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NOTES
1 It is important to note that trends in delinquent behaviour may vary across countries and years.
2 Within developmental theory, a risk factor increases the likelihood of developing antisocial behaviour. This is not to be confused with risk factor for recidivism.
3 A protective factor mitigates the risk associated with antisocial behaviour.
4 Indirect aggression, relational aggression, and social aggression are similar concepts with respect to the types of manipulative acts they involve. They differ in their emphasis and how researchers using the three concepts have developed them (see Archer & Coyne, 2005).
21 Interventions for Offenders with Intellectual Disabilities
R. LINDSAY, WILLIAM L. TAYLOR JOHN AND AMANDA M. MICHIE
CHAPTER OUTLINE
21.1 INTRODUCTION
21.2 THE PREVALENCE OF ID IN OFFENDER POPULATIONS
21.3 ID AS A RISK FACTOR FOR OFFENDING
21.4 ASSESSMENT OF OFFENDERS WITH ID 21.4.1 Assessment of Anger Motivated Offenders
21.4.2 Assessment of Sexual Offenders
21.4.3 Assessment of Arsonists (Fire-setters)
21.4.4 Assessment of Risk for any Future Incidents
21.5 INTERVENTIONS WITH OFFENDERS WITH ID 21.5.1 Treatment for Anger and Violence
21.5.2 Controlled Studies of Anger Management Training (AMT)
21.5.3 Treatment of Sexual Offenders with ID
21.5.4 Outcome Studies Evaluating Sex Offender Interventions
21.5.5 Treatment of Fire-setters
21.6 AUTISM SPECTRUM DISORDERS AND CRIME
21.7 SUMMARY
LEARNING OUTCOMES
BY THE END OF THIS CHAPTER, YOU SHOULD BE ABLE TO:
Understand the way in which psychological approaches to offenders with Intellectual and Developmental Disability (IDD) might differ from mainstream approaches
Appreciate the principal research methods used to explore the way in which offenders with IDD respond to assessment and treatment
Understand the implications of existing findings for the care and treatment of offenders with IDD.
21.1 INTRODUCTION
The fact that a subgroup of offenders is known to have significant intellectual limitations has, for many years, presented difficulties for the development of assessment, management and treatment services in the criminal justice system. Therefore, researchers and service planners have been interested in prevalence, characteristics of offenders with intellectual limitations, types of crimes and so on. Once characteristics and special needs have been established, procedures must be adapted so that individuals can engage meaningfully with the criminal justice system and other agencies. Finally, an important question is the extent to which services can reduce reoffending and enable individuals to return to community living. In a worst-case scenario, it may be that any particular subgroup of offenders is impervious to intervention aimed at rehabilitation and the prevention of reoffending.
It will not be possible to review research on all these issues in this chapter and we will restrict ourselves to the effectiveness of assessment and treatment for offenders with intellectual disability (ID). We will evaluate the evidence on the psychometric properties of assessments for psychological variables related to offending. We will also evaluate the effectiveness of treatment of some main criminal behaviours, such as violence and sexual offending.
21.2 THE PREVALENCE OF ID IN OFFENDER POPULATIONS
Lindsay, Hastings, and Beech (2011) have noted three major methodological difficulties in studying the prevalence of offenders with ID in criminal populations. First studies have been conducted in a variety of settings including prisons (MacEachron, 1979), Probation Services (Mason & Murphy, 2002), and appearances at court (Vanny, Levy, Greenberg, & Hayes, 2009). Vanny et al. (2009) studied 250 individuals appealing in magistrates courts in New South Wales, Australia and, using an intellectual screening test, found that 10% fell into the category of ID while a further 20% fell into the category of borderline intelligence. On the other hand, MacEachron (1979) found prevalence rates of 0.6–2.3% in state prisons in Maine and Massachusetts USA. She concluded that the method used in the assessment made a significant difference to the rates found.
Screening tools tend to find higher prevalence rates than full psychometric assessment since screening assessments are designed to be over-inclusive, identifying people for further more exhaustive assessment. A third source of variation is the inclusion criteria used, particularly if those considered to be functioning in the borderline intelligence range (IQ 70–79) are included. It can be seen in the Vanny et al. (2009) study that prevalence would triple from 10% to 30%, if people with borderline intelligence were included in those offenders with ID. Indeed, when low intelligence is considered in studies on offenders (e.g. Farrington, 2005), IQ under 85 is sometimes the criterion.
A number of recent reports have arrived at similar findings. In a study on prisons in the UK, Hayes, Shackell, Mottram, and Lancaster (2007) used a full psychometric assessment and also assessed adaptive behaviour in 140 prisoners and found that 2.9% of their sample fell in the range of ID. Herrington (2009) used a screening assessment to re-evaluate 185 young adult male prisoners in a young offender’s institution. He reported 10% of prisoners fell into the ID range. A study in Norway (Søndenaa, Rasmussen, Palmstierna, & Nøttestad, 2008), on 143 inmates randomly chosen from the prison population, used a screening instrument to assess for intellectual disability. They reported that 10.8% of their sample fell into the category of ID. It is important to remember that screening tools are designed to be over-inclusive.
The methodological differences between studies continue. Crocker, Cote, Toupin, and St-Onge (2007) attempted to assess 749 offenders in a pre-trial holding centre in Montréal. For a number of reasons including refusal to participate, administrative difficulties and technical problems, they were only able to assess 281 participants with three subscales locally standardised mental ability scale (equivalent to a screening test). They reported that 18.9% were in the probable ID range and a further 29.9% in the borderline range. This is an unusually high prevalence. On the other hand, Holland and Persson (2011) investigated al
l sentenced male prisoners released from Victorian prisons, Australia, from July 2003 until June 2006 (9,481 prisoners). Using the WAIS III to assess IQ and using a criterion of IQ less than 70, they found a prevalence rate of 1.3%, which is consistent with the general population.
Clearly, there are huge methodological differences between these two studies, one assessing a proportion of those presenting in a pre-trial holding centre and the other assessing all prisoners in a state, one using an intelligence screening and the other using a full cognitive assessment. The method of assessment, the location of the sample and the extent of the sample are likely to be the source of the differences in findings between studies. In a systematic review of studies of prevalence in prison, Fazel, Xenitidis and Powell (2008) concluded that in studies that fulfilled their criteria for scientific integrity, typically, 0.5–1.5% of prisoners were diagnosed with ID. This figure falls at the lower end of the prevalence estimates but, they concluded, still represents a highly significant number of individuals with ID in prisons and has implications for policy and practice.
These methodological differences also are likely to be the source of differences found between studies in characteristics of offenders with ID. Walker and McCabe (1973) reported a high prevalence of sexual offences and arson in this client group. Lunsky, Gracey, Koegl, Bradley, Durbin, and Raina (2011) also found a higher rate of fire-setting and property destruction in offenders with ID held in psychiatric institutions when compared to those without ID. Hogue et al. (2006) reviewed the number of characteristics of offenders with ID across community, the medium/secure and high secure settings. They found that the rates of arson as an index offence depended on the setting with low rates in the community sample (2.9%) and higher rates in the medium secure sample (21.4%). This suggested that while rates of arson in offenders with ID are consistent with mainstream offenders, there may be a tendency to refer arsonists with ID to medium secure psychiatric settings, such as that found in the Lunsky et al. (2011) study, raising the prevalence in this setting.