Criminal Justice & ADHD

48 Pages·2014·2.82 MB·English

NACM 19th Annual Case Management Conference
Atlantic City, NJ
October 1, 2013
Kyle Dopfel, B.A.
is the Justice Projects Director for the Attention Deficit Disorder
Association (ADDA). Previously, she served as Project Coordinator for the ADHD
Corrections Project- a pilot reentry program established by ADDA and the Delaware
Center for Justice in Wilmington, DE. Kyle earned her Bachelor’s Degree in Anthropology
from Duke University, where most of her fieldwork focused on justice issues.

Ashley Biden, MSW
is the Associate Executive Director at the Delaware Center for
Justice. Previously, she worked with the Delaware Department of Services for Children,
Youth, and their Families (DSCYF) since 2007. Prior to working with the state,
she worked with West End Neighborhood House in Wilmington and the Children's
Psychiatry Center of Northwestern Human Services in Philadelphia. Ashley earned her
Masters Degree in Social Work from the University of Pennsylvania and her Bachelor's
Degree from Tulane University.

Carol Kuprevich, Ed.D.
is Director of Community Planning, Program Development,
and Training for the Delaware Division of Substance Abuse and Mental Health. She has
worked in several states as a case manager, administrator, and educator and continues
to provide these services through a private consulting practice. Dr. Kuprevich has served
on the Executive Board of NACM for over a decade and is on the advisory councils of
numerous academic institutions.
Presentation Objectives:
By the completion of this workshop participants will be able to:

1. Explain the importance of addressing ADHD and coordinating response
throughout service systems, using new knowledge of the key components
for the diagnosis of ADHD.

2. Describe an innovative partnership between the Attention Deficit Disorder
Association and the Delaware Center for Justice to address ADHD in the
criminal justice system.

3. Identify outcome opportunities for case managers working with persons
who have involvement with criminal justice and who have ADHD.
Experiential Learning: ADHD Screening
From the Adult ADHD Self-Report Scale (ASRS-vI.I) Symptom Checklist
Circle the number that best describes how you have
felt and conducted yourself over the past 6 months.

1. How often do you have difficulty getting things in order
0 1 2 3 4
when you have to do a task that requires organization?
2. When you have a task that requires a lot of thought,
0 1 2 3 4
how often do you avoid or delay getting started?
3. How often are you distracted by activity or noise around you? 0 1 2 3 4
4. How often do you leave your seat in meetings or other
0 1 2 3 4
situations in which you are expected to remain seated?
5. How often do you feel restless or fidgety? 0 1 2 3 4
6. How often do you have difficulty waiting your turn
0 1 2 3 4
in situations when turn taking is required?
Total:
A score of 11 points or higher indicates that your
symptoms may be consistent with Adult ADHD.
What is ADHD?
…and how does it manifest itself in
the Criminal Justice System?
Attention Deficit-
Hyperactivity Disorder
Neurodevelopmental disability present at birth, directly
related to different from usual chemical signaling in the
nervous system that can be passed on from parent to child
and may be negatively impacted throughout life by brain
trauma and injury. (Kramer)

Impacts the behavior, emotional functioning, learning and
cognition of effected individuals.
Attention Deficit Hyperactivity Disorder
(ADHD) occurs in 4.4% of the general adult
population in the United States, but has been
found in over 25% of our adult incarcerated
population.

ADHD incidences in correctional facilities may
range from 20% to greater than 50%
(Eme & Hurley)
In Barkley’s research of youth over 10 years,
matched for socioeconomic setting:
• 20% of his control group were arrested,
compared to 48% of the ADHD group
• Control group arrested on average 2.1 times,
compared to 6.4 for ADHD group

Washington State’s CHOICES Program-
Consistently reduced recidivism by ~40% over 20 years

Unfortunately, the initial mental health screenings
now used by the mental health staff in United States
correctional facilities do not specifically identify those
with ADHD or learning disabilities.
As demonstrated by its prevalence
within the prison population,
the role ADHD plays in one’s
decision-making process is
particularly relevant to issues of
criminal justice.
Characteristics of inmates who
screen positive for ADHD:
Distractibility
Selective Attention: focusing on one task at a time Increased difficulty achieving mainstream success can
lead to esteem issues, a sense of feeling misunderstood
Sustained Attention: staying on task until complete
and a tendency toward alternative pathways for finding
Working Memory Deficit: forgetfulness
acceptance and achievement– e.g. gangs.

Impulsivity

People with ADHD have problems inhibiting their The need for more frequent and intense rewards can
prepotent responses: responses that favor lead to sensation-seeking behaviors, such as substance
short-term reinforcement at the cost of abuse. (Also as a means of self-medication.)
long-term outcomes.
Sense of time impairment: “Now” vs. “Not Now”
Reward Deficit: focus on immediate gratification

Hyperactivity
AD/HD has been linked to an increased likelihood of
developing Oppositional Defiant Disorder and Conduct
Disorder, characterized by behaviors such as:
• Defiance, stubbornness, temper problems (ODD)
• Aggression, theft, destruction of property (CD)
• Other serious violations of societal rules