Screening for Autism Spectrum Disorder (ASD) and intellectual disability in the criminal justice system: a systematic review

In the general population, it is estimated that Autism Spectrum Disorder (ASD) affects around 1% to 1.5% (Centre for Disease Control and Prevention, 2014) and Intellectual Disability (ID) 2–3% (2001). Studies across the criminal justice system (CJS) have estimated the prevalence of prisoners with ASD and ID at 4.4% (Fazio et al, 2012) and 7% (Mottram, 2007) respectively, suggesting that they are over represented in the CJS (Hellenbach et al, 2017). Moreover, the presence of ASD and ID within the CJS is associated with poorer outcomes (Vanny et al, 2009), increasing the likelihood of future recidivism, or custodial or more restrictive or punitive sentencing (McCarthy et al; 2016). There is little research into the prevalence of ID and ASD in courts and varying estimates have been reported from 3-23%, whilst in police stations estimates have ranged between 2%
and 9% (Murphy and Mason, 2014). Identification has highlighted individuals with ID are more likely to present with mental health problems and that those with borderline ID have similar characteristics to those with mild ID (Hayes, 1997). The characteristics of ID offenders it is argued are different to defendants without ID (Vinkers, 2013). While there should be parity of access to identification and screening programmes between individuals with ASD and ID and mental illness, little research has been published on the prevalence of ASD and ID in police, court, probation and prison, and how identification of these conditions may influence an individuals’ journey in the CJS from arrest to sentencing. Traditionally screening tools used within the CJS have concentrated on identifying mental disorder focussed on serious mental illness and risk. To complement the use of self-report and routine clinical interview and assessment in identifying ID and ASD, there have been several screening tools aimed at people with ID and ASD piloted in the CJS in a number of countries over the last decade such as the Rapid Assessment of Potential Intellectual Disability (RAPID) (Ali et al, 2016), Hayes Ability Screening Index (HASI) (Hayes, 2000) Learning Disability Screening Questionnaire, and the Kaufman Brief Intelligence Test (KBIT) (Kaufman, 1990) for ID and the AQ-10 for ASD (see Booth et al, 2013). Given the recent growth of screening, this proposal seeks to review the effect and impact of
screening of adults for ASD and ID across the CJS