justice Project flow chart
6
Ethics
Ethics approval for this project was granted by the University of Western Australia Human Research
Ethics Committee (HREC). Approval to conduct the survey was granted by the DCS Research and
Evaluation Committee, the DotAG Research Application Advisory Committee via the DCS Research
and Evaluation Committee and the WA Police Research Application Review Committee.
Reference Group
A Reference Group was established to advise and assist the study investigators in conducting the
Justice Project. Representation from the following legal associations and societies, related
government departments and relevant non-government organisations was sought to participate in
the Reference Group:
 Aboriginal Legal Service of WA (ALSWA)

 Criminal Lawyers Association of WA
 Department of Corrective Services
 Family Law Practitioners Association of WA
 Foster Care Association of WA
 Law Society of WA
 Legal Aid WA
 National Organisation for Fetal Alcohol Syndrome and Related Disorders
 WA Bar Association
 WA Police
In addition to the letter of invitation from the Telethon Institute for Child Health Research (Telethon
Institute) and an outline of the project circulated to all groups, the legal associations and societies
received a letter of introduction from the Chief Justice of WA.
Membership
Due to time and resource constraints not all organisations were able to nominate a representative.
The following organisations nominated a representative to the Reference Group:
 Department of Corrective Services, Youth Justice Community and Youth Justice Division
 Foster Care Association of WA
 Law Society of WA, Criminal Law Committee
 Legal Aid WA
 National Organisation for Fetal Alcohol Syndrome and Related Disorders, WA
 WA Police, Judicial Services
The Lead Investigator and the Project Manager were also members of the Reference Group.
Role
The role of the Reference Group was to:
 Assist with the study design, survey development and recruitment

 Review and approve the final report to FARE
7
The Reference Group primarily conducted business via email, with face-to-face meetings convened
on one occasion during the project.
Survey Development
Prior to developing the survey, two study investigators met with the ALSWA, the Youth Court Team
and the Criminal Law Committee. While some legal professionals questioned the relevance of FASD
to their work, others noted that even if they suspected a client or offender had FASD there were no
diagnostic or support services available to assist either them or the person with FASD. It was also
noted that it was only in rare instances that medical record evidence of the client’s exposures to
prenatal substances was available to legal professionals and the court. The increasing occurrence of
youth committing serious offences at much younger ages than previously recorded and the potential
association of this trend with in-utero exposure to alcohol was also raised. Examples included young
people committing serious crimes as first offences, including gender-based violence. Experienced
staff acknowledged that they were aware of FASD and how this may impact on the actions and
behaviours of some youth in the justice system. Informants were supportive of the project,
especially if it led to a greater understanding of FASD through educational opportunities for
members of the justice system and ultimately services that could support youth in the justice
system.
Literature review
A systematic review of the literature was conducted to identify existing surveys or questionnaires
that assessed FASD knowledge, attitudes and practice within justice systems. Two relevant studies
were identified: a survey of Canadian provincial judges and crown prosecutors to determine their
attitudes, knowledge, behaviours and training needs,20 and a survey of Alaskan health, education
and service professionals to explore knowledge, attitudes and behaviour.48
Reference Group
Researchers initially proposed to conduct in-depth interviews with personnel across the justice
system to develop a more detailed understanding of the context relevant to this study and to hear
real life experiences of what is occurring with the WA justice system. However, feedback on the
proposed study design from Reference Group members indicated that they could provide the most
appropriate means to access relevant background information on the study context and information
specific to each organisation involved in this study, and it was not necessary to conduct in-depth
interviews with individual judicial officers, lawyers or police.
Survey
The study investigators reviewed the existing survey instruments identified in the literature review
and ascertained that the survey used by Cox and colleagues20 provided the most appropriate basis
for the Justice Project survey. This survey was subsequently reviewed by the justice sector
representatives on the Reference Group who concluded that it did not meet the needs of, or use
language that was relevant to each sector in the WA justice system. Based on recommendations
from the Reference Group a new survey instrument was developed to incorporate a series of generic
questions that would be applicable to all sectors, and include questions that were specific to each
8
sector of the WA justice system. Several question areas were modified or adapted from the Cox
survey.20
The initial generic section of the survey included questions to measure descriptive information such
as age, gender, location of work, position (including title and role), year of graduation, and years of
experience in the justice system. The generic section also encompassed questions on knowledge of
FAS/FASD, where participants had heard of or found out about FAS/FASD, what information they
would like and how they would like this information delivered. The sector specific items focussed on
participant experiences and practices using language particular to each sector. To offer participants
the opportunity to express their views, expand on issues and offer information that was relevant to
their work situation, open-ended questions were also incorporated into the survey. WA Justice
Project study investigators also communicated with researchers surveying QLD judicial officers and
lawyers to discuss the respective projects and facilitate the collection of comparable data in these
two projects.
Drafts of the survey instrument were disseminated to members of the Reference Group with a
request that they discuss the questions with their colleagues and provide feedback on their
suitability and content. Following this process staff from the WA Police Academic Research Unit,
Legal Aid WA, DotAG and DCS sought specific feedback from colleagues on the proposed survey. The
survey was pilot tested within each organisation to ensure the questions were clear and easily
understandable. It was agreed that the surveys to lawyers and police could be administered using
SurveyMonkey®. Because of security concerns within DotAG and DCS the survey could not be
conducted using SurveyMonkey®, and internal systems were used to host and administer the survey
at these study sites. The final survey instruments can be found in Appendix 2.
Recruitment
Participants were recruited by each sector using different methods as detailed below. Each
participant was provided with a covering email from their organisation and project information from
the Telethon Institute (Appendix 3).
Judicial
The survey was sent to 133 judicial officers (judges, magistrates and registrars) in the Supreme
Court, District Court, Family Court, Children’s Court, Magistrates Court, State Administrative Tribunal
and the Coroner’s Court through a secure internal DotAG system. These courts preside over both
criminal and civil matters.
Legal
Legal Aid sent the survey to an estimated 90 lawyers in criminal, family and civil law across the
organisation in Perth and WA regions, with a request to circulate to new lawyers who were not on
the original email list. Requests to disseminate the survey were sent to the Criminal Lawyers
Association of WA and the Law Society of WA but these requests were not actioned.
Corrections
The survey was circulated to all staff within the Youth Justice Service (400) and Youth Custodial
Service (250) through a secure internal survey system. In addition the survey was advertised on the
DCS intranet.
9
Police
The survey was sent to a random sample of 1,000 sworn police officers. This sample was selected
from the overall WA Police staff list which was filtered to contain only sworn police officers (both
detectives and general duties) from all over WA and from the rank of constable to inspector inclusive
(n=5,201). Sworn officers are deemed operational unless they have an injury or other reason
precluding their deployment to the front line if necessary.
Survey administration and follow up

Follow-up is crucial to achieving a high response. As the survey was distributed to participants by
DotAG, Legal Aid, DCS, and WA Police, respective department and organisation staff were also
responsible for sending follow up emails encouraging staff to complete the survey. Each organisation
sent at least one reminder to potential participants, with most sending two reminders.
Data analysis
Data received from the online questionnaires were converted into SPSS format, and IBM SPSS
Statistics Version 19 was used to analyse the quantitative response data. Results were summarised
using descriptive statistics. In this report Likert scale responses of ‘strongly agree’ and ‘agree’ are
reported collectively as ‘agree’, and ‘strongly disagree’ and ‘disagree’ are reported collectively as
‘disagree’.
Qualitative data were independently coded and analysed by two study investigators using qualitative
content analysis methods.51, 52 Data from each open-ended question were reviewed and coded
inductively, based on the underlying meaning of the data. Responses were read line by line prior to
coding for each question, and significant words and phrases were identified. The main intent of each
response was then conceptualised and coded. For questions which had a sufficient number and
depth of responses, first level codes were also reviewed and categorised based on their
characteristics or properties.52, 53 Both analysts’ independent coding schemes were documented and
then reviewed for consistency to ensure credibility and trustworthiness of the analysis process.51
Both quantitative and qualitative findings were summarised by sector.
10
Results
Participation
A total of 427 people from across the WA justice system completed the survey. Survey response is
summarised by sector in Table 1. The response was low across all sectors.
Table 1: Survey response
Judicial Legal Corrections Police Total

n (%) n (%) n (%) n (%) n (%)
† †
Invited 133 90 650 1000 1873
Responded 30 (22.6) 25 (27.8) 157 (24.2) 215 (21.5) 427 (22.8)
†
Estimated number invited
Participant characteristics
Socio-demographic characteristics assessed included; gender, age, length of time working in the
justice system, location of work and year of graduation from university or training college. Overall
54.8% of participants were male and 45.2% female. The gender distribution of respondents varied
according to sector. Lawyers and DCS staff responders were predominantly female, whereas police
officers responding were predominantly male (Figure 2).
90% 80.9%
80.0%
80% 75.8%
Percentage of participants
70%
60% 56.7%
50% 43.3%
40%
30% 24.2%
20.0% 19.1%
20%
10%
0%
Female Male
Figure 2: Gender of survey participants (n=427)
11
Participants were most commonly aged between 40-49 years (Figure 3), although the age
distribution of participants varied by sector (Table 2.1). Judicial officers were more likely to be aged
50 years or older compared to other participants.
140
121
120 110
104
Number of participants
100
80
64
60
40 28
20
0
≤ 29 30-39 40-49 50-59 ≥ 60
Age group (years)
Figure 3: Age distribution of survey participants (n=427)
Table 2.1: Age of survey participants

n=30 (%) n=25 (%) n=157 (%) n=215 (%)
≤ 29 years 0 (0.0) 5 (20.0) 37 (23.6) 22 (10.2)
30-39 years 0 (0.0) 8 (32.0) 31 (19.7) 65 (30.2)
40-49 years 8 (26.7) 6 (24.0) 34 (21.7) 73 (34.0)
50-59 years 20 (66.7) 6 (24.0) 38 (24.2) 46 (21.4)
≥ 60 years 2 (6.7) 0 (0.0) 17 (10.8) 9 (4.2)
The majority of participants worked in the Perth metropolitan area (Table 2.2). Approximately half
the 427 participants (51.8%) had worked in the justice system for 11 or more years (Table 2.3).
Judicial and police officers reported longer periods of service in the justice system than lawyers and
DCS staff. Lawyers, DCS staff and police officers who reported graduating from university/training
college were most likely to have graduated between 2000 and 2009 (Table 2.4).
12
Table 2.2: Location of survey participants’ work
† † †
n=30 (%) n=25 (%) n=157 (%) n=215 (%)
Perth 24 (80.0) 13 (52.0) 64 (40.8) 112 (52.1)
Outer metropolitan 4 (13.3) 4 (16.0) 18 (11.4) 41 (19.1)
Regional 8 (26.7) 6 (24.0) 51 (32.3) 45 (20.9)
Rural 2 (6.7) 2 (8.0) 10 (6.3) 13 (6.0)
Remote 2 (6.7) 5 (20.0) 14 (8.9) 11 (5.1)
†
Percentages sum to more than 100% as multiple responses were permitted
Table 2.3: Length of time survey participants worked in the justice system

n=30 (%) n=25 (%) n=157 (%) n=215 (%)
< 1 year 0 (0.0) 2 (8.0) 15 (9.7) 1 (0.5)
1-5 years 1 (3.3) 7 (28.0) 54 (34.8) 30 (14.0)
6-10 years 0 (0.0) 9 (36.0) 48 (31.0) 37 (17.2)
11+ years 29 (96.7) 7 (28.0) 38 (24.5) 147 (68.4)
Table 2.4: Year of graduation of survey participants

n=30 (%) n=25 (%) n=157 (%) n=215 (%)
Not applicable 0 (0.0) 0 (0.0) 42 (26.8) 3 (1.4)
1979 or before 11 (36.7) 0 (0.0) 13 (8.3) 25 (11.6)
1980-1989 15 (50.0) 3 (12.0) 11 (7.0) 47 (21.9)
1990-1999 4 (13.3) 5 (20.0) 16 (10.2) 55 (25.6)
2000-2009 0 (0) 15 (60.0) 64 (40.8) 79 (36.7)
2010 or after 0 (0) 2 (8.0) 11 (7.0) 6 (2.8)
Survey participants were asked to provide information on their role, position or title. Judicial officers
held appointments in the Supreme Court, District Court, Family Court, Magistrates Court, State
Administration Tribunal, Children’s Court and Coroner’s Court. The majority of lawyers who
responded to the survey (88.0%) classified their position as solicitor, which may include senior or
principal solicitor. Within Corrections the most frequently reported roles included: Youth Justice
Officer (11.6%), Prevention and Diversion Officer (8.4%), Prison Officer (7.1%) and Youth Custodial
Officer (7.1%). Just over half the police officers (52.4%) had the rank of Sergeant, including Senior
Sergeant and those who may be in charge of a unit or station; and 30.6% classified their position as
Constable, including First Class Constable, intelligence, forensics and training. A further 14.5% of
13
police officers identified their position as Detective, including Detective Senior Constable, Detective
Sergeant and Detective Senior Sergeant.
Awareness of FAS and FASD

Initial survey questions explored respondents’ awareness of both FAS and FASD. All lawyers (100.0%)
and a high proportion of DCS staff (96.5%) and judicial officers (90.0%) had heard of FAS. Across all
sectors, fewer participants had heard of FASD, with awareness lowest amongst police officers
(Figure 4). Among those who reported being aware of FAS or FASD, most participants had heard
about FAS or FASD in the mainstream media (Table 3). Other frequently reported sources of
information included a legal practitioner or other justice professional for both judicial officers and
lawyers; and professional training and education for both DCS staff and police officers.
100.0%
100% 96.5%
90.0%
90%
80% 76.7% 74.8% 74.9%
70% 64.0%
60%
50%
40.9%
40%
30%
20%
10%
0%
FAS FASD
Figure 4: Proportion of participants who had heard of FAS and FASD
14
Table 3: Reported source of FAS/FASD information
† † †
n=30 (%) n=25 (%) n=96 (%) n=148 (%)
Mainstream media 22 (75.9) 15 (60.0) 65 (47.1) 83 (56.1)
University education or 0 (0.0) 3 (12.0) 66 (47.8) 14 (9.5)
professional training
Legal practitioner or other 12(41.4) 12 (48.0) 14 (10.1) 5 (3.4)
justice professional
Colleague 3 (10.3) 6 (24.0) 40 (29.0) 18 (12.2)
Professional journal 6 (20.7) 6 (24.0) 27 (19.6) 3 (2.0)
Education session 5 (17.2) 4 (16.0) 49 (35.5) 13 (8.8)
Court pre-sentence report 10 (34.5) 11 (44.0) 20 (14.5) 9 (6.1)
Court ordered psychological 12 (41.5) 8 (32.0) 33 (23.9) 3 (2.0)
or psychiatric report
Other 4 (13.8) 3 (12.0) 37 (26.8) 0 (0.0)
†
Other ways in which participants found out about FAS/FASD included their own investigations for
work or personal purposes; previous work or work of a partner in the health, disability or child
protection sectors; personal or family member experiences as foster carers; and working with
female offenders. Participants who had worked in rural and remote areas highlighted their
involvement with communities and health professionals as a source of information about FASD and
associated problems.
Participants who were aware of FAS/FASD were asked to rate their knowledge on a 3-point scale.
Approximately one half of those who responded to this question (51.1%) described their level of
knowledge as a basic understanding of the condition and how it affects children and adults (Figure
5). DCS staff showed the highest level of understanding of the condition and how it affects children
and adults (Table 4).
26.1% 22.7% Awareness of the condition

