Comprehensive Clinical Paediatric Assessment of Children and Adolescents Sentenced to Detention in Western Australia

ObjectivesTo describe the comprehensive clinical paediatric assessment of a representative sample of children and adolescents (young people) sentenced to detention in Western Australia (WA) and participating in the first Fetal Alcohol Spectrum Disorder (FASD) prevalence study. SettingsIndividuals with FASD have lifelong difficulties with memory, attention, communication, emotional reg-ulation and social skills with associated risk of engagement with juvenile justice. We found prevalence of FASD in 36% of young people sentenced to juvenile detention in WA. This paper describes the comprehensive clinical paediatric assessment of all young people participating in this study. ParticipantsAll young people aged 10–17 years 11 months and sentenced to detention in WA were eligible. All assess-ments were completed by a multidisciplinary team comprising a speech and language pathologist, occupational therapist, neuropsychologist and a paediatrician. ResultsIn all, 103 young people completed the comprehensive clinical paediatric assessment, with maximum num-ber of males (93%) and Aboriginal Australians (73%). One in two participants reported someone close to them, or themselves, having experienced a frightening event with associated symptoms of post-traumatic stress. One-third (36%) of participants had experienced suicide of a family member. Half of the young people had one or no parent (53%), an incarcerated sibling (44%) or an incarcerated family member (57%). One-fifth of participants talked about experiences of emotional neglect (20%), physical neglect (19%), physical abuse (21%) and suicidal ideation (18%). More than half (60%) of participants were 1 year or more behind their school-year grade according to their chronological age, and 73% reported waking tired. Polysubstance use was common, including cigarettes (82%), marijuana (76%), alcohol (66%) and methamphetamine (36%). Almost two-thirds (64%) had abnormal neuromotor findings, 47% reported head injury without hospitalisation, 38% had prior musculoskeletal injuries, 29% had impaired motor skills and 15% had abnormal visual fields. ConclusionComprehensive clinical paediatric assessment of young people sentenced to detention in WA found signif-icant psychosocial and physical difficulties. The findings of multiple and serious impairments and health issues, through completion of comprehensive clinical paediatric and multidisciplinary health and neuro-developmental assessments for this study, support their routine provision to all young people on entry to systems of juvenile justice.