RISK AND PROTECTIVE FACTORS FOR CRIMINALITY AMONG ADULTS WITH FASD

Although Fetal Alcohol Spectrum Disorder (FASD) is a lifelong disability, there is a paucity of research on the longitudinal effects of prenatal alcohol exposure. In part, the lack of systematic studies has been attributed to the methodological challenges that hinder research. In the current paper, the author outlines the challenges encountered in conducting a mixed methods study that sought to compare the experience of offenders and non-offenders who have FASD. Methodological issues such as having a small sample size, the use of convenience sampling, the inclusion of adults without a formal diagnosis, and difficulty in establishing operational definitions limited the ability to draw overarching conclusions and compare the findings to previous research. Furthermore, special considerations were taken in the selection and administration of psychometric measures, which may not be suitable to the unique needs and vulnerabilities of individuals with FASD. In addition, practical limitations interfered with the research process, including recruitment issues and high attrition rates related to the many adverse life outcomes experienced by individuals with FASD. Recommendations to guide future research are also discussed. METHODOLOGICAL CHALLENGES 38 Methodological Challenges in Conducting Research with Adults who have FASD Despite growing concern with the economic and social implications associated with FASD (Amendah, Grosse, & Bertrand, 2011; Chudley et al., 2005; Nash et al., 2006; Popova, Lange, Burd, & Rehm, 2012; Stade, Ungar, Stevens, Beyen, & Koren, 2007), the lifelong teratogenic effects of prenatal alcohol exposure remain understudied (Streissguth & O’Malley, 2000). Furthermore, the extant research on FASD is often hindered by a myriad of conceptual, methodological, and practical limitations (Cronk & Weiss, 2007; Irner, 2012; Warren, Hewitt, & Thomas, 2011). Several methodological issues have been identified by researchers, including the paucity of research using large sample sizes (e.g., Ase et al., 2012; Carr, Agnihotri, & Keightley, 2010; Chasnoff, Wells, Telford, Schmidt, & Messer, 2010), the need for more consistency in sample characteristics and operational definitions across studies (e.g., Arenson et al., 2010; Pei, Job, Kully-Martens, & Rasmussen, 2011), as well as concerns with the limitations of the psychometric measures employed (e.g., Kully-Martens, Denys, Treit, Tamana, & Rasmussen, 2012a; Schonfeld, Paley, Frankel, & O’Connor, 2006). Contributing to the challenge of addressing the methodological limitations are practical barriers relating to the recruitment and retention of participants, particularly when studying adults with FASD (May et al., 2009; Sayal, 2007). The aim of this paper is to identify some the methodological challenges related to the design and implementation of research with adults prenatally exposed to alcohol and to propose solutions to guide future research. This paper draws on the author’s experience conducting a mixed methods study on the protective factors associated with criminality in adults with prenatal alcohol exposure to reflect on some important limitations that may be encountered when conducting similar research. METHODOLOGICAL CHALLENGES 39 Fetal Alcohol Spectrum Disorder FASD is an umbrella term that refers to the continuum of physical, neurobiological, and behavioural consequences resulting from gestational exposure to ethanol. Although FASD is not a diagnostic label, diagnoses of fetal alcohol syndrome (FAS), partial FAS (pFAS), and alcoholrelated neurodevelopmental disorder (ARND) are used to describe the specific congenital birth defects resulting from prenatal alcohol exposure (Astley & Clarren, 2000). According to Canadian diagnostic criteria, the teratogenic effects of alcohol are characterized by facial dysmorphology, growth deficiency, and abnormalities of the central nervous system (Astley & Clarren, 2000). In particular, specific craniofacial malformations have been associated with prenatal alcohol exposure, including short palpebral fissures, flat upper lip, flattened philtrum, and a flat midface (Connor & Streissguth, 1996). Furthermore, individuals who were prenatally exposed to alcohol may have growth deficits such as low birth weight, decelerating weight that is not attributable to malnutrition, and a disproportionate weight-to-height ratio (Chudley et al., 2005). Exposure to alcohol during pregnancy can also lead to neurodevelopmental abnormalities of the central nervous system, such as microcephaly, agenesis of the corpus callosum, and impaired functioning of the frontal lobe, basal ganglia, and hippocampus (Guerri, Bazinet, &