(heard/seen reference) but not
how it affects people
Basic understanding of the
condition and how it affects
people
51.1%
Good understanding of the
condition and how it affects
people
Figure 5: Reported knowledge of FAS/FASD across the justice system (n=347)
15
Table 4: Participant responses to the question ‘Which would best describe your knowledge of FAS/FASD?’

n=30 (%) n=25 (%) n=137 (%) n=160 (%)
Have an awareness of the 9 (30.0) 11 (44.0) 7 (5.1) 53 (33.1)
condition (heard/seen
reference) but not how it
affects children and adults
Have a basic understanding of 16 (53.3) 12 (48.0) 70 (51.1) 82 (51.3)
the condition and how it
affects children and adults
Have a good understanding and 5 (16.7) 2 (8.0) 60 (43.8) 25 (15.6)
how it affects children and
adults
Knowledge and Beliefs about FASD

The following questions about knowledge and beliefs were prefaced with an explanation about the
use of the term FASD: “The remaining questions refer only to FASD. We use the term FASD as this
incorporates the unique syndrome of FAS and all other conditions related to prenatal alcohol
exposure”.
Seven Likert statements were used to assess participants’ knowledge and beliefs about FASD (Tables
5.1 – 5.7). There was overall agreement that FASD is a real ‘syndrome’ (78.8%); alcohol’s negative
effect on fetal development has been proven (77.2%); and FASD is not only an issue for children and
youth (75.7%). Fewer participants agreed that FASD is relevant to their work in the justice system
(65.8%); and assessment and diagnosis of FASD would improve possibilities of appropriate
consequences for unacceptable behaviour (63.8%). Most participants (75.7%) disagreed that
children grow out of FASD and 36.1% of participants disagreed that FASD occurs primarily in
Indigenous families.
Table 5.1: Participant agreement with the statement ‘FASD is a real syndrome’

n=28 (%) n=25 (%) n=132 (%) n=215 (%)
Agree 20 (71.4) 25 (100.0) 126 (95.5) 144 (67.0)
Neither agree nor disagree 7 (25.0) 0 (0.0) 6 (4.5) 68 (31.6)
Disagree 1 (3.6) 0 (0.0) 3 (1.9) 3 (1.4)
16
Table 5.2: Participant agreement with the statement ‘FASD is relevant to my work in the criminal justice
system’

n=28 (%) n=25 (%) n=132 (%) n=213 (%)
Agree 22 (78.6) 23 (92.0) 113 (85.6) 104 (48.4)
Disagree 1 (3.6) 0 (0.0) 1 (0.8) 23 (10.8)
Table 5.3: Participant agreement with the statement ‘Alcohol’s negative effect on fetal development has
been proven’

n=29 (%) n=25 (%) n=132 (%) n=213 (%)
Agree 28 (96.9) 23 (92.0) 118 (89.4) 139 (65.3)
Disagree 0 (0.0) 0 (0.0) 0 (0.0) 4 (1.9)
Table 5.4: Participant agreement with the statement ‘FASD is only an issue for children and youth not adults’

n=29 (%) n=25 (%) n=132 (%) n=213 (%)
Agree 1 (3.4) 0 (0.0) 4 (3.0) 7 (3.3)
Disagree 23 (79.3) 25 (100.0) 120 (90.9) 134 (62.6)
Table 5.5: Participant agreement with the statement ‘Assessment and diagnosis of FASD would improve
possibilities of appropriate consequences for unacceptable behaviour’

n=28 (%) n=25 (%) n=132 (%) n=213 (%)
Agree 22 (78.6) 23 (92.0) 111 (84.1) 98 (46.0)
Disagree 0 (0.0) 0 (0.0) 3 (2.3) 21 (9.9)
17
Table 5.6: Participant agreement with the statement ‘People grow out of FASD’

n=30 (%) n=25 (%) n=132 (%) n=213 (%)
Agree 0 (0.0) 0 (0.0) 1 (0.8) 4 (1.9)
Disagree 18 (64.3) 24 (96.0) 117 (88.6) 81 (38.0)
Table 5.7: Participant agreement with the statement ‘FASD occurs primarily in Indigenous families’

n=30 (%) n=24 (%) n=132 (%) n=210 (%)
Agree 9 (32.1) 6 (25.0) 25 (18.9) 36 (17.1)
Disagree 8 (28.6) 14 (58.3) 67 (50.8) 54 (25.7)
When asked “In your own words, what do you understand FASD to be?” the majority of participants
(81.1%) were able to identify the cause of FASD. This included 31.6% of respondents who mentioned
high or excessive levels of alcohol use. Several respondents also referred to effects of alcohol
consumption at specific stages or times during pregnancy. Most were able to identify one or more of
the effects of prenatal alcohol exposure and some participants were able to provide detailed
information on physical, neurological and behavioural impairments. Overall, 28.6% of survey
participants were able to identify physical development, growth or facial features; 48.5% of
participants mentioned psychological development or used the term cognitive, intellectual, mental,
behavioural, neurological or brain development; and 16.6% of participants noted that FASD is
permanent, irreparable or lifelong. Table 6 summarises the number of participants within each
sector able to identify the key features of FASD.
Table 6: Participant identification of key features of FASD
† † † †
n=28 (%) n=24 (%) n=129 (%) n=211 (%)
Alcohol consumption 25 (89.5) 23 (95.8) 111 (86.0) 159 (75.4)
during pregnancy
Physical development 13 (46.4) 12 (50.0) 53 (41.1) 34 (16.1)
Psychological 15 (53.6) 19 (79.2) 86 (66.7) 70 (32.2)
development
Permanent 5 (17.9) 6 (25.0) 30 (23.3) 24 (11.4)
†
18
Requests for Information
Four questions were used to assess participants’ requirements for more information, including type
of information and the mode of delivery. Overall most participants reported that they would like to
receive more information about FASD (71.5%) and saw merit in having a forum with other
professionals in the justice system to discuss the development of a co-ordinated approach to FASD in
WA (81.0%). Police officers were less likely to agree with the need for more information or a forum
about FASD, than respondents from other sectors (Tables 7.1 and 7.2).
Table 7.1: Participant responses to the question ‘Would you like more information about FASD?’

n=27 (%) n=25 (%) n=114 (%) n=211 (%)
Yes 25 (92.6) 22 (88.0) 103 (90.4) 120 (56.9)
No 2 (7.4) 3 (12.0) 11 (9.6) 91 (43.1)
Table 7.2: Participant responses to the question ‘Would it be helpful to have a forum with other
professionals within the justice system to discuss the development of a co-ordinated approach to FASD in
WA?’

n=27 (%) n=25 (%) n=132 (%) n=213 (%)
Yes 26 (96.3) 23 (92.0) 128 (97.0) 144 (67.6)
No 1 (3.7) 2 (8.0) 4 (3.0) 69 (32.4)
Among participants who wanted to receive more information about FASD, information was most
frequently requested on: behaviours to prompt the need for assessment, guidelines on how to deal
with people with FASD, and contact details for organisations that specialise in the support of people
with FASD (Figure 6 and Table 7.3). Other kinds of information requested included strategies for
government agencies and schools to manage behaviours in children, youth or adults who are
suspected of having FASD but have not had a formal diagnosis. Participants also recommended that
information on how FASD affects people in the justice system should be provided to government
departments to instigate changes to policy and procedures. This is reflected in one participant’s
comment that “the existing infrastructure will prevent managing these offenders in anything other
than mainstream”.
Among participants who wanted to receive more information about FASD, the preferred modes of
delivery of this information were: website or email, continuing professional development event, and
printed information/resources (Table 7.4). Police officers were less likely to request all types of
information compared with respondents from other sectors. Other modes of information delivery
suggested by participants included having ‘Fact Sheets’ and information on internal government
department portals, and internal newsletters that could include information on FASD, recent cases,
what happened and the outcomes achieved.
19
Table 7.3: Participant responses to the question ‘What type of information would you prefer?’
† † † †
n=30 (%) n=22 (%) n=96 (%) n=119 (%)
Information on behaviours to 22 (88.0) 22 (100.0) 77 (80.2) 77 (64.7)
prompt need for assessment
Contact details for organisations 14 (56.0) 19 (86.4) 65 (67.7) 59 (49.6)
which specialise in the care of
people with FASD
More research information 15 (60.0) 14 (63.6) 56 (58.3) 39 (32.8)
List of qualified specialists 9 (36.0) 15 (68.2) 51 (53.1) 21 (17.6)
Guidelines on how to deal with 21 (84.0) 20 (90.9) 86 (89.6) 85 (71.4)
FASD
Information about where to refer 11 (44.0) 17 (77.3) 70 (72.9) 40 (33.6)
for diagnosis
Other 5 (20.0) 0 (0.0) 16 (16.7) 2 (1.7)
†
90%
79.4%
80%
71.2%
70%
58.8%
60% 51.7%
50% 46.4%
40% 36.0%
30%
20%
8.6%
10%
0%
Information on Contacts Research List qualified Guidelines deal Information on Other
behaviours support information specialists with FASD referrals for
organisations diagnosis
†
Figure 6: Summary of participant responses to the question ‘What type of information would you prefer?’
20
Table 7.4: Participant responses to the question ‘How would you prefer the information on FASD was
delivered?’
† † † †
n=30 (%) n=22 (%) n=96 (%) n=141 (%)
Website or email 13 (52.0) 18 (81.8) 62 (64.6) 98 (69.5)
Continuing professional 14 (56.0) 17 (77.3) 50 (52.1) 17 (12.1)
development event
Conferences/seminars 12 (48.0) 8 (36.4) 44 (45.8) 25 (17.7)
Special visit to your practice, 6 (24.0) 8 (36.4) 54 (56.3) 24 (17.0)
department or organisation
‡ ‡
Printed resources N/A 11 (50.0) N/A 46 (32.6)
Other 2 (8.0) 0 (0.0) 9 (9.4) 2 (1.4)
†
‡
Response option not included in survey
Experiences and Practices

Participants were asked to reflect on their experience within the justice system and how FASD
impacts on their work practice. The phrasing of questions in this section varied by sector, consistent
with the different roles of judicial officers, lawyers, DCS staff and police officers. For clarity, generic
terminology is used in the presentation of survey results. For example terms such as clients,
offenders, witnesses, parties have been replaced with the generic term ‘person’. The specific
wording used in each sector survey can be found in Appendix 2.
Suspected FASD
When asked if they had ever dealt with a person who may have been affected by a FASD, police
officers were least likely to report ever dealing with a person who may have been affected by a FASD
(42.8%), followed by lawyers (60.0%), judicial officers (60.7%), and DCS staff (67.0%) (Table 8.1).
Table 8.1: Participant responses to the question ‘Have you have ever dealt with a person who you suspect
had a FASD?’

n=28 (%) n=25 (%) n=106 (%) n=215 (%)
Never 3 (10.7) 4 (16.0) 11 (10.4) 29 (13.5)
Once 2 (7.1) 1 (4.0) 11 (10.4) 9 (4.2)
2-5 times 3 (10.7) 5 (20.0) 31 (29.2) 26 (12.1)
6-10 times 2 (7.1) 2 (8.0) 8 (7.5) 8 (3.7)
11+ times 10 (35.7) 7 (28.0) 21 (19.8) 49 (22.8)
Don’t know 8 (28.6) 6 (24.0) 24 (22.6) 94 (43.7)
21
Participants who reported suspecting that a person had a FASD, were asked to identify factors that
made them suspect a person had FASD. The list of response options provided for this question varied
by sector, for example the corrections survey included “continually disobeys Correctional Services
officer’s instructions”. Response options for judicial officers and lawyers included “unable to follow
court proceedings and instructions”. Overall the most frequently endorsed factors for suspecting
that a person had FASD were: poor attention span, obvious low IQ, know mother is an alcoholic, and
physical appearance (Table 8.2).
Table 8.2: Participant responses to the question ‘What factors made you suspect a person had a FASD?’
† † † †
n=16 (%) n=14 (%) n=68 (%) n=92 (%)
Physical appearance 12 (75.0) 12 (85.7) 53 (77.9) 59 (64.1)
Obvious low IQ 13 (81.3) 11 (78.6) 50 (73.5) 63 (68.5)
Inability to learn from mistakes 6 (37.5) 6 (42.9) 45 (66.2) 49 (53.3)
Repeat offender 7 (43.8) 7 (50.0) 31 (45.6) 58 (63.0)
Does not show empathy 3 (18.8) 6 (42.9) 24 (35.3) 23 (25.0)
Genuinely seems to not 7 (43.8) 6 (42.9) 38 (55.9) 30 (32.6)
remember
Poor attention span 13 (81.3) 10 (71.4) 54 (79.4) 69 (75.0)
Disinterested during interview, 5 (31.3) 7 (50.0) 28 (41.2) 30 (32.6)
consultation, interrogation
Highly suggestible 7 (43.8) 8 (57.1) 31 (45.6) 23 (25.0)
Poor understanding of time 8 (50.0) 7 (50.0) 37 (54.4) 39 (42.4)
Know mother is an alcoholic 0 (0.0) 10 (71.4) 50 (73.5) 69 (75.0)
‡ ‡
Unable to follow court 8 (50.0) 8 (57.1) N/A N/A
proceedings, instructions
‡ ‡
Unable to comply with parole 0 (0.0) 4 (28.6) N/A N/A
orders
‡ ‡
Vulnerable to peer pressure N/A N/A 47 (69.1) 42 (45.7)
‡ ‡
Continually disobeys correctional N/A N/A 26 (38.2) 28 (30.4)
services officers/police officer
instructions
‡ ‡
Cannot read or comprehend N/A N/A 40 (58.8) 47 (51.1)
basic instructions
‡ ‡
Has explosive episodes N/A N/A 38 (55.9) 30 (32.6)
‡ ‡
Has multiple substance N/A N/A 28 (41.2) 55 (59.8)
addictions
‡ ‡
Other 0 (0.0) 1 (7.1) N/A N/A
†Percentages sum to more than 100% as multiple responses were permitted
‡
22
When asked if they would consider taking a more detailed family history (including mother’s
substance abuse history) for juveniles who they suspected had a FASD, 8.0% of judicial officers
responded that they would in every case, 76.0% responded that they would in some cases and
16.0% responded not at all. When judicial officers were asked why they would or would not take a
more detailed family history, many highlighted the limitations of the criminal justice system and
available sentencing options:
“Our criminal justice system’s ability to properly deal with a FASD child is on a par with the FASD
child's ability to deal with the system. Where it is established a child has a FASD, the management
plan never provides for specialist input, and mostly has a minimalist approach.”
“Currently no different/alternative programs are available for juveniles diagnosed with a FASD, so
obtaining a diagnosis or confirming such a suspicion would probably not impact much on the
decisions made by the court as to sentencing.”
“In my experience unless the defendant has an obvious mental impairment which makes him/her
unfit to stand trial no one is interested in getting the defendant assessed or diagnosed. Cost was
the issue for health services, State and NGO [sic] [Non Government Organisation]. However there
are many, many adults and children who transit through the justice system which appear to suffer
one or more of the deficits which FASD encompasses. Without some evidence of even a
preliminary diagnosis the court is not permitted, arguably, to proceed on the basis of diminished
culpability.”
When asked if they would consider taking a more detailed family history (including mother’s
substance abuse history) for juveniles who they suspected had a FASD, 88.0% of lawyers and 87.6%
of DCS staff responded in the affirmative. When lawyers and DCS staff who reported that they would
not consider taking a more detailed family history were asked to identify the reasons for their
response, most indicated that it was outside their role; that they did not know where to refer the
person; or that it would be pointless as it would not change how they managed the client.
Known FASD
Overall, the majority of survey participants (75.1%) had never been informed that a person had a
FASD, and police officers were least likely to report having ever been informed that a client had a
FASD (Table 9).
Table 9: Participant responses to the question ‘Have you ever been informed that a person had a FASD?’

