Identification and support of autistic individuals within the UK Criminal Justice System: a practical approach based upon professional consensus with input from lived experience.

BACKGROUND: Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual's journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes. METHODS: This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS. RESULTS: The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS. CONCLUSION: Greater attention needs to be given to this population as they navigate the CJS.

Exploring the similarities and differences amongst service users with and without learning disabilities attending Saint Marys Sexual Assault Referral Centre.

BACKGROUND: People with learning disabilities are over-represented amongst Sexual Assault Referral Centre service users. This work aims to explore the similarities and differences between service users with and without learning disabilities. METHOD: Medical notes of 52 service users likely to have a learning disability were compared with 52 service users not likely to have a learning disability (according to the Learning Disability Screening Questionnaire); all of whom attended Saint Marys SARC for a forensic medical examination during a 12-month period. RESULTS: Significant associations were found between the likelihood of learning disability and relationship to perpetrator; location of assault; alcohol use; time taken to present to SARC; domestic violence; self-harm; suicide attempts and mental health service involvement. CONCLUSIONS: People with learning disabilities in the sexually assaulted population are more likely to present with intersecting vulnerabilities emphasising the need for timely, accessible and appropriate patient-centred care for this group.

The high prevalence of pre-existing mental health complaints in clients attending Saint Mary's Sexual Assault Referral Centre: Implications for initial management and engagement with the Independent Sexual Violence Advisor service at the centre.

BACKGROUND: The Saint Mary's Sexual Assault Referral Centre has a unique service delivery model whereby it provides an integrated physical and psychological support services to clients, women men and children, living in Greater Manchester. The service is available to those who have reported rape or sexual assault, whether this is recent or historic. Clients living in surrounding areas of Cheshire are provided with forensic and medical services at Saint Mary's Centre, with follow-up care provided locally, as appropriate. AIMS: The primary objective was to identify the prevalence of self-reported pre-existing mental health complaints amongst adult clients who attended Saint Mary's Centre for a forensic medical examination. The secondary objective was to consider levels of engagement with the Centre's Independent Sexual Violence Advisor service by comparing clients who reported a mental health complaint to clients who did not. METHOD: One-hundred and eighty sets of client's notes from 2016 were retrospectively analysed. Client inclusion criteria were that they were (a) over the age of 18 years when attending the Centre, (b) had attended for a forensic medical examination. RESULTS: 69% of clients analysed reported a pre-existing mental health complaint. The time taken for clients to present to Saint Mary's Centre following a reported assault tended to be later for the clients with self-reported mental health problems than those without. However, there was no difference in the long-term engagement with the Centre's Independent Sexual Violence Advisor service at the Centre between the two groups. CONCLUSION: Prevalence of self-reported pre-existing mental health complaints is extremely high in clients presenting at Saint Mary's Centre as compared to national and regional prevalence rates for mental health complaints in the general population. The vulnerability of this client group should be considered when they attend a SARC and support provided should be appropriate and accessible to their needs. Staff should have adequate training and supervision to be able to respond in this way.

Drawing the answers: Sketching to support free and probed recall by child witnesses and victims with autism spectrum disorder.

The success of witness interviews in the criminal justice system depends on the accuracy of information obtained, which is a function of both amount and quality of information. Attempts to enhance witness retrieval such as mental reinstatement of context have been designed with typically developed adults in mind. In this article, the relative benefits of mental and sketch reinstatement mnemonics are explored with both typically developing children and children with autism. Children watched a crime event video, and their retrieval of event information was examined in free and probed recall phases of a cognitive interview. As expected, typically developing children recalled more correct information of all types than children with autism during free and probed recall phases. Sketching during free recall was more beneficial for both groups in both phases in reducing the amount of incorrect items, but the relative effect of sketching on enhancing retrieval accuracy was greater for children with autism. The results indicate the benefits of choosing retrieval mnemonics that are sensitive to the specific impairments of autistic individuals and suggest that retrieval accuracy during interviews can be enhanced, in some cases to the same level as that of typically developing individuals.

No Evidence Against Sketch Reinstatement of Context, Verbal Labels or the Use of Registered Intermediaries for Children with Autism Spectrum Disorder: Response to Henry et al. (2017).

Recently, Henry et al. (J Autism Dev Disord 8:2348-2362, 2017) found no evidence for the use of Verbal Labels, Sketch Reinstatement of Context and Registered Intermediaries by forensic practitioners when interviewing children with a diagnosis of autism spectrum disorder. We consider their claims, noting the limited ecological validity of the experimental paradigm, the impacts of repeated interviewing where retrieval support is not provided at first retrieval, question the interviewer/intermediary training and their population relevant experience, and comment on the suppression of population variances. We submit that rejecting these techniques on the basis of this study is completely unwarranted and potentially damaging, particularly if used in legal proceedings to undermine the value of testimony from children with ASD, who continually struggle to gain access to justice.

Gender Differences in Psychosocial Predictors of Attitudes Toward Reporting Child Sexual Abuse in the United Kingdom.

There is a dearth of research investigating psychosocial correlates of attitudes toward reporting child sexual abuse in males and females and a lack of such studies drawing on participants from the United Kingdom. Therefore, the main objective of this article is to examine gender differences in social and psychological predictors of attitudes toward reporting child sexual abuse. Participants drawn from the United Kingdom general population were recruited via an opportunistic sampling method. Cross-sectional design using a self-report questionnaire was utilized. Hierarchical multiple regression analyses revealed that social support, masculinity, and age form significant associations with attitudes toward reporting child sexual abuse in females (total variance explained by the model was 25%). In the male sample, the only significant predictor of attitudes toward reporting child sexual abuse was interpersonal manipulation (total variance explained by the model was 9%). This study provides an important insight into psychosocial barriers and facilitators to reporting child sexual abuse. Such knowledge is crucial for the early detection and prevention of abuse.

Sketching to remember: episodic free recall task support for child witnesses and victims with autism spectrum disorder.

Deficits in episodic free-recall memory performance have been reported in children with autism spectrum disorder (ASD), yet best practice dictates that child witness/victim interviews commence with a free-recall account. No 'tools' exist to support children with ASD to freely recall episodic information. Here, the efficacy of a novel retrieval technique, Sketch reinstatement of context (Sketch-RC), is compared with mental reinstatement of context and a no support control. Ninety children (45 with ASD; 45 matched typically developing) viewed a stimulus film, and were interviewed using one of the aforementioned techniques. The Sketch-RC technique was most effective, improving ASD participants' remembering without a concomitant increase in intrusions. This procedure offers a population-appropriate method for supporting free recall in criminal justice settings.