Lives and crimes: Kids who suffer foetal alcohol spectrum disorder

Date

February 16, 2014

Children who suffer from foetal alcohol syndrome are much more likely to fall into crime.

Illustration: Simon Letch.

Before Jack ever had a drink, alcohol permanently changed his brain. The 26-year-old’s mother drank while pregnant and today Jack suffers from foetal alcohol spectrum disorder (FASD). He is impatient, impulsive, with a poor memory and a short attention span.

”He can’t think about the future, he’s only thinking immediately,” says Janet Hammill, who informally adopted Jack when he was 14.

Notions of right and wrong rarely occur to him. Convicted of burglary, drug dealing and assault, Jack has spent the past decade in and out of juvenile detention and prison.

”Alcohol is our new thalidomide,” says Hammill, a researcher who co-ordinates the Collaboration for Alcohol Related Developmental Disorders at the University of Queensland Centre for Clinical Research. Others describe the disorder as ”invisible brain damage”.

FASD is a lifelong injury that leaves sufferers much more likely to break the law, and to break it repeatedly, even after long jail stints.

Research published in 2013 in the Journal of Judicial Administration suggests many people with the disorder, like Jack, will fall into a life of crime while still children. Professor Elizabeth Elliott, a paediatrician at Sydney University, says: ”A lot of the kids that are in juvenile justice, particularly in indigenous settings, may well be kids with foetal alcohol spectrum disorder.

”They find themselves in juvenile justice, or even imprisoned in some circumstances, without people recognising that these are children who are disabled intellectually.”

A federal parliamentary inquiry in 2012 called for FASD to be officially recognised as a disability, stressing the need for better awareness among police, lawyers, judges and prison staff.

A month before the 2013 election, Labor placed sufferers under the ambit of the national disability insurance scheme and announced $20.2 million for an ”action plan” over four years. Now responsibility falls to the Coalition’s assistant health minister, Fiona Nash. Asked whether the government would implement the plan, Nash replied: ”We are looking carefully at the action plan to ensure it addresses the many complex social and medical issues involved.”

Crime is one of the most complex issues and experts warn the justice system is ill-equipped to recognise, let alone support, sufferers of FASD.

In the US, the National Organisation on Foetal Alcohol Syndrome found 60 per cent of adolescent sufferers had been in trouble with the law. One-third over the age of 12 had been incarcerated.

”They often don’t understand that they have done something wrong,” Elliott says. ”They can’t understand the consequences of their actions.”

The parliamentary inquiry estimated 2 per cent of the population is affected by the disorder but Elliott believes the number might be higher.

The National Health and Medical Research Council recommends abstinence from alcohol during pregnancy and breastfeeding. But polling by the Foundation for Alcohol Research and Education shows almost 50 per cent of women drink alcohol not knowing they are pregnant, while one in five continue to drink once their pregnancy has been confirmed.

Sometimes referred to as ”the hidden harm”, FASD can be mistaken for autism or attention deficit disorder, but often sufferers receive no diagnosis at all.

”The behaviours are perceived as deliberate, wilful, manipulative,” says Vicki Russell, chief executive of the National Organisation of Foetal Alcohol Syndrome and Related Disorders.

”But at the end of the day, they’re symptomatic of brain damage – invisible brain damage.”

In court, people with FASD struggle with the abstract language used by lawyers and judges. They cannot explain themselves and are much more likely to make a false confession by readily accepting a barrister’s version of events.

Hammill says Jack tends to look bored and restless when in the dock. ”He sits there as if to say ‘get on with it’.”

A University of Queensland law professor, Heather Douglas, fears sufferers may receive harsher sentences from judges who see them as unrepentant, rather than incapable of change. ”We have a long way to go in Australia just making sure that those in the criminal justice system are aware of the problems associated with FASD,” Douglas says. ”A lot of people just don’t realise it exists.”

In a survey of Queensland judges, Douglas found most had never requested an assessment for a suspected case of FASD, often because of scarce resources.

The judges surveyed tended to associate the disorder with abnormal physical features and low intelligence. But although some people with FASD have distinctive physical features – a small head, small eyes, a thin upper lip – most sufferers look like everyone else.

And most receive normal IQ scores because their problems with memory, attention and behaviour control do not tend to show up on standard intelligence tests.

Once in prison, people with FASD are very likely to reoffend, often on behalf of others, US and Canadian studies have found.

”They’ll be asked to carry out certain deeds by other, more powerful elements in the jail, so they might carry out the dirty work,” Douglas says. Chances of early parole fade further for sufferers who regularly fail the mandatory rehabilitation programs. A PhD candidate in indigenous health at Queensland University, Lorian Hayes, has seen their frustration.

”I’ve had young people say, ‘Why can’t I just be like my friends? Why am I dumb? Why can’t I learn?” Hayes says. ”They don’t fail the programs; the programs aren’t addressed to their specific needs. They are failing the kids.”

Frequently people with FASD are back in jail soon after their release, having breached their parole conditions. The chief legal officer at the Aboriginal Legal Service NSW/ACT, John McKenzie, says many are bound to breach inappropriate conditions such as strict curfews.

Some sufferers can’t even tell the time. ”There is all too often a complete disconnect between the supposed serious authority of the court and what the child can actually understand,” McKenzie says.

When in opposition, now Health Minister Peter Dutton said that FASD was a ”national disgrace” and that combating the problem should become a ”national priority”.

”The federal health minister should take a personal interest in finding a better outcome to what is a terrible situation,” he told the ABC program Lateline in 2009.

The woman in charge of responding to FASD, Fiona Nash, says it is a serious problem in some parts of the Australian community.

”I am very mindful of the harmful impact of FASD on children and families,” she says.

Foundation for Alcohol Research and Education chief executive Michael Thorn is anxious that the new government commit to the plan announced by Labor.

But the plan also has its shortcomings, Thorn says, particularly when it comes to recognising sufferers, with only $500,000 over four years for diagnosis and early management.

”We run the risk that, overwhelmingly, people with FASD will be excluded from access to national disability insurance scheme support,” he says.

Anne Russell says she did not drink much at all during her first pregnancy; during her second she had about three drinks, three times a week, a level her doctor suggested was acceptable. As the mother of two adult sons with the disorder, Russell says Australia is ”20-odd years behind Canada” when it comes to diagnosis and treatment. She worries that funding is ”lopsided” towards prevention, leaving out support for sufferers and their carers, what she calls ”the other half of the equation”.

”It just breaks my heart to see these kids set up for failure, time and time and time again.”

Janet Hammill has not met with Jack since he was released from a Queensland prison in May, and she worries for him. ”He’s losing faith in himself, because he’s been inside for so long,” she says. Hammill remembers when Jack had just been released from prison after three years, how he stood on a riverbank, mesmerised by the passing ferries. ”He’s neither fish nor fowl,” she says.