§
N/A n=24 (%) n=102 (%) n=215 (%)
Never 13 (54.2) 62 (60.8) 181 (84.2)
Once 0 (0.0) 25 (24.5) 16 (7.4)
2-5 times 9 (37.5) 13 (12.7) 8 (3.7)
6-10 times 0 (0.0) 1 (1.0) 2 (0.9)
11+ times 2 (8.3) 1 (1.0) 8 (3.7)
Don’t know 0 (0.0) 0 (0.0) 0 (0.0)
§
Question not included in judicial survey
23
When asked if they had dealt with a person that they knew had a FASD, the majority of participants
responded in the negative (Table 10.1). Respondents who reported knowing that a person had been
diagnosed with a FASD were asked how they knew the person had a FASD. Lawyers, DCS staff and
police officers frequently identified a known history of prenatal alcohol exposure; and judicial
officers most frequently reported that investigation by, or on behalf of the court revealed a positive
diagnosis (Table 10.2).
Table 10.1: Participant responses to the question ‘Have you ever dealt with a person who you know had a
FASD?’

n=28 (%) n=25 (%) n=99 (%) n=215 (%)
Never 12 (42.9) 14 (56.0) 31 (31.8) 96 (44.7)
Once 1 (3.6) 1 (4.0) 24 (24.2) 12 (5.6)
2-5 times 5 (17.9) 7 (28.0) 21 (21.2) 16 (7.4)
6-10 times 2 (7.1) 0 (0.0) 3 (3.0) 2 (0.9)
11+ times 4 (17.9) 2 (8.0) 4 (4.0) 19 (8.8)
Don’t know 3 (10.7) 1 (4.0) 16 (16.2) 70 (32.6)
Table 10.2: Participant responses to the question ‘How did you know that a person had a FASD?’
† † † †
Factor Judicial Legal Corrections Police
n=13 (%) n=10 (%) n=51 (%) n=49 (%)
‡ ‡ ‡
Investigation by, or on behalf of, 10 (76.9) N/A N/A N/A
the court revealed a positive
FASD diagnosis
‡ ‡ ‡
The defence counsel advised you 7 (53.8) N/A N/A N/A
that the person had FASD
‡ ‡ ‡
The prosecution advised you that 1 (7.7) N/A N/A N/A
the person had FASD
‡ ‡ ‡
File notes indicated a FASD 2 (15.4) N/A N/A N/A
diagnosis
‡
Awareness of positive FASD N/A 6 (60.0) 31 (60.8) 11 (22.4)
diagnosis
The person advised you that s/he 1 (7.7) 2 (20.0) 8 (15.7) 6 (12.2)
had FASD
Known history of prenatal 6 (46.2) 5 (50.0) 31 (60.8) 37 (75.5)
alcohol exposure
Characteristic facial features 5 (38.5) 5 (50.0) 24 (47.1) 18 (36.7)
Other 2 (15.4) 3 (30.0) 10 (19.6) 6 (12.2)
†
‡
24
Support and Services
When asked if they had ever recommended, required or referred a person for a diagnosis most
judicial officers, lawyers and DCS staff responded that this had never occurred (Table 11).
Participants who had referred a person for a diagnosis did not provide specific information about
where this occurred. However, one participant commented that “they are expected to manage the
behaviours, while ‘experts’ are appointed to provide this diagnosis yet they are not privy to this as it
is considered confidential medical information”.
Several participants stated they strongly suspected that a lot of people within the prison and youth
justice systems are afflicted with this disorder but they had never been advised that these
individuals had been assessed or diagnosed. Some also commented that it was not their role and
questioned who would listen if they suggested FASD as an issue. One participant remarked that they
were not sure if it was appropriate for them to be suggesting the need for a medical diagnosis.
Table 11: Participant responses to the question ‘Have you ever recommended, required or sent a person for
diagnosis for FASD where you suspected FASD may be relevant?

§
n=26 (%) n=23 (%) n=92 (%) N/A
Never 19 (73.1) 19 (82.6) 75 (81.5)
Once 0 (0.0) 0 (0.0) 8 (8.7)
2-5 times 4 (15.4) 3 (13.0) 5 (5.4)
6-10 times 0 (0.0) 0 (0.0) 2 (2.2)
11+ times 3 (11.5) 1 (4.3) 0 (0.0)
§
Question not included in police survey
Among judicial respondents who reported having never recommended that an offender be sent for
diagnosis for FASD 50.0% stated that is was not part of their role, 41.7% said it would not change
how they consider the case, 16.7% did not know where to refer the person and 8.3% stated they had
no knowledge of FASD at the time. Among legal respondents who reported having never
recommended that a client be sent for diagnosis for FASD 55.6% said they did not know where to
refer the person, 33.3% reported trying a number of options which did not work, and 11.1% said it
would be pointless because it would not change how they manage the client. Among corrections
respondents who reported having never recommended that a client be sent for diagnosis for FASD
82.4% said they did not know where to refer the person, 11.8% reported trying a number of options
which did not work, and 5.9% said it would be pointless because it would not change how I manage
the client.
Few respondents reported using a trained person to communicate with a client or offender that they
knew had a FASD (Table 12.1). Among the respondents who reported never using a trained
communicator, the most frequent reason given was that no such services exist (Table 12.2). In
addition to responses reported in Table 12.2, lawyers, DCS staff and police officers provided other
responses to explain why they did not use a trained communicator. These responses most
frequently indicated a lack of awareness of the existence of services.
25
Table 12.1: Participant responses to the question ‘Have you ever used a trained person to communicate with
a person that you knew had a FASD?’

n=29 (%) n=25 (%) n=86 (%) n=212 (%)
Never knowingly 7 (24.1) 9 (36.0) 83 (96.5) 92 (43.4)
encountered a person
with FASD
Never 22 (75.9) 16 (64.0) 1 (1.1) 118 (55.7)
Once 0 (0.0) 0 (0.0) 2 (2.3) 1 (0.5)
2-5 times 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)
6-10 times 0 (0.0) 0 (0.0) 0 (0.0) 1 (0.5)
11+ times 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)
Table 12.2: Participant explanations for not using a trained person to communicate with a client or offender
they knew had a FASD
† †
n=21 (%) n=12 (%) n=0 (%) n=87 (%)
No such services exist 18 (85.7) 8 (66.7) 0 (0.0) 60 (69.0)
Services are difficult to 3 (14.3) 4 (33.3) 0 (0.0) 22 (25.3)
access due to location
Such services are only 2 (9.5) 0 (0.0) 0 (0.0) 3 (3.4)
available for those with a
diagnosis and the person
did not have a diagnosis
I am well trained to 1 (4.8) 0 (0.0) 0 (0.0) 2 (2.3)
communicate with a
person with a FASD
‡ ‡
Not necessary to have 3 (14.3) 0 (0.0) N/A N/A
such a service
†Percentages sum to more than 100% as multiple responses were permitted
‡
Sentencing
Counselling and use of behaviour change programs (61.9%) were most frequently reported by
judicial officers when asked what current diversionary sentencing options were they most likely to
consider. Other sentencing options included: use of the juvenile justice team (47.6%), alcohol
programs (47.6%), and drug programs (42.9%). Judicial officers were also asked to consider what
alternative treatment/diversionary sentencing options would be helpful.
26
“I believe some alternative programs/treatment options would need to be developed that take
into account the cognitive deficits, behavioural patterns and developmental delays of individual
offenders with FASD. This is particularly required in respect of adult offenders, where current
programs are provided on a "one size fits all" basis and where consequences for breach of orders
if they fail to attend or successfully complete such programs can be onerous. Strong supervision
in the community, with strong long-term relationship with offender. Appropriate medical
supports.”
“As Judges we are not trained to identify FASD and it is not in our power to refer offenders to a
specific treatment facility. All we can do as part of the sentencing process is to ask for
psychological or psychiatric reports and we rely on them for identification of any mental
disorders and suggested treatment. If the offender is given a community based order,
Community Corrections decide what programmes/ treatment the offender should attend. A
Judge can only make a recommendation. If it is a prison sentence, prison authorities decide what
courses or treatments are offered in prison. I am very interested to learn more about FASD, but
the people who would identify this disorder or make treatment available would be Community
Corrections, the psychologists employed by them and the prison authorities. Lawyers also need
to be trained to identify the symptoms so they can ask the judge to order a psychological report
to determine fitness to stand trial or for purposes of sentencing. A judge has very little personal
contact with an offender, as all discussions are with the offender's lawyer.”
“Diversion through the IDD [sic] [Intellectual Disability Diversion] or Mental Health Court. FASD
symptoms and low IQ in particular make it very difficult to succeed in Drug or Family Violence
Court, especially the latter which relies on group therapy. Inclusion of DCP and signs of safety in
relation to a juvenile.”
“…programmes run specifically for people suffering FASD impairment, or catering specifically for
people with similar impairments. There is a need to undertake a specific assessment of the
defendant’s needs, and a programme developed to assist and support the defendant and the
family. If that person is Aboriginal then there need to be Aboriginal people involved in the
assessment/delivery of the programme/support.”
“I believe that in Canada a programme for dealing with FASD offenders has been developed, and
I would like to see similar programmes in WA. However, because of the limited capacity to
change the behaviours of FASD sufferers, the provision of a supportive environment, other than
a custodial environment, in which the exposure of FASD offenders to the stimuli which might
encourage re-offending can be reduced, would provide an important alternative to prison. At
present we are essentially dependent upon family members for the provision of such an
environment, and in some cases there are simply no family members who are willing or able to
provide such an environment.”
Lawyers and police officers were asked to respond to a series of questions with respect to
sentencing options. While most participants thought that it would be helpful to have alternative or
diversionary sentencing options for people with FASD (Table 13.1), many neither agreed nor
disagreed with specific sentencing options listed in Table 13.2.
27
Table 13.1: Participant responses to the question ‘Do you think it would be helpful to have
alternative/diversionary sentencing options?’

§ §
N/A n=25 (%) N/A n=102 (%)
Yes 23 (92.0) 102 (100.0)
No 2 (8.0) 0 (0.0)
§
Question not included in judicial and corrections survey
Table 13.2: Lawyer and police officer agreement with statements on sentencing options
Practice Agree (%) Neither agree nor Disagree (%)

disagree (%)
In your opinion is a longer custodial sentence an appropriate sentence for a person diagnosed with a
FASD?
Legal n=25 0 (0.0) 5 (20.0) 20 (80.0)
Police n=205 23 (11.1) 122 (59.5) 60 (29.3)
In your opinion is a higher level of supervision an appropriate sentence for a person diagnosed with a
FASD?
Legal n=25 14 (56.0) 8 (32.0) 3 (12.0)
Police n=209 130 (62.2) 77 (36.8) 2 (1.0)
In your opinion is a suspended term of imprisonment an appropriate sentence for a person
diagnosed with a FASD?
Legal n=24 2 (8.3) 10 (41.7) 12 (50.0)
Police n=202 25 (12.4) 119 (58.9) 58 (28.7)
In your opinion is an unsupervised community based order an appropriate sentence for a person
Legal n=25 2 (8.0) 10 (40.0) 13 (52.0)
Police n=201 6 (3.0) 80 (39.8) 115 (57.2)
In your opinion is a supervised community based order an appropriate sentence for a person
Legal n=25 16 (64.0) 8 (32.0) 1 (4.0)
Police n=207 103 (49.8) 85 (41.1) 19 (9.2)
Practices
Judicial officers were asked to evaluate a series of statements on modifying practices when dealing
with a person with FASD. As summarised in Table 14 most judicial officers agreed that they would
change or modify their language, their approach to communicating with the person, and the
formality with which they conducted the proceedings. Over 80.0% of judicial officers indicated that a
more detailed knowledge of FASD would assist their work in the justice system.
28
Table 14: Judicial officer responses to statements on changes or modifications to practice
Practice Agree (%) Neither agree nor Disagree (%)

disagree (%)
I would change or modify my approach to 16 (61.5) 10 (38.5) 0 (0.0)
formality n=26
I would change or modify my use of 18 (72.0) 7 (28.0) 0 (0.0)
language n=25
communication methods n=26
I would change or modify the speed of 13 (54.2) 11 (45.8) 0 (0.0)
proceedings n=24
closing the court n=25
fitness to plead n=26
A more detailed knowledge of FASD would 22 (84.6) 4 (15.4) 0 (0.0)
assist my work in the criminal justice
system n=26
Lawyers, DCS staff and police officers were also asked to indicate if a more detailed knowledge of
FASD would assist in their work (Table 15). More than 85.0% of lawyers and DCS staff, and 65.5% of
police officers responded that it would occasionally or frequently be of benefit.
Table 15: Lawyer, DCS staff and police officer responses to the question ‘Do you think a more detailed
knowledge of FASD would assist in your work in the criminal justice system?’

§
N/A n=25 (%) n=80 (%) n=215 (%)
Not at all 1 (4.0) 0 (0.0) 29 (13.5)
Rarely 1 (4.0) 9 (11.3) 45 (20.9)
Occasionally 10 (40.0) 21 (26.3) 116 (54.0)
Frequently 13 (52.0) 50 (62.5) 25 (11.6)
§
Question not included in judicial survey
Decision making
An open-ended question was used to identify how knowledge that a client or accused has FASD
impacts on the work of judicial officers, lawyers and police officers. A total of 29 judicial officers, 25
lawyers and 207 police officers responded to the question and findings are summarised below by
sector.
29
Judicial Officers
The knowledge that a defendant had been diagnosed with FASD was perceived by most respondents
as relevant to the assessment of fitness to plead and relevant to culpability when sentencing. This
knowledge would also inform decision making as to the defendant’s likelihood to comply with the
order and if it would be setting them up to fail. Judicial officers stated that all impairments were
highly relevant to sentencing, irrespective of the cause.
“We deal with people with low IQ, learning difficulties and emotional deficits, however caused,
daily. We respond to the effects, not the syndrome.”
“I might try to be more creative in sentencing in order to accommodate particular behavioural

