[T]here is hope. We can change how lawyers, clients, police, judges, probation officers,

prison guards, and family members work with FAS clients.1

—David Boulding, attorney for clients with fetal alcohol spectrum disorders

Y

n

oung people who are affected by fetal alcohol spectrum disorders (FASD) are at increased

risk for involvement with the juvenile justice system.2,3 Most youth who have an FASD have 

ever received a diagnosis or services, and they reach the system after a long fall through the cracks.

HOW IS FASD LINKED TO PROBLEMS WITH

THE JUVENILE JUSTICE SYSTEM?

Youth with an FASD were born with brain damage that can

make it difficult for them to stay out of trouble with the law.

They do not know how to deal with police, attorneys, judges,

social workers, psychiatrists, corrections and probation officers,

and others they may encounter.

Professionals who work with the court system can reach out

to young people who may have an FASD to ensure that they

receive needed help. Education and training can help

professionals identify young people who may have an FASD.

This can help them get fair treatment and appropriate services.

WHAT IS FASD?

“FASD” is an umbrella term describing the range of effects that

can occur in an individual whose mother drank alcohol during

pregnancy. These effects may include physical, mental, behavioral,

and/or learning disabilities with possible lifelong implications.

The term FASD is not used as a clinical diagnosis. It refers to

conditions such as fetal alcohol syndrome (FAS), alcohol-related

neurodevelopmental disorder (ARND), and alcohol-related

birth defects (ARBD). FASD occurs in about 10 per 1,000 live

births, or about 40,000 babies per year in the United States.4

WHAT ARE THE CHALLENGES FOR YOUTH

WITH AN FASD?

FASD’s effects on the brain can result in cognitive or

behavioral deficits. These deficits may include mental

retardation, learning disabilities, hyperactivity, attention

deficits, and poor social skills. These and other problems

associated with FASD may increase the chance that a person

will break the law.

Individuals with an FASD typically are impulsive and have

trouble foreseeing the consequences of their actions. They

may have a poor sense of personal boundaries. Many are

very susceptible to peer pressure and can be easily led. Their

judgment is often poor.2

FASD also presents challenges throughout the judicial process,

from questioning through arrest, hearings, sentencing, and

detention. Many youth who have an FASD have poor

communication skills, while others may “talk” much better

than they can function. They may become confused under

pressure. They often cannot understand their rights and may

confess or otherwise implicate themselves and others, even

if they are not guilty. Youth who have an FASD may believe

that if they confess, they will be allowed to go home. They

also want people to like them and may provide a false

confession in an effort to please the police.

Youth who have an FASD typically have memory problems,

which can contribute to forgotten court dates or meetings

with probation officers, judges, and attorneys. Their risk for

victimization in detention is high, as they may fall prey to

other inmates.

It can be difficult for persons with an FASD to learn from

their mistakes. Because the judicial process can be lengthy,

they may not draw a connection between their actions and

the later consequences. Once released from detention, youth

who have an FASD may commit similar offenses and cycle

through the system again and again.

HOW CAN THE SYSTEM HELP YOUTH WITH

AN FASD?

Youth should be screened for FASD at all entry points into

the juvenile justice system. Those who work in the system,

especially attorneys and social workers, should look for a

history of behavior that suggests an FASD. They also should

ask questions about prenatal exposure to alcohol. When they

suspect that an FASD is present, they should request a complete

FETAL ALCOHOL SPECTRUM DISORDERS AND JUVENILE JUSTICE:

HOW PROFESSIONALS CAN MAKE A DIFFERENCE
evaluation by clinicians qualified to diagnose an FASD. The

evaluation should include assessments of possible co-occurring

psychiatric disorders and adaptive behavior.5

Attorneys should be aware of FASD and use their knowledge

to advocate effectively for their clients, particularly in proceedings

related to:

• Competency—Youth with an FASD may be unable to

understand the charges against them and participate in

their own defense.

• Diminished capacity—Young people with an FASD may

find it difficult to distinguish right from wrong, form intent

to commit an offense, and understand consequences.

• Decisions to decline/remand/waive—Youth with an FASD

are likely to be safer in a juvenile facility than in an adult

prison due to potential victimization.

• Sentencing—In some cases, attorneys may be successful in

presenting FASD as a mitigating or exculpatory factor.

They also should explore alternative sentencing options.

• Treatment—Court-ordered treatment is sometimes the

only way for youth with an FASD to receive appropriate

interventions.

Information from evaluations, medical records, family history,

and school and employment records should be included in

presentencing investigations. The outcome may influence

whether or not the youth will be detained, where, for how

long, and what support he or she will receive. Appropriate

services are essential, including medication or substance

abuse treatment (if necessary), vocational training, life skills

training, mentoring, and advocacy.

Detention of youth with an FASD may be unproductive. It can

increase the risk of recidivism because they may copy the deviant

behavior of other juveniles. For probation or aftercare, a highly

supervised, structured living arrangement is critical for success.

People with an FASD often have difficulty managing their

money or tending to household chores. Attorneys should

ensure that clients who were receiving developmental

disabilities support do not lose their benefits while

they are in the system.6,7

Throughout the judicial process, communication with

young people who have an FASD should be concrete,

simple, and repetitive. Youth with an FASD have trouble

following multistep instructions and understanding figures of

speech. Using frequent reminders, visual cues, and open-ended

questions can help them follow rules and understand what is

happening.

FASD is not an excuse for breaking the law. However, all youth,

including those with an FASD, deserve to be treated fairly by

the juvenile justice system. Increased awareness and action at

all levels of the system can offer a lifeline to young people with

an FASD. In addition, the potential benefits to society, through

decreased crime and costs, are tremendous.

ADDITIONAL RESOURCES

SAMHSA FASD Center for Excellence. 2005. What You Need

To Know: Understanding Fetal Alcohol Spectrum Disorders:

Getting a Diagnosis. Rockville, MD: fasdcenter.samhsa.gov

Minnesota Organization on Fetal Alcohol Syndrome. Tools for

Success: Working With Youth With Fetal Alcohol Syndrome

and Effects in the Juvenile Justice System Resource Guide.

www.mofas.org

REFERENCES

1. Boulding, D. 2001. Mistakes I Have Made With Fetal Alcohol Syndrome Clients: Fetal Alcohol Syndrome and Fetal Alcohol Effects in the Criminal

Justice System. depts.washington.edu/fadu/legalissues/Mistakes.pdf

2. Streissguth, A., and Kanter, J., eds. 1997. The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities. Seattle: University of

Washington Press.

3. Fast, D.K.; Conry, J.; and Loock, C. 1999. Identifying fetal alcohol syndrome among youth in the criminal justice system. Journal of Developmental

and Behavioral Pediatrics 20:370-372.

4. May, P.A., and Gossage, J.P. 2001. Estimating the prevalence of fetal alcohol syndrome: A summary. Alcohol Research & Health 25(3):159-167.

5. LaDue, R, and Dunne, T. 1996. Capacity concerns and fetal alcohol syndrome. The FEN Pen 4(1):2-3.

6. LaDue, R, and Dunne, T. 1997. Fetal alcohol syndrome: Implications for sentencing in the criminal justice system. The FEN Pen 5(2):2-3.

7. Streissguth, A. 1998. Attaining human rights, civil rights, and criminal justice for people with fetal alcohol syndrome. TASH Newsletter September:18-20.

DHHS Publication No. (SMA) 06–4240

Printed 2007

Stop and think. If you’re pregnant, don’t drink.

For more information, visit fasdcenter.samhsa.gov or call 866-STOPFAS.

www.stopalcoholabuse.gov