Social Policy in Ontario

Turning around Ontario lives hurt by fetal alcohol spectrum disorder

Posted on September 1, 2012 in Child & Family Debates

Source: Toronto Star — Authors: Sheila Burns

TheStar.com – opinion/editorialopinion
August 31, 2012.   Sheila Burns

Fetal alcohol spectrum disorder is the most common of developmental disabilities, affecting an estimated one in 100 Canadians or 130,000 Ontarians. But this province lags far behind the rest of the country in addressing this complex yet preventable disability, and is unnecessarily relegating far too many people to the margins of society.

We aren’t doing enough to prevent, diagnose or support people living with fetal alcohol spectrum disorder. Nor do we have the comprehensive strategy other provinces have developed to make all this happen in a co-ordinated way. Recent roundtable discussions and a provincial conference focusing on fetal alcohol spectrum disorder in the justice system have defined ways in which we must and can do better.

Like Alzheimer’s, fetal alcohol spectrum disorder is an invisible, brain-based disability that impacts thinking. Individuals may appear capable but typically have significant limitations. They have difficulty recalling past experiences, anticipating consequences, adapting to new situations, solving problems and interacting socially.

This puts them at heightened risk of involvement with the justice system as either victims or perpetrators of crime. No one tracks how often they are victimized but research suggests that youth with fetal alcohol spectrum disorder are 19 times more likely to be incarcerated, and the incidence of FASD may be as high as three in 10 among federal inmates.

That staggering over-representation results from a legal system in which individuals with fetal alcohol spectrum disorder are too often treated as bad and wilfully non-compliant rather than disabled. This handcuffs us to a continuing cycle of ineffective responses. It fills prisons with individuals whose permanent neurobiological impairments won’t be fixed through punishment, and eats up resources that could be invested in avoiding victimization and criminality.

It doesn’t need to be this way and many of the solutions are relatively straightforward.

FASD is preventable, and with the annual cost associated with the disorder estimated at $5.3 billion in Canada, there’s ample motivation for sustained awareness campaigns. Men and women need information on alcohol use and pregnancy prevention, and women need access to treatment for the issues that contribute to alcohol use during pregnancy.

We need to develop assessment and diagnostic capacity. Research can help us target our initial efforts, since we know fetal alcohol spectrum disorder is commonly encountered in the child protection and criminal justice systems where costs are high and there is considerable value for identification.

Services for caregivers who deal with the daily challenges of this chronic disability are essential, yet fetal alcohol spectrum disorder is typically excluded from the eligibility criteria. Respite and other support help stabilize home-life and can prevent criminal behaviour and its escalation. Such programs are also much more cost-efficient than annual per-inmate incarceration price tags of $50,000 to $120,000.

Fetal alcohol spectrum disorder training must be available to health, education, justice and corrections, and human and social services-sector staff. These front-line professionals need a better understanding of the characteristics of individuals with fetal alcohol spectrum disorder and of the reasons for their behaviour. They need to be able to design care plans with FASD-specific impairments and strengths in mind.

Aware and informed professionals, parents and caregivers can better maximize the innate strengths of individuals, while accommodating learning needs and developmental and sensory issues. By matching expectations with abilities, they can reduce stress and disordered behaviour on the part of people with fetal alcohol spectrum disorder, and create effective lifelong support networks that help them navigate their world constructively and safely.

This is perhaps most crucial in the justice system context. The disability requires simplified and more nuanced judicial responses. This is in stark contrast to the complex bail, probation and parole conditions often being levied now. These only increase the risk of reoffending, and can result in years of escalating and ineffective intervention and imprisonment, which is often entirely out of proportion to the original offence.

And upon release, individuals with fetal alcohol spectrum disorder will still need for the very supports that might well have diverted them from criminal behaviour, had they been available in the first place.

The provincial government needs to direct actions to enable Ontario to catch up with what’s already being done elsewhere and to improve services and outcomes. Continued inaction has a cost: A cost to the disabled of course — many consigned to prison or other bleak life trajectories — and also to their families, communities and the taxpayer.

Sheila Burns is Community Leadership in Justice Fellow, Law Foundation of Ontario; the opinions expressed are those of the author. Reach her at sheila.burns@rogers.com .

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Tags: disabilities, economy, Health, mental Health, participation, poverty, standard of living, youth

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