features of an offender. I might decide against a formal order if I felt to do so would be setting
the offender up to fail. (i.e. If they have no realistic prospects of complying with its
requirements)”
Lawyers
Of the lawyers who responded to this question, almost a third were of the view that the knowledge
their client had FASD would change the way in which they dealt with them; and over half considered
it relevant to the issues of fitness to plead and alternative or appropriate sentencing. Respondents
also identified the impact of FASD when taking instructions from a client and the need for expert
evaluation, diagnosis and support services.
“I am very careful to ensure the accused understands the charge; the facts alleged; the process;
the consequences of their plea. I am mindful to ensure that they are fit to plead and that they, at
the relevant time, had the mental capacity to form an intent. I regularly seek expert
assessment.”
“I would change the way I deal with a child – and make me think even more carefully about how
I explain complex legal matters. I would ask the court to source more resources for sentencing
options.”
Police
Over one third of police officers identified the effect of FASD in dealing with, interviewing and
cautioning an offender. Approximately one fifth of respondents identified that the knowledge that
an offender had FASD would have no impact on their work. Respondents also frequently indicated
that knowledge that an offender had FASD would enable them to understand the offender’s
behaviour.
Police officers noted that they must deal with an offender in accordance with rules and regulations
imposed on them. A number of police officers commented that there should be justice for everyone,
including the victim. It was also noted that FASD should not be used as an excuse for violent or
recidivist offending, and that the community is deserving of protection from offenders.
“As my purpose is to keep victims safe or reduce crime, the knowledge that an offender has
FASD would not impact on my functions in those areas. I can feel sorry for the offender but I
cannot avoid the consequence, it is up to another area of justice to deal with the offender after
he is charged.”
30
“You usually have greater difficulty dealing with them as they tend to have no concept of how
their offending affects others and do not show any regard for possible punishments”.
“I am not sure if putting a specific 'title' to a person’s condition would help. Police officers have
to be able to adapt their communication style to effectively communicate and deal with every
person they interact with. Highly educated people, poorly educated people, people that have
English as a second language, people with learning impairments all present unique problems
that all law enforcement officers have to deal with. If the individual is dealt with as per WAP
[sic] [WA Police policy] and procedure and the CIA [sic] [Criminal Investigations Act 2006] then
the knowledge that an offender has FASD (ie the specific title) should only be relevant to the
court. I am open to being convinced though....”
Challenges
An open-ended question was used to identify what challenges judicial officers, lawyers and police
officers face in dealing with, and ensuring fair justice outcomes for an individual with FASD. A total
of 23 judicial officers, 24 lawyers and 205 police officers responded to the question and findings are
summarised below by sector.
Judicial officers
Approximately one third of respondents identified the challenge of ensuring that the individual with
FASD understands the charges and court processes. Other challenges identified included: issues of
appropriate sentencing and effective rehabilitation, and access to support and services.
“When the offending is in the more serious categories. Unsuitability for a CBO [sic] [Community
Based Order] due to lack of engagement, low IQ etc. Lack of sentencing options. The complexity
of their issues. The use of alcohol and substance abuse as complicating factors and lack of
preparedness to address substance abuse issues. Difficulty of implementing long term strategies
for behaviour change. The difficulties of no discretion in the sentencing process when facing
mandatory imprisonment, eg third striker.”
“It is a long term problem that will always impact on the sufferer's life. The system rarely has the
ability to address the behaviour in a long term manner, and almost never with the continuity of
supervision and relationship needed to have an impact.”
Lawyers
Half the legal respondents made reference to the challenge posed by a lack of knowledge and
recognition of FASD. Other challenges identified included: issues of appropriate sentencing, and
access to diagnosis and health professionals.
“Is the whole process relevant to them? Do they understand? They need assistance but they
often do not comply/attend appointments. How is specific deterrence going to be relevant if
they don’t really comprehend what is happening? The flip-side of submissions that your client is
mentally unwell is that they will continue to compromise the protection of the community.”
“Diagnosis and recognition of it as separate mental health issue. Little understanding of how the
condition might be managed.”
31
Police Officers
Police officers most frequently identified that they were unsure of the challenges faced in dealing
with an individual with FASD and ensuring fair justice outcomes. Respondents commonly referred to
their role within the justice system and that it was the responsibility of the courts to make a
determination of guilt and examine any mitigating factors. Other challenges included appropriate
sentencing, effective rehabilitation, and the issue of reoffending and protection of the community.
Some police officers also identified that they did not face any challenges in ensuring fair justice
outcomes for an offender with FASD.
“There is not much awareness of it and it is not known what systems are in place to assist the
individual or police officer.”
“We don't want to add to the 'revolving door' justice system. By tailoring sentences to
individuals, the system is more likely to have a positive impact on offenders, break the cycle of
offending and reduce crime.”
“It is the role of the police to gather evidence and present this to the court, it is the role the
Department of Justice and the Courts to ensure fair justice.”
“A police officer is not so involved with the outcome that more relates to courts and prosecutors
etc but we need to know about FASD so we can present the facts and communicate better.”
Support
An open-ended question was used to identify what information, services and processes might assist
judicial officers, lawyers and police officers in dealing with and ensuring fair justice outcomes for an
individual with FASD. A total of 21 judicial officers, 24 lawyers and 201 police officers responded to
the question and findings are summarised below by sector.
Judicial officers
Respondents most frequently identified access to support and services, including multi-agency input
and access to health professionals and diagnostic services would assist them in dealing with an
individual with FASD. The need for appropriate rehabilitation options including sentencing and
diversionary options was also identified by judicial officers. Other responses highlighted the
importance of improved awareness and knowledge of FASD and its effects within the community.
“Case studies which reveal the success and failures of alternate approaches would be of
considerable value. Similarly it would be of value to know of other approaches adopted in other
jurisdictions and any studies measuring their success.”
“… more education about FASD and its effects (for judiciary, lawyers and service providers),
more information about having it effectively diagnosed and more appropriate treatment
options/diversion programs to which to refer such offenders.”
Lawyers
The importance of greater awareness and knowledge of FASD and its effects within the community
was most frequently mentioned by lawyers. Access to health professionals and diagnostic services;
support and services, including multi-agency input; and easily accessible information on FASD, were
also identified as important resources in dealing with an individual with FASD.
32
“The availability of experts who can diagnose and inform the court of those who have FASD, and
the cognitive and behavioural ramifications involved in individualised assessments of FASD
clients. More appropriate and diversionary sentencing options.”
“Knowledge, education, treatment options, and guideline recommendations on general capacity

for diagnosed FASD clients to comply with various sentencing dispositions.”
Police officers
Police officers most frequently identified that they were unsure of what information, services and
processes may assist them in ensuring fair justice outcomes for an individual with FASD. Other
responses included the need for access to support and services including multi-agency input, greater
awareness and knowledge of FASD and its effects within the community, and access to training and
education.
“If it is a diagnosed disability and this is taken into account at sentencing with the justice
outcome fair to the offender AND the community, that would lead to a fairer result all round. I
do not know if there is a treatment program. The problem has to be resolved before the child is
born ie by education in the communities where FASD is an issue of the dangers of alcohol abuse
whilst pregnant.”
“…Police can't affect sentencing but we can offer or direct persons to help if we know where to
send/refer them (this can help in prevention).”
“Information so that a warning can be given to officers so that they manage there [sic] [their]
investigations with FASD in mind.”
“Earlier intervention with persons effected. If the sufferer is in the Justice system in most cases it
is too late to save them. In my experience there is a very strong link between juvenile offenders
and FAS.”
33
Discussion
This study provides the first description of perceptions and practices related to FASD in the WA
justice system. Many of the findings from this study are consistent with the original study of judges
and prosecutors in Canada which provided the foundation for this work.20 Our study extends the
work of Cox and co-workers to examine the perceptions and practices of professionals from all four
sectors of the justice system in WA – judicial, legal, corrections and police. More than 75% of
participating judicial officers, more than 85% of participating lawyers and DCS staff, and almost 50%
of police officers perceived FASD as relevant to their work. Across all four sectors of the justice
system most participants reported only a basic understanding of FASD and how it affects individuals,
and most indicated a need for improved knowledge about FASD, including information to improve
the identification of individuals in need of specialist assessment, and guidelines on how to deal with
people with FASD. We also found strong support across all sectors for the development of
appropriate alternative or diversionary sentencing options for people with FASD. These findings
provide valuable evidence which can be used to improve the ability of justice system professionals to
deliver appropriate and effective services to the WA community, and improve the application of
equality before the law in WA for people with FASD.
Awareness and Knowledge

Over 90% of participating judicial officers, lawyers and DCS staff were aware of FAS. Awareness of
FASD was lower than for FAS across all sectors, and slightly lower than levels found among judicial
officers and lawyers in QLD.49, 50 Similar to findings reported from studies in QLD49, 50and Canada,20
the mainstream media was reported as the primary source of information on FASD. Formal training
or professional education was identified as a significant source of information only among DCS staff,
highlighting differences between sectors in the provision of training and development related to
FASD. Although others have noted the potentially inaccurate nature of information about FASD
communicated in the mainstream media,49, 50 the recent implementation of two health promotion
campaigns in WA to improve awareness of the harms associated with alcohol exposure during
pregnancy54 may positively influence awareness, knowledge and the mainstream media discourse.
In contrast to findings among QLD judges, where there was only 50% agreement that ‘FASD is an
identifiable syndrome’49 almost 80% of WA participants agreed that FASD is real, and that the
negative effect of alcohol on fetal development has been proven. When participants were asked to
describe their understanding of FASD, we found few differences in response between the judicial,
legal and corrections sectors in the frequency of identification of the following four key aspects of
FASD: identification of the cause as alcohol consumption during pregnancy, identification of
potential impacts on physical and psychological development, and recognition that the damage is
permanent. Despite little access to formal assessment and diagnosis or specific support services for
FASD within the justice system, some descriptions of how FASD can affect an individual a person
were highly accurate.
As found in studies of United States service professionals48 and QLD judges and lawyers,49, 50
participants were most knowledgeable about the cause of FASD, and factors therefore important for
prevention. Notably, some participants described FASD as caused by excessive alcohol use, alcohol
34
abuse or dependence. Although evidence generally supports the presence of a dose-response
relationship between prenatal alcohol exposure and the severity of observed impairments,55-57 the
epidemiology of FASD remains complex, and there is currently no known safe level of alcohol for
consumption during pregnancy.58
Consistent with the importance of formal training or professional development as a source of

