ADHD NOT a Recipe for Life of Crime
Crime is not a way of life for the vast majority of persons with ADHD. Dr. Emmy Werner’s work provides an insight into and understanding of how ADHD can be overcome and individuals develop into productive members of society leading satisfying lives.
Dr. Werner is known in the field of child development for her leadership of a thirty year longitudinal study of 698 infants on the Hawaiian island of Kauai —the island’s entire birth cohort for the year 1955. The study indicated that many children exposed to reproductive and environmental risk factors (for instance, premature birth coupled with an unstable household and a mentally ill mother) go on to experience more problems with delinquency, mental and physical health and family stability than children exposed to fewer such risk factors.
One of Dr. Werner’s most significant findings was that one third of all high-risk children displayed resilience and developed into normal, happy adults despite their problematic development histories. She and her fellow researchers identified a number of protective factors in the lives of these resilient individuals which, they hypothesized, helped to balance out risk factors at critical periods in their development. Among these factors were a strong bond with a nonparent caretaker (such as an aunt, babysitter, or teacher) and involvement in a church or community group. [i]
The modification of behavioral outcomes is possible through positive environmental experiences. An early history of positive support and care increases the individuals’ ability to adapt and cope in stressful situations. These individuals can learn coping skills and techniques which enable them to transition successfully into adult life.
Children with early histories of secure attachment at infancy and generally supportive care in the first two years of life demonstrate a greater capacity to rebound from a period of poor adaptation in the elementary school years compared to those with less supportive histories.
Dr. Werner’s study indicates that high risk children who have difficulties in their teen years can with support and help became responsible employees, spouses and parents in their thirties and forties. These typically were individuals who participated in sources of community support. The ability to seek support and accept help created the acceptance of the concept of trust which in turn opened them to positive development.
Longitudinal studies suggest that it is the combination of ADD/ADHD with adverse environments during childhood that have the greatest negative impact on individuals who are genetically vulnerable.
Dr. Werner noted, “In most cases, the factors that mitigated the negative effects of childhood adversity also benefitted children who lived in stable and secure homes but they appear to have particular importance when adversity levels are high.”
However, those who engage in activities that bring them into conflict with the criminal justice system generally have considerable difficulty controlling their impulses. The majority of high risk children, those who had become troubled teenagers, were recovered in the third and fourth decades of life and became responsible partners, parents and citizens in their communities.
Individuals who availed themselves of informal sources of support in the community and whose lives then took a positive turn, differed in significant ways from those who did not make use of such resources. They had also been exposed to more positive interactions with their primary caregivers in the first two years of life. Dr. Werner suggests that their early rearing conditions fostered a sense of trust which served them well much later in life.
The highly impulsive and unpredictable nature of an ADHD individual makes the individual more likely to be a part of the criminal justice system. Treatment programs designed to develop skills to control impulses and exercise more control will benefit the individuals and society.
ADD/ADHD and the Criminal Justice System
There has been a growing consensus based both academic research and criminal justice analysis that there exists a fairly strong association between measures of ADHD and criminal and delinquent behavior.
Attention Deficit – often combined with hyperactivity – Disorder (ADD and/or ADHD) as a neuropsychological condition has been found to influence criminal and delinquent behavior.
Individuals with ADHD are not all criminals. Most will have no greater contact with the criminal justice system than individuals without the disorder. ADHD and criminal behavior appears to occur when there is a history of antisocial behavior in adolescence. Those with a tendency toward impulsive behavior run a greater risk of coming into contact with the justice system than others.
Problems characterized as attention disorders and hyperactivity have long constituted the most chronic childhood behavioral disorders and the largest sources of referral to child mental health centers.[i]
The diagnosis of ADHD among children and adolescents is increasing consistently. Attention-deficit/hyperactivity disorder is found in as many as one in every 20 children. Boys are four 4 times more likely than girls to have the disorder according to the U.S. Department of Health and Human Services, 1999.
Symptoms of ADHD largely stem from impulsive, non-thinking behavior. ADHD reflects an exaggeration of normal behavior. The individual over reacts to situations. Strong emotional displays are common. Dramatic responses to small matters may occur frequently.
An ADHD individuals cognitively understands what is expected of them but under stress or in a demanding situation their sense of immediate need overwhelms their limited capacity for self-control. Their actions create consequences that are difficult to manage. These individuals are characterized as unpredictable and their actions may include violence.
ADHD individuals are easily bored. It is difficult for them function in an environment where the tasks are repetitive and dull. Their ability to focus on detail is diminished. There is a need for immediate gratification and embracing the concept of a long term goal with a long term reward is not meaningful.
The majority of adults with ADHD are undiagnosed and consequently untreated. They suffer with the untreated consequences with symptoms which occur in varying types and severity. ADHD symptoms have the potential and often do impair interpersonal relations including marriage. The symptoms destroy the emotional well-being of the individual, disrupt stable employment and even the work environment at large for other employees.
Criminal justice professionals deal with the consequence of ADD/ADHD daily and in large quantities in terms of investigation, prosecution, and incarceration.
P.H. Wender, “The Minimal Brain Dysfunction Syndrome,” Annual Review of Medicine, 26, 1975, 45-62; R.A. Barkley, Hyperactive Children: A Handbook for Diagnosis and Treatment (New York: Guilford Press, 1981).
Identification and Treatment of Children with Psychiatric Disorders in Circumventing Adult Criminal Justice System
Improved identification and treatment of children with psychiatric disorders in the criminal justice system is most likely the most cost effective method of approaching social issues and the long term costs of incarceration of adults. In short it is cost effective to identify psychiatric disorders and treat them before the child becomes an adult criminal.
While the effective identification of mental health issues in children would not alone be sufficient to divert all young adults from criminal activity it is one significant indication various paths to criminality.
Nearly half of the young adults with a criminal record had a history of mental illness, as compared with one in three male or one in four female young adults with no criminal history in the American Journal of Psychiatry.[i] This rate was only slightly lower among young adults who had no involvement with the juvenile justice system, and the added risk of childhood psychopathology for young adult criminality remained after analyses controlled for childhood conduct disorder.
Children with specific patterns of psychopathology with and without conduct disorder have been found to be at risk of later criminality. A recent article in the American Journal of Psychiatry has concluded that effective identification and treatment of children with such patterns may reduce later crime. Many studies in indicate that combinations of disorders may be the more specific indicators of the risk of criminality than only a single disorders.