information on FASD among DCS staff, knowledge about FASD was highest among DCS staff, who
were more likely to report a good understanding of how FASD affects children and adults (44%) than
participants from all other sectors. Few DCS staff reported not being aware of how FASD affects
children and adults (5%) compared with 30% or more among participants from other sectors. A good
understanding of FASD among DCS staff is important to enable the appropriate identification and
management of individuals with FASD, and FASD prevention within the corrections sector. However,
appropriate management of people with FASD within the justice system requires adequate
awareness of FASD and its consequences across all sectors where people with FASD experience
disadvantage.42, 59
An understanding of how FASD affects individuals and their behaviour is critical to the identification
of appropriate responses to this issue across all sectors of the justice system. Over 70% of
participants requested further information and training on FASD, indicating the need for effective
training programs designed to meet the specific requirements of staff within each sector, as have
been recommended elsewhere.20 Practical information on the identification and management of
people with FASD was most frequently requested, as was also found among judges and prosecutors
in Canada.20 Requested information included assistance in identifying the need for specialist
assessment, guidelines on how to deal with people with FASD, and where to go for support.
Participants most commonly desired delivery of information electronically and via continuing
professional development events.
Compared with all other participants, police officers reported lower awareness of FAS and FASD, and
identified fewer key features of FASD. Police officers were also least likely to have been informed
that a person had a FASD, and most likely to be unsure if they have ever dealt with a person they
suspected of having a FASD. Lower awareness of, and less experience with FASD, may in part explain
the findings that only approximately half of police officers were likely to perceive FASD as relevant to
their work, that they were less likely to request both general and specific information about FASD,
that they were less likely to agree that more detailed knowledge of FASD would assist their work,
and that they were less likely to endorse the need for a co-ordinated approach to FASD in WA than
participants from other sectors.
Recognition of FASD
Participants across all sectors frequently reported recognition of suspected FASD among individuals
they dealt with, and raised concerns about the management of these individuals within the current
system. Although this study was not designed to assess the prevalence of individuals with FASD
within the justice system, participant responses indicate considerable awareness of FASD as an
unaddressed issue within the justice system, and a perceived need for improved knowledge, services
and programs to address the disadvantage experienced by individuals with FASD across all sectors of
35
the justice system.42 A high rate of incarceration among individuals with FASD has been
demonstrated in North America,18, 28, 60 and formal investigations are required to assess the extent of
involvement of people with FASD in the justice system in Australia and address this critical
information gap.
Reported suspicion of FASD was most commonly based on identification of a poor attention span,
low IQ, maternal history of alcoholism and physical appearance. Attention and arousal issues are
frequently encountered among people with FASD.55, 57, 61 While low IQ does occur among some
individuals, it is not a characteristic feature of FASD. Most individuals with FASD have an IQ within
the normal range.8, 62 Low IQ was also frequently associated with suspicion of FASD among both
judges and lawyers in QLD.49, 50 The consistency of this finding between the WA and QLD studies
suggests that perceptions of low IQ among individuals with FASD may be based on understanding of
IQ as a well-known general indicator of cognitive function. However, IQ score is a composite
indicator which can mask variability in performance and correlate poorly with successful functioning
outside a structured test environment, and does not often indicate the spectrum of behaviours or
nature of the cognitive impairments exhibited by people with FASD.63 Identification of specific
deficits in cognitive abilities including executive function, memory and adaptive function is needed
to ensure that the impairments of individuals with FASD are recognised.59
Approximately 60% of participants from the judicial and legal sectors and 67% of staff from the
corrections sector reported ever dealing with a person who may have FASD, a finding similar to
those reported among judges and lawyers in QLD (69% and 58% respectively)49, 50 and judges and
prosecutors in Canada (59% and 53% respectively).20 Considerably fewer participants had ever
recommended or referred person for diagnosis, as was also found in QLD49, 50 and Canada.20 The
most common reasons for never referring for diagnosis among judicial officers were that it was not
their role, and that it would not change how the case is managed. Among lawyers and DCS staff the
most common reason for never referring for diagnosis was that they did not know where to refer
the person. These findings demonstrate the impact of sector on both experiences and requirements
for specific knowledge about FASD in the justice system. These findings reinforce the call for specific
multidisciplinary diagnostic services for FASD in WA.64
Participants from all sectors recognised the need for appropriate medical support for people with
FASD. Judicial officers highlighted the need for formal evidence of impairment relevant to the
assessment of culpability and sentencing, and the role of lawyers in identifying when specialist
assessment is required. Participants from all sectors noted the lack of services available for
assessment, management and support for individuals with FASD and identified the need for further
information in these areas. Over 70% of DCS staff and lawyers, 44% of judicial officers and 34% of
police officers requested information about where to refer individuals for FASD diagnosis. DCS staff
were most likely to report dealing with a person that they knew had FASD, consistent with both their
greater awareness of FASD and their primary role in the management, rehabilitation and support of
offenders.
Police officers frequently stated the limited nature of their role in the determination of justice
outcomes for individuals with FASD, citing their primary responsibilities as investigation and the
presentation of evidence for consideration in court, where mitigating circumstances are then
considered. Many perceived the delivery of fair justice outcomes to be governed by legislative
requirements and largely determined by factors outside of their control and their sector.
36
Identification of FASD
Police officers and other participants frequently referred to the constant need to adapt their
practices to the needs of individuals with a variety of impairments, irrespective of the cause.
Participants noted that FASD is only one of many conditions that can impair an individual’s cognition
and behaviour, and the impact of a disorder on an individual’s cognition and behaviour was
considered of central importance, rather than the specific cause of the impairment. Studies in other
countries have highlighted that, due to poor awareness of the specific impairments associated with
FASD, and the apparent ability of individuals with FASD to communicate normally, FASD often
remains an unidentified impairment.59, 65 Although the services of health professionals are required
to provide specific information and advice about individuals with FASD, for the effective
identification of FASD there is a need for justice system professionals to recognise and understand
the basic neurocognitive impairments experienced by people with FASD to prompt the need for
specialist assessment.26
We found widespread agreement among judicial officers, lawyers and DCS staff that the assessment
and diagnosis of FASD would improve the possibilities of appropriate consequences for unacceptable
behaviour, with levels of agreement found among judicial officers (79%) and lawyers (92%) in WA
similar to those reported in Canada (87% and 82% respectively),20 and slightly higher than those
found in QLD (69% and 81% respectively).49, 50 This is in line with the views expressed by the Chief
Justice of WA in his submission to the WA Legislative Assembly Education and Health Standing
Committee enquiry into FASD. 42 Many participants commented that the current system was
unprepared and inadequately resourced to deal with FASD, with limited availability of alternative
sentencing options.
Consistent with the CBA and ABA resolutions which urge avoidance of the criminalisation of people
with FASD30, 31 participant responses highlighted the need for improved capacity within the system to
ensure effective identification of people with FASD and to provide programs which meet the specific
needs of these individuals. Participants recognised that individuals with FASD required practice
modifications to meet their needs during police interviews and cautioning, interactions with and
giving instructions to their lawyer, and during and following the court process, including during
incarceration, complying with court orders and provision of appropriate support within the
community. Participants from all sectors recognised the need for alternative sentencing options,
including diversion through a mental health court and programs which provide a supportive
environment for individuals where the propensity to reoffend can be reduced.
Improved general awareness of FASD and access to specialist assessment services are important to
ensure that the specific deficits experienced by individuals with FASD do not remain undetected and
unaddressed in the justice system and in the general community. Failure to provide specific
screening and diagnostic services for FASD precludes recognition of critical impairments in capacity
and appropriate treatment. Formal evaluation of screening tools, including use of a locally
appropriate checklist66 and facial photography67, 68 is needed to develop a standard and effective
approach to the identification and referral of individuals for specialist assessment. Specialist
multidisciplinary diagnostic services are recognised as the current standard for diagnosis69 and there
is an acknowledged need for improved national diagnostic capacity for FASD in Australia.64 Work is
continuing on the development of a national standard diagnostic tool for FASD in Australia,70,71 and
reinforcing calls for the establishment of specialist diagnostic capacity for FASD within the health
37
service of WA.64, 72 Resources are also required to improve awareness of issues faced by people with
FASD in the justice system and the management of individuals with FASD throughout the justice
process, including the development of support services, legal resources and case law for FASD.20, 32
The lack of awareness of FASD in the general community, and lack of support services for people
with FASD in the community were identified as important factors contributing to difficulties and
issues encountered with FASD in the justice system. The frequent lack of family support for many
people with FASD was also identified as a specific challenge. Strengthened prevention and
management of these disorders in the community were considered key to preventing encounters
with the justice system and addressing the drug and alcohol use and social circumstances that
contribute to offending and recidivism.25, 73
There is growing evidence from North America describing programs which have proven efficacy in
changing the behaviours of people affected by prenatal alcohol exposure and the lives of their
families, carers and education.74, 75 There is a need to develop effective locally-appropriate programs
able to induce positive and sustained changes in behaviour and outcomes in the Australian context,
including early intervention strategies to prevent children and youth with FASD appearing, or
reappearing, before the courts. Policymakers have recognised that the cost of establishing programs
for the diagnosis, management and prevention of FASD may be offset at a later date against the
savings in the criminal justice system.42
Limitations
As a result of the consistently low response across sectors, our survey findings are unlikely to be
generalisable. The inability of the investigators to directly administer the survey and provide
personalised follow-up is likely to have contributed to the low response. A low response was also
observed among similar surveys of judicial officers49 and lawyers50 in QLD despite considerable
support for the research among the target group. A comparatively higher response (46% overall) was
observed in a Canadian study of judges and prosecutors which differed to the current study in the
use of personalised follow-up, including provision of the option to complete the survey via
telephone interview, and the use of a considerably shorter questionnaire.20
The comparability of findings between sectors may also be influenced by variation in the nature of
the participating organisations and the sampling methods used. Unlike participants from the other
sectors, police officers who were invited to participate in the study were a random sample of all
sworn officers. The larger police and corrections sector organisations also include significant
specialisation of work roles, some of which may have more limited relevance to FASD. This may also
occur in the judicial and legal sectors.
38
Conclusions
Our findings reveal deficits in the treatment of individuals with FASD within the justice system which
are similar to those reported in studies of judges, lawyers and prosecutors in QLD49, 50 and Canada,20
and demonstrate important similarities and differences in perceptions and practice between
professionals working in different sectors of the justice system. Overall we found that the WA justice
system is poorly prepared and resourced to consider the neurocognitive impairments associated
with FASD. Identified challenges to the effective management of individuals within the justice
system include the need for:
1. training and education to improve awareness of the specific impairments associated with FASD
that impact on the treatment of individuals with FASD across the justice system of WA;
2. training and education to describe how individuals with FASD should be managed;
3. improved methods for the identification of individuals with FASD and referral for specialist
assessment;
4. identified specialist diagnostic services for FASD;
5. information to enable the appropriate recognition and management of an individual’s
neurocognitive and behavioural impairments within the justice system;
6. effective alternative sentencing options;
7. programs and resources to provide appropriate treatment for the underlying fixed brain injury;
and
8. management and supportive environments specific to the needs of individuals with FASD.
Ultimately, the findings from this work emphasise the need for change within and outside of the
justice system to prevent the continued engagement of people with FASD with the justice system.
Participants recognised the importance of a co-ordinated cross-sector approach to the development
of policies to improve both the recognition of, and response to, FASD. The strong engagement
established among project partners provides a valuable foundation for continued collaboration to
facilitate the development of locally appropriate resources and interventions to enable the more
effective identification and management of people with FASD in the WA justice system.
39
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64. Mutch R, Peadon EM, Elliott EJ, Bower C. Need to establish a national diagnostic capacity for
foetal alcohol spectrum disorders. J Paediatr Child Health [Article]. 2009; 45(3):79-81.
65. Burd L, Selfridge RH, Klug MG, Juelson T. Fetal Alcohol Syndrome in the Canadian corrections
system. Journal of FAS International. 2003:e14.
66. Conry Julianne, Asante Kwadwo Ohene. Youth Probation Officers' Guide to FASD Screening and
Referral. Maple Ridge; 2010. Available from:
http://www.asantecentre.org/_Library/docs/Youth_Probation_Officers_Guide_to_FASD_Screening_
and_Referral_Printer-Friendly_Format_.pdf
67. Astley SJ, Stachowiak J, Clarren SK, Clausen C. Application of the Fetal Alcohol Syndrome facial
photographic screening tool in a foster care population. J Pediatr. 2002; 141:712-717.
68. Clarren SK, Sampson PD, Larsen J, Donnell DJ, Barr HM, Bookstein FL, et al. Facial effects of fetal
alcohol exposure: Assessment by photographs and morphometric analysis. Am J Med Sci. 1987;
26:651-666.
69. Astley SJ. Diagnosing Fetal Alcohol Spectrum Disorders (FASD). In: Adubato SA, Cohen DE,
editors. Prenatal Alcohol Use and FASD: A Model Standard of Diagnosis, Assessment and Multimodal
Treatment. Oak Park, Illinois: Bentham Science Publishers Ltd. Bentham eBooks; 2011.
70. Watkins Rochelle E, Elliott Elizabeth J, Mutch Raewyn C, Latimer Jane, Wilkins Amanda, Payne
Janet M, et al. Health professionals' perceptions about the adoption of existing guidelines for the
diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatrics. 2012; 12:69.
71. Watkins Rochelle E, Elizabeth J Elliott, Raewyn C Mutch, Janet M Payne, Heather M Jones, Jane
Latimer, et al. Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a
modified Delphi study. British Medical Journal Open. 2012; :e 001918 doi:1136/bmjopen-2012-
001918
72. Mutch R, Wray J, Bower C. Recording a history of alcohol use in pregnancy: An audit of the
knowledge, attitudes and practice at a child development service. J Popul Ther Clin Pharmacol. 2012;
19(2):e227-e233.
73. Malone M, Koren G. Alcohol-induced behavioural problems in fetal alcohol spectrum disorders
versus confounding behavioural problems. Journal of Population Therapeutics & Clinical
Pharmacology. 2012; 19(1):e32-40.
74. Bertrand J. Interventions for children with fetal alcohol spectrum disorders (FASDs): overview of
findings for five innovative research projects. Res Dev Disabil. 2009; 30(5):986-1006.
45
75. Streissguth AP, Barr HM, Kogan J, Bookstein FL. Understanding the Occurrence of Secondary
Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE), Final Report
to the Centers for Disease Control and Prevention (CDC). Seattle; 1996.
46
Appendix 1: FASD and Justice Websites
New Zealand
Court in the Act - Newsletter of the Youth Court of New Zealand (2-part special on FASD December
2010)
Part 1: http://www.lsa.co.nz/courts/youth/documents/publications-
andmedia/newsletters/Issue%2050.pdf
Part 2: http://www.youthmentoring.org.nz/content/docs/Court%20in%20the%20Act.Dec.pdf
Fetal Alcohol Spectrum Disorder (FASD): Undiagnosed and Unrecognised - Judge Stephen
O’Driscoll
http://www.courts.govt.nz/courts/youth/publications-and-media/principal-youth-court-
newsletter/issue-53#6
Canada
Asante Centre
Identifying Fetal Alcohol Syndrome amongst Youth in the Criminal Justice System
http://www.asantecentre.org/_Library/docs/IdentifyingFASYouth.pdf
Legal Resources
http://www.asantecentre.org/legal.html
Youth Probation Officers Guide to FASD Screening

http://www.asantecentre.org/_Library/docs/Youth_Probation_Officers_Guide_to_FASD_Screening_
and_Referral_Printer-Friendly_Format_.pdf
Canadian Bar Association

FASD as an Access to Justice Issue
http://www.cba.org/cba/submissions/pdf/11-20-eng.pdf
Resources
http://www.cba.org/cba/home/includes/SearchPage.aspx?txtSearch=FASD&txtSearchSubDir=
Professional Development – Addressing Fetal Alcohol Spectrum Disorder in the Criminal Justice
System
http://www.cba.org/pd/details_en.aspx?id=NA_ONMAY111R
Correctional Services Canada

The Challenge of FASD in adult offender populations
http://www.csc-scc.gc.ca/text/pblct/forum/e143/e143s-eng.shtml
Department of Justice Canada

Victims and FASD: A Review of the Issues
http://www.justice.gc.ca/eng/pi/rs/rep-rap/rd-rr/rr07_vic4/p4.html
47
FASD and Youth Criminal Justice: A Discussion Paper (Sentencing)
http://www.justice.gc.ca/eng/pi/rs/rep-rap/2003/rr03_yj6-rr03_jj6/p5.html
FASD Ontario Networks of Experts (FASD ONE)

Justice Committee
http://www.fasdontario.ca/cms/groups/justice-committee
FASD and Justice

FASD and the Justice System was developed by the FASD ONE Justice Committee of FASD ONE (FASD
Ontario Network of Expertise) with funding from the Public Health Agency of Canada and the
Department of Justice Canada, Youth Justice Policy
http://fasdjustice.ca/
Government of Alberta
Criminal Justice System: Issues for Defence
http://www.fasd-cmc.alberta.ca/uploads/1010/fasdandpracticeissue79624.pdf
John Howard Society of Ontario

FASD and the Justice System: A Poor Fit
http://johnhoward.on.ca/pdfs/FactSheet_26_FASD_and_the_Criminal_Justice_System.pdf
Motherisk
Fetal Alcohol Syndrome in the Canadian Corrections System
http://www.motherisk.org/JFAS_documents/FAS_Corrections_REV.pdf
5th National Biennial Conference on Adolescents and Adults with FASD

It’s a Matter of Justice Conference Presentations
http://www.interprofessional.ubc.ca/AdultsWithFASD/presentations.asp
Public Health Agency of Canada

Inventory of Education and Training Programs: FASD and the Judicial/Criminal Justice System
http://www.phac-aspc.gc.ca/hp-ps/dca-dea/publications/ietp-rpdf/pdf/ietp-rpdf-eng.pdf
Public Safety Canada

FASD and the Criminal Justice System, Aboriginal Corrections Policy Unit
http://www.publicsafety.gc.ca/res/cor/apc/apc-32-eng.aspx
Royal Canadian Mounted Police

Fetal Alcohol Spectrum Disorder: FASD Guidebook for Police Officers
http://www.asantecentre.org/_Library/docs/latestfasguide.pdf
United States
American Bar Association

Resolution with respect to FASD – 2012 Conference
http://www.americanbar.org/content/dam/aba/administrative/child_law/FASDRES_080712.authch
eckdam.pdf
48
Children and the Law
Fetal Alcohol Spectrum Disorders: Legal Issues
http://www.americanbar.org/groups/child_law/what_we_do/projects/child_and_adolescent_healt
h/fasd.html
Come on Over
FASD in the Court System
http://www.come-over.to/FAS/Court/
Journal of Psychiatry and the Law

Vol 39, No 1, Spring 2011 Special Issue FASD
http://www.federallegalpublications.com/journal-of-psychiatry-law/201110/jpl-2011-39-1-journal-
of-psychiatry-law-volume-39-number-1-spring-2
National Institute on Alcohol Abuse and Alcoholism

Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders
http://www.niaaa.nih.gov/ICCFASD
North West Territories Justice Corrections Service Case Management Conference

FASD and the Criminal Justice System: An Exploratory Look at Current Treatment Practices
http://www.justice.gov.nt.ca/CommunityJustice/documents/Handouts-
CaseManagementConference-June2010.pdf
You Tube: 123 Video presentations FASD and Justice 2008 - 2012
http://www.youtube.com/watch?v=VVaXchwh3AA
US Department of Health and Human Services, Substance Abuse and Mental Health Services
Administration (SAMHSA)
FASD and the Criminal Justice System
http://fascenter.samhsa.gov/documents/WYNK_Criminal_Justice5.pdf
What corrections need to know about FASD

Santa Clara County Fetal Alcohol Spectrum Disorder Task Force, Santa Clara County Superior Court,
District Attorney's Office, Probation Departments
http://www.youtube.com/watch?v=eT4i-nVFfn8&feature=share
Australia (not specifically FASD and Justice, however reports and submission do
refer to FASD and justice)
House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs
Doing Time – Time for Doing: Indigenous youth in the criminal justice system
http://www.alsnswact.org.au/media/BAhbBlsHOgZmSSJ8MjAxMS8wOC8xNS8yM18xNl81N184MDdf
RG9pbmdfdGltZV9UaW1lX2RvaW5nX0luZGlnX1lvdXRoX2luX0NyaW1pbmFsX0p1c3RpY2VfU3lzdGVtX
0p1bmVfMjAxMV9Ib3VzZV9vZl9SZXBzX1JlcG9ydC5wZGYGOgZFVA
49
House of Representatives Standing Committee on Social Policy and Legal Affairs
Inquiry into FASD (Submissions and public hearings)
Western Australia Legislative Assembly Education and Health Standing Committee

Inquiry into FASD Final Report
Foetal Alcohol Spectrum Disorder: the hidden disability
http://www.parliament.wa.gov.au/C8257837002F0BA9/(Report+Lookup+by+Com+ID)/1740F63B37
A1314A48257A7F000766DD/$file/Final+FASD+Report+with+signature.pdf
Foundation for Alcohol Research and Education (FARE)

FASD Action Plan 2013-2016
http://www.fare.org.au/wp-content/uploads/2011/07/FARE-FASD-Plan.pdf
National Indigenous Drug and Alcohol Committee position paper on Fetal Alcohol Spectrum
Disorder
http://www.healthinfonet.ecu.edu.au/about/news/885
Western Australian Department of Health, Child and Youth Health Network FASD Model of Care
http://www.healthnetworks.health.wa.gov.au/modelsofcare/docs/FASD_Model_of_Care.pdf
FASD Support and Advocacy Groups in Australia
National Organisation for Fetal Alcohol Syndrome and Related Disorders (NOFASARD)
NOFASARD is the peak national non-government organisation representing the interests of parents,
carers and others interested in or affected by FASD.
NOFASARD delivers support to families living with FASD and education and training workshops for
both government and non-government agencies throughout Australia.
Email: [email protected]
Phone: 1300 306 238
Website: http://www.nofasard.org/.au
Russell Family Fetal Alcohol Disorders Association (rffada)

rffada is a not-for-profit health promotion charity dedicated to ensuring that individuals affected
prenatally by alcohol have access to diagnostic services, support and multidisciplinary management
planning in Australia and that carers and parents are supported with a “no blame no shame” ethos.
Email: [email protected]
Phone: 1800 733 232
Website: http://rffada.org/
50
Resources that may also be useful for staff within the justice system to
understand people with a FASD
Living with Fetal Alcohol Spectrum Disorders: A Guide for Parents and Caregivers (Australia)
http://beta.den2.handbuiltcreative.com/wp-content/uploads/2011/05/Living-with-FASD-A-Guide-
for-Parents-and-Caregivers-VR-4-2011-2.pdf
Edmonton and Area Fetal Alcohol Network (EFAN)

FASD - Strategies not Solutions – A Downloadable Manual
http://www.faslink.org/strategies_not_solutions.pdf
DVD Information Parents and Teachers – Finding Hope

http://findinghope.knowledge.ca/home.html
FASD Diagnosis
There are various guidelines used to diagnose FASD throughout the world. In 2012 the Australian
FASD Collaboration led by Winthrop Research Professor Carol Bower from the Telethon Institute for
Child Health Research and Professor Elizabeth Elliott from the University of Sydney finalised a report
on the development of a FASD diagnostic instrument for use in Australia to the Commonwealth
Department of Health and Ageing (DoHA). At the time of submitting this report to FARE the DoHA
was considering the report and implementation. The proposed Australian instrument combines
elements from the Canadian Guidelines and the University of Washington 4-Digit Code for FASD.
Canadian Guidelines for Diagnosis (Canadian Guidelines)

Chudley, A. E., Conry, J., Cook, J. L., Loock, C., Rosales, T., & LeBlanc, N. (2005). Fetal Alcohol
Spectrum Disorder: Canadian guidelines for diagnosis. Canadian Medical Association Journal, 172(5
Suppl), S1-S21.
http://www.cmaj.ca/content/172/5_suppl/S1.full
University of Washington 4-Digit Diagnostic Code for FASD (UW Guidelines)

Astley, S. J. (2004). Diagnostic Guide for Fetal Alcohol Spectrum Disorders: The 4-Digit Diagnostic
Code (Third ed.). Seattle: University of Washington.
http://depts.washington.edu/fasdpn/htmls/4-digit-code.htm
51
Appendix 2A: Judicial Survey
52
Judicial Survey
1. What is your gender?
Male Female
2. What is your age?
20-29
30-39
40-49
50-59
60+
3. What is the location of your work? (Please tick more than one if appropriate)
Perth
Outer metropolitan
Regional (eg. Mandurah, Bunbury, Geraldton, Broome Albany,)
Rural
Remote
4. What year did you graduate from Law School/University/Training (relevant to the criminal justice
sector)?
a) Not applicable
b) 1969 or before
c) 1970 – 1979
d) 1980 – 1989
e) 1990 – 1999
f) 2000 – 2009
g) 2010 or after
5. What is your role/position/title? (eg Children’s Court Magistrate)
6. What is your current or usual area of work or practice?
7. How long have you worked in the justice sector (including time in practice)? (Years)
Less than one
1-5 years
6-10 years
11 or above
8. Have you heard of Fetal Alcohol Syndrome (FAS)?
Yes No
9. Have you heard of Fetal Alcohol Spectrum Disorder (FASD)?
Yes No
10. If you answered YES to Questions 8 and/or 9, from which of the following sources do you know
about FAS/FASD? (Tick more than one if appropriate)
a) In the mainstream media
b) During my university education or professional training
c) Legal Practitioner or other justice professional
d) Colleague
e) Professional journal
f) Education session – conference, seminar, workshop
g) Court Pre-sentence Report
h) Court Ordered Psychological/Psychiatric Report
i) Other (Please specify)
53
11. If you answered YES to Questions 8 and/or 9 which of the following would best describe your
knowledge of FAS/FASD?
a) Have an awareness of the condition (seen references) but not how it affects children and adults
b) Have a basic understanding of the condition and how it affects children and adults
c) Have a good understanding of the condition and how it affects children and adults
12. The remaining questions refer only to FASD. We use the term FASD as this incorporates the unique
syndrome of FAS and all other conditions related to prenatal alcohol exposure.
Please indicate your level of agreement with the following statements.
a) FASD is a real syndrome

b) FASD is relevant to my work in the criminal justice system
c) Alcohol’s negative effect on fetal development has been proven
d) FASD is only an issue for children and youths and not adults
e) Assessment and diagnosis of FASD would improve possibilities of appropriate consequences for
unacceptable behaviour
f) People grow out of FASD
g) FASD occurs primarily in Indigenous families
13. In your own words, can you say what you understand FASD are?
14. Would it be helpful to have a forum to discuss the development of a co-ordinated approach to FASD
in WA?
Yes No
15. Would you like more information about FASD?
Yes No
16. If YES, what kind of information would you prefer? (Tick more than one if appropriate)
a) Information on behaviours to prompt need for FASD assessment
b) Contact details for organisations which specialise in the support of people with FASD
c) Research articles on FASD
d) List of qualified medical specialists
e) Guidelines on how to deal with FASD
f) Information about where to refer for diagnosis
g) Other (Please specify)
17. How would you prefer this information be delivered? (Tick more than one if appropriate)
a) Email
b) Continuing professional development event
c) Conferences/seminars
d) Special visit to your workplace
e) Other (Please specify)
18. In the next 12 months we expect to explore further knowledge, attitudes and practices of FASD in
the criminal justice system. If requested in the future are you likely to be willing to participate in an
interview?
Yes No
19. Have parties or witnesses ever appeared before you or given evidence in your court who you
SUSPECT had a FASD
a) Never
b) Once
c) 2-5 times
d) 6-10 times
e) 11+ times
f) Don’t know
54
20. What factors made you SUSPECT a person had a FASD? (Tick more than one if appropriate)
a) Physical appearance
b) Obvious low IQ
c) Inability to learn from mistakes
d) Repeat offender
e) Does not show empathy
f) Genuinely seems to not remember things
g) Poor attention span
h) Disinterested during consultation
i) Highly suggestible
j) Unable to follow court proceedings
k) Poor understanding of time (eg. inability to keep bail or court appointments)
l) Mother was a known alcoholic
m) Unable to comply with parole or bail requirements
n) Other (Please specify)
21 Have parties or witnesses ever appeared before you or given evidence in your court who you KNEW
had been diagnosed with a FASD?
a) Never
b) Once
c) 2-5 times
d) 6-10 times
e) 11+ times
f) Don’t know
22 How did you know the person had a FASD?
(Tick more than one if appropriate)
a) Investigation by, or on behalf of, the Court revealed a positive FASD diagnosis
b) The person advised you that s/he had a FASD
c) Known history of prenatal alcohol exposure
d) Characteristic facial features
e) The defence counsel advised you that the person had a FASD
f) The prosecution advised you that the person had a FASD
g) File notes indicated a FASD diagnosis
h) Other (Please specify)
23. If you SUSPECTED that a JUVENILE defendant had a FASD, would you consider taking a more
detailed family history of the child (including mother’s substance abuse history)?
Yes No
24. Why / why not?
25. If you SUSPECTED that a JUVENILE defendant had a FASD, would you recommend that an expert
opinion is sought for a formal diagnosis of the condition?
Yes No
26. Have you ever recommended or required that a defendant be sent for a diagnosis or assessment for
FASD where you have SUSPECTED FASD may be relevant?
a) Never
b) Once
c) 2 – 5 times
d) 6-10 times
e) 11+ times
Please provide details of where you sourced your expert from:
55
27. If you answered NO to Question 26 was it because: (Tick more than one if appropriate)
a) I did not have the power to request this
b) You had no knowledge of FASD at the time
c) This is not part of your role
d) It would not change how you consider the case
e) I did not know where to refer the person
f) Tried a number of options which did not work
g) Other (Please specify)
28. Have you ever used a specially-trained FASD facilitator to communicate with a person that you
KNOW had a FASD?
a) Never knowingly encountered a person with a FASD
b) Never
c) Once
d) 2-5 times
e) 6-10 times
f) 11+ times
29. If you answered NEVER to Question 28 was it because: (Tick more than one if appropriate)
a) I did not know that such a service exists
b) Such services are difficult due to location
c) Such services are only available for those with a diagnosis and the person did not have a diagnosis
d) I am well trained to communicate with a child or youth with a FASD
e) Not necessary to have such a service
f) Other
30. What alternative treatment/diversionary sentencing options for offenders with FASD are you most
likely to consider?
(Select one)
31. Do you think it would be helpful to have additional alternative treatment/diversionary sentencing
options to clients with a FASD?
Yes No If YES, what options could these include and if NO why not helpful?
32. Please indicate your level of agreement with the following statements to reflect the likelihood that
you will change or modify your practices, if a defendant was diagnosed with a FASD.
a) I would change or modify my approach to use of formality
b) I would change or modify my use of language
c) I would change or modify my approach to communication methods
d) I would change or modify my speed of proceedings
e) I would change or modify my approach to closing the court
f) I would change or modify my approach to fitness to plead
33. A more detailed knowledge of FASD would assist my work in the criminal justice system
a) Strongly agree
b) Agree
c) Neither agree nor disagree
d) Disagree
e) Strongly disagree
34. How does/would the knowledge that an accused had a FASD impact on your decision-making?
35. What challenges do you face in the dealing with an individual with a FASD?
36. What information, services and processes might assist you to deal with an individual with a FASD?
Thank you for completing this survey.
56
Appendix 2B: Legal Survey
57
Knowledge, attitudes and practice of FASD within the criminal justice

*1. What is your gender?

j Female
k
l
m
n

j Male
k
l
m
n
*2. What is your age?

j 2029
k
l
m
n

j 3039
k
l
m
n

j 4049
k
l
m
n

j 5059
k
l
m
n

j 6069
k
l
m
n

j 70+
k
l
m
n
*3. What is the location of your work? (Please tick more than one if appropriate)

c Perth
d
e
f
g

c Outer metropolitan
d
e
f
g

c Regional (eg. Mandurah, Bunbury, Albany, Broome)
d
e
f
g

c Rural
d
e
f
g

c Remote
d
e
f
g
Please list the postcode of your primary location
*4. What year did you graduate from Law School/university (relevant to the criminal
justice system)?

j Not applicable
k
l
m
n

j 1969 or before
k
l
m
n

j 19701979
k
l
m
n

j 19801989
k
l
m
n

j 19901999
k
l
m
n

j 2002009
k
l
m
n

j 2010+
k
l
m
n
*5. What is your current role/position/title (eg Senior Solicitor)?

5
6
Page 1
*6. What is your current or usual area of work/practice?
5
6
*7. How long have you worked in the justice sector/been in practice?

j < 1 year
k
l
m
n

j 1 5 years
k
l
m
n

j 6 10 years
k
l
m
n

j 11+ years
k
l
m
n
*8. Have you heard of Fetal Alcohol Syndrome (FAS)?

j Yes
k
l
m
n

j No
k
l
m
n
*9. Have you heard of Fetal Alcohol Spectrum Disorder (FASD)?

j Yes
k
l
m
n

j No
k
l
m
n
10. If you answered YES to Questions 8 and/or 9, from which of the following sources
do you know about FAS/FASD? (Tick more than one if appropriate)

c In the mainstream media
d
e
f
g

c During my university education or professional training
d
e
f
g

c Legal practitioner or other justice professional
d
e
f
g

c Colleague
d
e
f
g

c Professional journal
d
e
f
g

c Education session – conference, seminar, workshop
d
e
f
g

c Court Presentence Report
d
e
f
g

c Court Ordered Psychological/Psychiatric Report
d
e
f
g
Other (please specify)
11. If you answered YES to Questions 8 and/or 9 which of the following would best
describe your knowledge of FAS/FASD?

c Have an awareness of the condition (heard/seen reference) but not how it affects children and adults
d
e
f
g

c Have a basic understanding of the condition and how it affects children and adults
d
e
f
g

c Have a good understanding of the condition and how it affects children and adutls
d
e
f
g
Page 2
*12. Please indicate your level of agreement with the following statements. The
remaining questions refer only to FASD. We use the term FASD as this incorporates the
unique syndrome of FAS and all other conditions related to prenatal alcohol exposure.
Neither agree nor
Stongly agree Agree Disagree Strongly disagree
disagree
FASD is a real syndrome j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
FASD is relevant to my j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
work in the criminal justice
system
Alcohol's negative effect j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
on fetal development has
been proven
FASD is only an issue for j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
children and youths and
not adults
Assessment and diagnosis j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
of FASD would improve
possibilities of appropriate
consequences for
People grow out of FASD j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
FASD occurs primarily in j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
indigenous families
*13. In your own words, can you say what you understand FAS/FASD are?
5
6
14. Would it be helpful to have a forum with other professionals within the justice
system to discuss the development of a coordinated approach to FASD in WA?

j Yes
k
l
m
n

j No
k
l
m
n

j Yes
k
l
m
n

j No
k
l
m
n
Page 3
16. If you answered YES to Question 15, what kind of information would you prefer?
(Tick more than one if appropriate)

c Information on behaviours to prompt need for FASD assessment
d
e
f
g

c Contact details for organisations which specialise in the care of people with FASD
d
e
f
g

c More research information
d
e
f
g

c List of qualified specialists
d
e
f
g

c Guidelines on how to deal with FASD
d
e
f
g

c Information about where to refer for diagnosis
d
e
f
g
17. How would you prefer this information was delivered? (Tick more than one if
appropriate)

c Website/email
d
e
f
g

c Continuing professional development event
d
e
f
g

c Conferences/seminars
d
e
f
g

c Special visit to your practice, department or organisation
d
e
f
g

c Printed information/resources
d
e
f
g
18. Have you ever acted for a person or questioned a witness who you SUSPECT has a
FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n

j Don't know
k
l
m
n
Page 4
19. What factors made you SUSPECT a witness or party had a FASD? (Tick more than
one if appropriate)

c Physical appearance
d
e
f
g

c Obvious low IQ
d
e
f
g

c Inability to learn from mistakes
d
e
f
g

c Repeat offender
d
e
f
g

c Does not show empathy
d
e
f
g

c Genuinely seems to not remember
d
e
f
g

c Poor attention span
d
e
f
g

c Disinterested during consultation
d
e
f
g

c Highly suggestible
d
e
f
g

c Unable to follow court instructions
d
e
f
g

c Poor understanding of time (eg. inability to keep bail or court appointments)
d
e
f
g

c Unable to comply with parole orders
d
e
f
g

c Know mother is an alcoholic
d
e
f
g
20. Notwithstanding your level of knowledge of FASD, in your entire career in the
justice system, have you ever been informed that a party or witness had a FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n
21. Have you ever acted for a person or questioned a witness who you KNOW has been
diagnosed with FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n

j Don't know
k
l
m
n
Page 5
22. How did you KNOW the person had a FASD?(Tick more than one if appropriate)

c Awareness of positive FASD diagnosis
d
e
f
g

c The person advised you that s/he had a FASD
d
e
f
g

c Known history of prenatal alcohol exposure
d
e
f
g

c Characteristic facial features
d
e
f
g
*23. How equipped do you feel to be able to deal with a person who has been
DIAGNOSED with a FASD?

j Very prepared
k
l
m
n

j Prepared
k
l
m
n

j Unprepared
k
l
m
n

j Very unprepared
k
l
m
n
24. If you SUSPECTED that a juvenile client has a FASD, would you consider taking a
more detailed family history of the child, including mother's substance abuse history
from sources such as Department for Child Protection or other family members (or refer
them to a psychologist to do so)?

j Yes
k
l
m
n

j No
k
l
m
n
25. If you answered NO to Question 24 was it because?

j It would be pointless because it would not change how I manage the client
k
l
m
n

j You did not know where to refer the person
k
l
m
n

j Tried a number of options which did not work
k
l
m
n
26. If you SUSPECTED that a client had a FASD would you recommend that an expert
opinion is sought for a formal diagnosis of the condition?

j Yes
k
l
m
n

j No
k
l
m
n
Page 6
27. Have you ever recommended or sent a client for a diagnosis for FASD where you
SUSPECTED that FASD maybe relevant?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n
Where did you/psychologist attend for an expert to complete an assessment for FASD?
28. If you answered NEVER to Question 27 was it because: (tick more than one if
appropriate)

j It would be pointless because it would not change how I care for the client
k
l
m
n

j You did not know where to refer the person
k
l
m
n

j Tried a number of options which did not work
k
l
m
n
29. If your client was DIAGNOSED with a FASD, would you consider consulting a
person who had been trained in working with FASD clients for the purpose of
interviewing or questioning the client?

j Yes
k
l
m
n

j No
k
l
m
n
30. Have you ever used a trained person to communicate with a client you KNOW has a
FASD?

j Never knowingly encountered a client with a FASD
k
l
m
n

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n
Page 7
appropriate)

j No such services exist
k
l
m
n

j Services are difficult to access because of the client's location
k
l
m
n

j Such services are only available for those with a diagnosis and the person did not have a diagnosis
k
l
m
n

j I am well trained to communicate with a child or youth with a FASD
k
l
m
n

j Not necessary to have such a service
k
l
m
n
32. If your client was diagnosed with a FASD would you consider changing or
modifying the language/terms that you use to advise and talk with or correspond with
them?

j Yes
k
l
m
n

j No
k
l
m
n
33. What practices have you modified? (Tick more than one if appropriate)

c Approach to questioning
d
e
f
g

c Approach to arguing/directing/giving instructions
d
e
f
g
34. If you were advised by an expert that a client had a FASD, would you consider use
of this diagnosis to explore the issue of the client’s fitness to plead?

j Yes
k
l
m
n

j No
k
l
m
n
35. If your client was diagnosed with a FASD, would you consider making extra or
different submissions as to sentencing options which require compliance with
appointments and meetings?

j Yes
k
l
m
n

j No
k
l
m
n
Page 8
36. Do you think it would be helpful to have additional alternative treatment/diversionary
sentencing options for clients with a FASD?

j Yes
k
l
m
n

j No
k
l
m
n
If YES, what options could these include and if NO why not helpful
37. In your opinion, is the following an appropriate sentence for a person diagnosed
with a FASD?
Neither agree nor
Strongly agree Agree Disagree Strongly disagree
disagree
Longer custodial sentence j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
Higher level of supervision j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
with a FASD?
Neither agree nor
disagree
Suspended term of j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
imprisonment
Unsupervised community j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
based order
Supervised community j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
based order
*39. Do you think a more detailed knowledge of FASD would assist your work in the
criminal jsutice system?

j Not at all
k
l
m
n

j Rarely
k
l
m
n

j Occasionally
k
l
m
n

j Frequently
k
l
m
n
If you answered NOT AT ALL please explain why
*40. How does the knowledge that a client has a FASD impact on your work as a legal
professional?
5
6
*41. What challenges do you face in ensuring fair justice outcomes for an individual
with a FASD?
5
6
Page 9
*42. What information, services and processes might assist you in ensuring fair
justice outcomes for an individual with a FASD?
5
6
Page 10
Appendix 2C: Corrections Survey
68
Survey : FASD survey for all staff

Separator
Page Break

Q1
1. What is your gender? *

Male
Female

Separator
Q2
2. What is your age? *

Less than 20
20-29
30-39
40-49
50-59
60-69
70+

Separator
Q3
3. What is the location of your work? *

Perth
Outer metropolitan
Regional (eg Mandurah, Bunbury, Albany, Broome)
Rural
http://www.questionpro.com/a/editSurvey.do?surveyID=3187270[20/08/2012 5:08:12 PM]

Remote

Separator
Q4
4. What year did you graduate from university/training (relevant to the

criminal justice system)? *
Not applicable
1969 or before
1970 – 1979
1980 – 1989
1990 – 1999
2000 – 2009
2010 or after

Separator
Q5
5. What is your role/position/title? (For example Youth Justice Officer, Prison Officer,
Nurse etc) *

Separator
Q6
6. What is your current or usual area of work/practice? *


Separator
Q7
7. How long have you worked in the justice sector/been in practice? (Years) *

Separator
Page Break

Q8
8. Have you heard of Fetal Alcohol Syndrome (FAS)? *

Yes
No

Q9
9. Have you heard of Fetal Alcohol Spectrum Disorder (FASD)? *

Yes
No

Separator
Q10
10. If you answered YES to Questions 8 and/or 9, from which of the

following sources do you know about FAS/FASD? (Select more than
one if appropriate)
In the mainstream media
During my university education or professional training

Legal Practitioner or other justice professional
Colleague
Professional journal
Education session – conference, seminar, workshop
Court Pre-sentence Report
Court Ordered Psychological/Psychiatric Report
Other (Please complete below)

Q11
11. If you answered YES to Questions 8 and/or 9 which of the

following would best describe your knowledge of FAS/FASD?
Have heard/seen references to the condition (eg court reports) but don’t know how it is caused or how it might

affect children and adults
Have a basic understanding of the condition but not how it affects children and adults
Have a good understanding of the condition and how it affects children and adults

Separator
Page Break

Q12
12. Please indicate your level of agreement with the following

statements. (The remaining questions refer only to FASD. We use the
term FASD as this incorporates the unique syndrome of FAS and all
other conditions related to prenatal alcohol exposure)
Strongly Agree Neither Disagree Strongly
agree agree nor disagree
disagree
FASD is a real syndrome *
FASD is relevant to my work
in the criminal justice system
*
Alcohol’s negative effect on
fetal development has been
proven *
FASD is only an issue for
children and youths and not

adults *
Assessment and diagnosis
consequences for
unacceptable behaviour *
People grow out of FASD *
FASD occurs primarily in
Indigenous families *

Separator
Q13
13. In your own words, can you say what you understand FASD is? *

Separator
Q14
14. Would it be helpful to have a session with other professionals

within the justice system to discuss the development of a co-
ordinated approach to FASD in WA? *
Yes
No

Separator
Page Break

Q15
15. Would you like more information about FASD? *

Yes » Q16
No » Q18

Separator
Automatic Logic Break


Q16
16. If YES, what kind of information would you prefer? (Select more
than one if appropriate) *
Information on behaviours to prompt need for FASD assessment
Contact details for organisations which specialise in the care of people with FASD
More research information
List of qualified specialists
Guidelines on how to deal with FASD
Information about where to refer for diagnosis

Separator
Q17
17. How would you prefer this information was delivered? (Select

more than one if appropriate) *
Email
Continuing professional development event
Conferences/seminars
Special visit to your practice, department or organisation

Separator
Q18

18. In the next 12 months we expect to explore further knowledge,

attitudes and practices of FASD in the criminal justice system. If
requested in the future would you be willing to participate in an
interview? *
Yes
No

Separator
Q19
19. While working for the Department of Corrective Services have you

ever dealt with or case managed a person who you SUSPECT has a
FASD? *
Never » Q21
Once
2-5 times
6-10 times
11+ times
Don’t know

Separator

Q20
20. What factors made you SUSPECT a person had a FASD? (Select

more than one if appropriate)
Physical appearance
Obvious low IQ
Inability to learn from mistakes
Repeat offender
Does not show empathy eg repeatedly steal from elderly
Genuinely seems to not remember
Poor attention span
Disinterested during interview
Highly suggestible
Vulnerable to peer pressure
Continually disobeys correctional service officers instructions
Poor understanding of time (eg. inability to keep bail or court appointments)

Cannot read or comprehend basic instructions
Has explosive episodes
Know mother is an alcoholic
Has multiple substance addictions

Separator
Q21
21. Notwithstanding your level of knowledge of FASD, in your

practice as a correctional services officer, have you ever been
informed that your client has a FASD? *
Never
Once
2 – 5 times
6-10 times
11+ times

Separator
Page Break

Q22
22. Have you ever dealt with or case managed a person who you
KNOW has a FASD? *
Never » Q24
Once » Q23
2 – 5 times » Q23
6-10 times » Q23
11+ times » Q23
I do not know » Q23

Separator

Q23
23. How did you know the person had a FASD? (Select more than one
if appropriate)

Awareness of positive FASD diagnosis
The person advised you that s/he had a FASD
Known history of prenatal alcohol exposure
Characteristic facial features

Separator
Q24
24. How equipped do you feel you are to be able to deal with a person
who has been DIAGNOSED with a FASD? *
Very prepared
Prepared
Unprepared
Very unprepared

Separator
Q25
25. If you SUSPECTED that a client has a FASD, would you consider
taking a more detailed family history of the child, including mother’s
substance abuse history from sources such as Department for Child
Protection or other family members (or refer them to a psychologist
to do so)? *
Yes » Q27
No » Q26

Separator

Q26

26. If you answered No to Question 25 was it because:

It would be pointless because it would not change how I case manage the client
You did not know where to refer the person
Tried a number of options which did not work

Separator
Q27
27. Have you ever recommended or sent a client for a diagnosis for

FASD where you SUSPECTED FASD may be relevant (or referred
them to a psychologist to do this)? *
Never » Q28
Once
2 – 5 times
6-10 times
11+ times
Where did you/psychologist attend

for an expert to complete an
assessment for a FASD?

Separator

Q28
28. If you answered Never to Question 27 was it because:

It would be pointless because it would not change how I case manage the client
You did not know where to refer the person
Tried a number of options which did not work


Separator
Page Break

Q29
29. If the client was diagnosed with FASD, would you consider
consulting a person who had been trained in working with FASD
clients for the purpose of interviewing or questioning the person in
your care?
Yes
No

Separator
Q30
30. Have you ever used a trained FASD professional to communicate

with a client you KNOW has a FASD? *
Never » Q31
Once
2-5 times
6-10 times
11+ times

Separator

Q31
31. If you answered Never to Question 30 was it because: (Select

more than one if approprite)
No such services exist
Services are difficult to access because of the individual’s location
Such services are only available for those with a diagnosis and the person did not have a diagnosis
I am well trained to communicate with a child or youth with a FASD


Separator
Q32
32. If a client was diagnosed with FASD would you consider changing
or modifying the language/terms that you use to advise and talk with
or correspond with them? *
Yes » Q33
No » Q34

Separator

Q33
33. What practices have you modified? (Select more than one if

appropriate)
Approach to questioning
Approach to arguing/directing/giving instruction

Separator
Q34

34. Do you think a more detailed knowledge of FASD would assist
your work in the criminal justice system?
Not at all » Q35
Moderately
Yes, but not very often

Yes, frequently
If you answered 'Not at all', can you please explain why

Separator

Q35

35. If you answered 'Not at all' to question 34, can you please explain why?

Separator
Edit Footer Thank You Page
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Appendix 2D: Police Survey
83
FASD Knowledge, Attitudes and Practices in the Criminal Justice System

*1. What is your gender?

j Female
k
l
m
n

j Male
k
l
m
n
*2. What is your age?

j 2029
k
l
m
n

j 3039
k
l
m
n

j 4049
k
l
m
n

j 5059
k
l
m
n

j 6069
k
l
m
n

j 70+
k
l
m
n
*3. What is the location of your work? (Please tick more than one if appropriate)

c Perth
d
e
f
g

c Outer metropolitan
d
e
f
g

c Regional (eg. Mandurah, Bunbury, Albany, Broome)
d
e
f
g

c Rural
d
e
f
g

c Remote
d
e
f
g
Please list the postcode of your primary location
*4. What year did you graduate from the Policy Academy?

j Not applicable
k
l
m
n

j 1969 or before
k
l
m
n

j 1970 – 1979
k
l
m
n

j 1980 – 1989
k
l
m
n

j 1990 – 1999
k
l
m
n

j 2000 – 2009
k
l
m
n

j 2010 or after
k
l
m
n
*5. What is your role/position/title? (eg Sergeant)

5
6
Page 1
*6. What is your current or usual area of work or practice?
5
6
*7. How long have you worked in the justice sector/been in practice?
(Years)

j < 1 year
k
l
m
n

j 1 5 years
k
l
m
n

j 6 10 years
k
l
m
n

j 11+ years
k
l
m
n
*8. Have you heard of Fetal Alcohol Syndrome (FAS)?

j Yes
k
l
m
n

j No
k
l
m
n
*9. Have you heard of Fetal Alcohol Spectrum Disorders (FASD)?

j Yes
k
l
m
n

j No
k
l
m
n
10. If you answered YES to Questions 8 and/or 9, from which of the following sources
do you know about FAS/FASD? (Tick more than one if appropriate)

j In the mainstream media
k
l
m
n

j During my university education or professional training
k
l
m
n

j Legal Practitioner or other justice professional
k
l
m
n

j Colleague
k
l
m
n

j Professional journal
k
l
m
n

j Education session – conference, seminar, workshop
k
l
m
n

j Court Presentence Report
k
l
m
n

j Court Ordered Psychological/Psychiatric Report
k
l
m
n
Page 2
11. If you answered YES to Questions 8 and/or 9 which of the following would best
describe your knowledge of FAS/FASD?

j Have only heard of it but don’t really know any of the symptoms or how it is caused
k
l
m
n

j Have seen references to the condition in court reports but do not really know how it might affect my client
k
l
m
n

j Have some information and a basic understanding of the condition but not how it affects children and adults
k
l
m
n

j Have a good understanding of the condition and how it affects children and adults
k
l
m
n
j I work with clients who are diagnosed with a FASD but do not feel confident to refer a client for a FASD assessment based on my
k
l
m
n
observations of that person
j I work with clients who are diagnosed with a FASD, and I would feel confident to be able to refer a client for a FASD assessment
k
l
m
n
based on my professional observations of that person
*12. Please indicate your level of agreement with the following statements. The
remaining questions refer only to FASD. We use the term FASD as this incorporates the
unique syndrome of FAS and all other conditions related to prenatal alcohol exposure.
Neither agree nor
disagree
FASD is a real syndrome j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
FASD is relevant to my j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
work in the criminal justice
system
Alcohol’s negative effect j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
on fetal development has
been proven
FASD is only an issue for j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
children and youths and
not adults
Assessment and diagnosis j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
consequences for
People grow out of FASD j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
FASD occurs primarily in j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
Indigenous families
*13. In your own words, can you say what you understand FAS/FASD are?
5
6
14. Would it be helpful to have a forum with other professionals within the justice
system to discuss the development of a coordinated approach to FASD in WA?

j Yes
k
l
m
n

j No
k
l
m
n
Page 3

j Yes
k
l
m
n

j No
k
l
m
n
16. If YES, what kind of information would you prefer? (Tick more than one if
appropriate)

c Information on behaviours to prompt need for FASD assessment
d
e
f
g

c Contact details for organisations which specialise in the care of people with FASD
d
e
f
g

c More research information
d
e
f
g

c List of qualified specialists
d
e
f
g

c Guidelines on how to deal with FASD
d
e
f
g

c Information about where to refer for diagnosis
d
e
f
g
17. How would you prefer this information was delivered? (Tick more than one if
appropriate)

c Website/email
d
e
f
g

c Continuing professional development event
d
e
f
g

c Conferences/seminars
d
e
f
g

c Special visit to your department or organisation
d
e
f
g

c Printed information/resources
d
e
f
g
*18. While working as a Police Officer have you ever dealt with a person who you
SUSPECT had a FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n

j Don’t know
k
l
m
n
Page 4
19. What factors made you SUSPECT a person had a FASD? (Tick more than one if
appropriate)

c Physical appearance
d
e
f
g

c Obvious low IQ
d
e
f
g

c Inability to learn from mistakes
d
e
f
g

c Repeat offender
d
e
f
g

c Does not show empathy
d
e
f
g

c Genuinely seems to not remember
d
e
f
g

c Poor attention span
d
e
f
g

c Disinterested during interrogation
d
e
f
g

c Highly suggestible
d
e
f
g

c Vulnerable to peer pressure
d
e
f
g

c Continually disobeys police officers instructions
d
e
f
g

c Poor understanding of time (eg. inability to keep bail or court appointments)
d
e
f
g

c Cannot read or comprehend basic instructions
d
e
f
g

c Has explosive episodes
d
e
f
g

c Know mother is an alcoholic
d
e
f
g

c Has multiple substance addictions
d
e
f
g
*20. Notwithstanding your level of knowledge of FASD, in your work as a Police

Officer, have you ever been informed that the offender had a FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n
*21. Have you ever dealt with an offender who you KNOW has a FASD?

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n

j Don’t know
k
l
m
n
Page 5
22. How did you KNOW the person had a FASD?(Tick more than one if appropriate)

c Awareness of positive FASD diagnosis
d
e
f
g

c The person advised you that s/he had a FASD
d
e
f
g

c Known history of prenatal alcohol exposure
d
e
f
g

c Characteristic facial features
d
e
f
g
*23. How equipped do you feel to be able to deal with a person who has been
DIAGNOSED with a FASD?

j Very prepared
k
l
m
n

j Prepared
k
l
m
n

j Unprepared
k
l
m
n

j Very unprepared
k
l
m
n
24. Have you ever used a trained FASD professional to communicate with an offender
you KNOW has a FASD?

j Never knowingly encountered a person with a FASD
k
l
m
n

j Never
k
l
m
n

j Once
k
l
m
n

j 25 times
k
l
m
n

j 610 times
k
l
m
n

j 11+ times
k
l
m
n
appropriate)

j No such services exist
k
l
m
n

j Services are difficult to access because of the individual’s location
k
l
m
n

j Such services are only available for those with a diagnosis and the person did not have a diagnosis
k
l
m
n

j I am well trained to communicate with a child or youth with a FASD
k
l
m
n
26. If an offender was diagnosed with a FASD would you consider changing or
modifying the language/terms that you use to interview them?

j Yes
k
l
m
n

j No
k
l
m
n
Page 6
27. What practices have you modified? (Tick more than one if appropriate)

c Approach to questioning
d
e
f
g

c Approach to cautioning
d
e
f
g
28. If an offender was diagnosed with a FASD, would you consider making extra or
different submissions as to sentencing options which require compliance with
appointments and meetings?

j Yes
k
l
m
n

j No
k
l
m
n
29. Do you think it would be helpful to have additional alternative treatment/diversionary

sentencing options for clients with a FASD?

c Yes
d
e
f
g

c No
d
e
f
g
If YES, what options could these include and if NO why not helpful?
30. In your opinion, is the following an appropriate sentence for an offender diagnosed
with a FASD?
Neither agree nor
disagree
Longer custodial sentence j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
Higher level of supervision j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
with a FASD? (Use rating scale)
Neither agree nor
disagree
Suspended term of j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
imprisonment
Unsupervised community j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
based order
Supervised community j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n j
k
l
m
n
based order
Page 7
*32. Do you think a more detailed knowledge of FASD would assist your work in the
criminal justice system?

j Not at all
k
l
m
n

j Rarely
k
l
m
n

j Occasionally
k
l
m
n

j Frequently
k
l
m
n
If you answered ‘Not at all’ please explain why
*33. How does the knowledge that an offender has a FASD impact on your work as a
police officer?
5
6
*34. What challenges do you face in ensuring fair justice outcomes for an individual
with a FASD?
5
6
*35. What information, services and processes might assist you in ensuring fair
justice outcomes for an individual with a FASD?
5
6
Page 8
Appendix 3A: Justice Project Information for Judicial Officers
92
Email from DotAG to Judicial Officers
We are inviting you to take part in a research project conducted by the Telethon Institute for Child
Health Research, Centre for Child Health Research (TICHR), the University of WA. The survey is being
run by the Research and Analysis Branch, in order to protect your privacy. The survey should take
approximately 10 minutes to complete. To complete the survey, please click on the link at the
bottom of this e-mail.
The purpose of the project is to:
 find out what people across the justice sector know about Fetal Alcohol Spectrum Disorders
(FASD), their attitudes towards adults, children and adolescents who may have a disorder in the
spectrum, and their current practices in dealing with FASD; and
 identify the training and information needs relating to FASD within the justice system, so that
people with FASD may receive appropriate consideration within the justice system and referral
for appropriate services within and outside the justice system.
You should have already received an information sheet about this survey. As a reminder, please
note that:
 participation in the survey is voluntary and you are free to withdraw from the research at any
time without prejudice in any way;
 if you do not wish to participate, you can reply to the e-mail containing the survey invitation and
let us know;
 identifying information will be removed before the data is sent securely to TICHR, where it
will be stored securely;
 the results of this project will be reported at scientific conferences, in scientific journals and
possibly the media;
 the results will also be used to identify the training and information needs relating to FASD
within the justice system, with the overall goal to improve referral for people with FASD for
appropriate services within and outside the justice system.
If you have any questions about this project or the survey please contact:
 Dr Raewyn Mutch, Chief Investigator on 0417 902 471 or [email protected];
 Ms Heather Jones, Project Manager on 08 9489 7724 or [email protected];
 Dr Monica Cass, Senior Research and Evaluation Officer, DotAG on 08 9264 6236 or
[email protected]; or
 Magistrate Andree Horrigan, DotAG representative on the Project Reference committee on
[email protected].
If you have any concerns or complaints about this research project, you may contact the Human
Research Ethics Office at The University of Western Australia on (08) 6488 3703 or by email to hreo-
[email protected].
If you encounter any technical difficulties completing the survey, please contact Monica Cass at the
above number.
Thank you for your time in completing this survey.
To participate in this survey, please click on the link below:
Http://...............
93
INTERDISCIPLINARY RESEARCH ON PROFESSIONAL KNOWLEDGE, ATTITUDES
AND PRACTICE OF FETAL ALCOHOL SPECTRUM DISORDERS (FASD) WITHIN
THE CRIMINAL JUSTICE SECTOR
A project conducted by the Telethon Institute for Child Health Research
(Telethon Institute)
Funded by a grant from the Foundation for Alcohol Research and Education (FARE)
INFORMATION SHEET – JUDICIAL OFFICERS
Health Research, Centre for Child Health Research, the University of WA.
Project objectives
 To find out what people across the justice sector know about Fetal Alcohol Spectrum Disorders
(FASD), their attitudes towards children and adolescents who may have a disorder in the
spectrum, and their current practices in dealing with FASD.
 To identify the training and information needs relating to FASD within the justice system, so that
What will your participation involve?
You will be asked to participate in a survey. You will be sent an email containing a link to the survey
and information on how to complete it.
The survey should take approximately 10 minutes to complete. By participating you will have
contributed your knowledge, experience and insight into current practices within the criminal justice
system.
Participation is voluntary
Participation in the survey is voluntary and you are free to withdraw from the research at any time
without prejudice in anyway. Should you withdraw your details will be removed from the database
and no further contact will be made unless you specifically request a copy of the final report.
How will your privacy be protected?
Study participants' identifying information is stored securely and separately from questionnaire
responses to protect individual confidentiality. For more information on this, please see the full
Telethon Institute privacy statement at www.ichr.uwa.edu.au/about/privacy.
94
How will your information be used?
Your information will be used to prepare a report to the FARE. The results of this project will be
reported at scientific conferences, in scientific journals and possibly the media. Individual
participants will not be identified in any publications or reports arising from the project.
The results will also be used to identify the training and information needs relating to FASD within
the justice system, so that people with FASD may receive appropriate consideration within the
justice system and referral for appropriate services within and outside the justice system.
Questions and further information
 If you have any questions about this project or the survey please contact:
 Dr Monica Cass, Senior Research and Evaluation Officer, DotAG on 08 9264 6236 or
[email protected]; or
 Magistrate Andree Horrigan, DotAG representative on the Project Reference committee on
[email protected].
Concerns or complaints about this research
[email protected].
Approvals for this research
This research project has been approved by the University of Western Australia Ethics Committee,
DotAG Research Advisory Group via the Department of Corrective Services Research and Evaluation
Committee. The Chief Justice of Western Australia, Wayne Martin has expressed his support for the
project in the form of letters to the various legal professional organisations in WA.
95
Appendix 3B: Justice Project Information for Lawyers
96
INFORMATION SHEET – LEGAL
Project objectives
You will be asked to participate in a survey. You will be sent an email containing a link to the survey
and information on how to complete it.
system.
97

 Ms Claire Rossi, Senior Solicitor Youth Law Team on 9261 6404 or
[email protected]
[email protected].
This research project has been approved by the University of Western Australia Ethics Committee,
DotAG Research Advisory Group via the Department of Corrective Services Research and Evaluation
Committee. The Chief Justice of Western Australia, Wayne Martin has expressed his support for the
project in the form of letters to the various legal professional organisations in WA.
98
Appendix 3C: Justice Project Information for Department of
Corrective Services Staff
99
INFORMATION SHEET – CORRECTIVE SERVICES OFFICERS
Project objectives
You will be asked to participate in a survey. You will be sent an email from the Department of
Corrective Services containing a link to the survey and information on how to complete it.
system.
without prejudice in any way. If you do not wish to participate, please reply to the e-mail containing
the survey invitation and let the survey administrator know.
To protect your privacy, the Department’s internal survey facility will be used. This will allow
identifying information to be removed before the data is sent securely to the Telethon Institute.
Study participants' identifying information will be deleted from the internal systems once the survey
period is finalised. All data will be stored securely at the Telethon Institute. For more information on
this, please see the full Telethon Institute privacy statement at www.ichr.uwa.edu.au/about/privacy.
100

 Dr Shona Hyde, Team Leader Research and Evaluation, Department of Corrective Services on
08 9264 6341 or [email protected]
[email protected].
This research project has been approved by the Department of Corrective Services Research and
Evaluation Committee. The Chief Justice of Western Australia, Wayne Martin has expressed his
support for the project in the form of letters to the various legal professional organisations in WA.
101
Appendix 3D: Justice Project Information for Police Officers
102
INFORMATION SHEET – WA POLICE
Project objectives
You will be asked to participate in a survey. You will be sent an email from WA Police containing a
link to the survey and information on how to complete it.
system.
103
 Dr Raewyn Mutch, Chief Investigator on 0417 902 471 or [email protected]

 Ms Heather Jones, Project Manager on 08 9489 7724 or [email protected]
 The Manager, Academic Research Administration Unit [email protected]
[email protected].
This research project has been approved by University of Western Australia Ethics Committee, the
DoTAG Research Advisory Group via the Department of Corrective Services Research and Evaluation
Committee and by the WA Police Research Application Review Committee. The Chief Justice of
Western Australia, Wayne Martin has expressed his support for the project in the form of letters to
the various legal professional organisations in WA.
104
Foundation for
Alcohol Research
& Education
Level 1
40 Thesiger Court
Deakin ACT 2600
PO Box 19
Deakin West
ACT 2600
www.fare.org.au
ISBN: 978-0-9875187-2-9
105

Fetal Alcohol Spectrum Disorder: Knowledge, Attitudes and Practice Within The Western Australian Justice System

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Fetal Alcohol Spectrum Disorder: Knowledge, Attitudes and Practice Within The Western Australian Justice System

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Fetal Alcohol Spectrum Disorder:

Knowledge, attitudes and

Investigators: Dr Rochelle Watkins, Ms Heather Jones,

Lead Investigator: Dr Raewyn Mutch

Investigators: Dr Rochelle Watkins, Heather Jones, Winthrop

Telethon Institute for Child Health Research, Centre for

This project was undertaken with the financial assistance of the

List of Figures ......................................................................................................................................... iv

List of Tables .......................................................................................................................................... iv

Executive Summary............................................................................................................................... vii

Introduction ...................................................................................................................................... vii

The Project ....................................................................................................................................... viii

Main Findings ................................................................................................................................... viii

Glossary of Terms and Abbreviations ..................................................................................................... x

Fetal Alcohol Spectrum Disorder ........................................................................................................ 1

Criminal Justice and FASD ................................................................................................................... 1

Justice System in Western Australia ................................................................................................... 4

Reference Group ................................................................................................................................. 7

Survey Development ........................................................................................................................... 8

Awareness of FAS and FASD ............................................................................................................. 14

Knowledge and Beliefs about FASD .................................................................................................. 16

Requests for Information .................................................................................................................. 19

Experiences and Practices................................................................................................................. 21

Awareness and Knowledge ............................................................................................................... 34

Appendix 1: FASD and Justice Websites ............................................................................................... 47

Appendix 2A: Judicial Survey ................................................................................................................ 52

Appendix 2B: Legal Survey .................................................................................................................... 57

Appendix 2C: Corrections Survey.......................................................................................................... 68

Appendix 2D: Police Survey .................................................................................................................. 83

Appendix 3A: Justice Project Information for Judicial Officers............................................................. 92

Appendix 3B: Justice Project Information for Lawyers ......................................................................... 96

Figure 2: Gender of survey participants (n=427) .................................................................................. 11

Figure 3: Age distribution of survey participants (n=427) .................................................................... 12

Table 2.1: Age of survey participants .................................................................................................... 12

Table 2.2: Location of survey participants’ work .................................................................................. 13

Table 2.4: Year of graduation of survey participants ............................................................................ 13

Table 3: Reported source of FAS/FASD information............................................................................. 15

Table 6: Participant identification of key features of FASD .................................................................. 18

 Ms Fay Alford: Director, Foster Care Association of Western Australia

Acronym Full Text

Fetus/Foetus and Fetal/Foetal

Fetal Alcohol Spectrum Disorder (FASD)

Criminal Justice and FASD

Justice System in Western Australia

Project Reference Group

Judicial Legal Corrections Police

Judicial Legal Corrections Police

Judicial Legal Corrections Police

Data analysis and draft report

Figure 1: Justice Project flow chart

 Aboriginal Legal Service of WA (ALSWA)

 Assist with the study design, survey development and recruitment

Survey administration and follow up

Table 1: Survey response

Judicial Legal Corrections Police Total

Figure 2: Gender of survey participants (n=427)

Age group (years)

Figure 3: Age distribution of survey participants (n=427)

Table 2.1: Age of survey participants

Judicial Legal Corrections Police

Judicial Legal Corrections Police

Table 2.4: Year of graduation of survey participants

Judicial Legal Corrections Police