Recent youth case provides insight into link between FASD and offending

Children with diagnosed or suspected Fetal Alcohol Spectrum Disorder (FASD) made up 15 per cent of youth custody numbers in Queensland in 2023, with a recent case providing important insight into the link.

In Western Australia, a 2018 study showed one third of detained children had FASD. Picture: iStock / Evgeniy Shkolenko

Fifteen per cent of children in youth custody are suspected or diagnosed with Foetal Alcohol Spectrum Disorder, data shows.

Queensland Health Minister Tim Nicholls said FASD was a “significant problem” while in Cairns earlier this week.

“We see it permeate through both the criminal justice system, the youth justice system, and importantly, through the health system,” he said.

The latest data from the 2023 Youth Justice Census showed that about one in six young people had or were suspected of having FASD while 29 per cent of young people in custody were diagnosed or suspected of having a cognitive or intellectual disability.

It comes as the Cairns Post launched ‘Cause and Effect’; a campaign that exposed wait times for public FASD diagnostic clinics in Queensland are up to two years, and can cost up to $10,000.

The campaign is calling for mandatory and free FASD testing for all at-risk children in Queensland, and calling for governments to significantly reduce these lengthy waiting times.

The Crisafulli government has committed $27.5m to a Healthy Kindy Kid program, which will provide free health checks to all kindy-aged kids and follow up tests for those with identified needs, to be rolled out after the 2025/26 budget is announced on June 28.

The state government also committed $7.1m in their 2024/25 budget to expand these health assessments over two years, however this funding is not recurrent.

Mr Nicholls said prevention and early intervention were important.

There are at least three of these clinics in Queensland — one in Townsville and two in Southeast Queensland — with the state government unable to confirm an exact number.

The statistics on the prevalence of FASD in youth custody are from Queensland’s 2023 Youth Justice Census. Picture: Queensland Government

“We are doing our part in terms of providing information and working with our colleagues in other departments to identify early areas of foetal alcohol syndrome being developed, and making steps to address those issues,” Mr Nicholls said.

The state government completes comprehensive health assessments of all children entering detention in Queensland, which includes screening for FASD.

The multidisciplinary team of psychologists, speech therapists, case works and education staff assess a child’s cognitive, physical and mental health.

One of the biggest criminal cases linked to FASD was in 2022 when a Cairns teenager with a diagnosis killed his 14-year-old friend, Bradley Smith, after crashing a stolen car.

Tim Nicholls. Picture: Annette Dew

The Cairns teenager, known only as BXY, lost control of the stolen car he was driving and crashed into a tree, killing his best friend Bradley, and seriously injuring three other passengers.

A pre-sentence assessment at the time undertaken psychologist by Dr Meg Perkins found the teenager was likely living in an “eternal present” as a result of FASD, with Ms Perkins saying his “severe level of pervasive brain dysfunction” was a major factor in his offending behaviour.

“The Crown Prosecutor said … when you look at BXY’s history, it was inevitable that he would either end up killing himself or someone else, as he did on this terrible night,” Chief Justice Helen Bowskill said in her sentencing remarks.

“That history started before he was born and involves multiple factors completely beyond his control.

“As Dr Perkins says, when FASD is undiagnosed, the person’s presentation is extremely confusing.

“So much so that their behaviours are put down to carelessness and conduct disorder, rather than to pervasive brain dysfunction.

“That is what occurred here.”

Ms Bowskill said Ms Perkins’ report explained how FASD resulted in “severe deficits in executive functioning”, the brain domain controlling decision making, goal setting and emotions.

Affected by drugs, BXY stole a car with his friend, who died, before driving it at high speeds through the streets of Cairns. Picture: iStock

“Severe deficits in this brain function mean that the child struggles to learn from the past or plan for the future; they simply live in an eternal present,” Ms Bowskill said.

Dr Perkins said this was how BXY’s brain operated.

“The child has great difficulty seeing more than five minutes ahead of the present moment, and also has a greatly reduced ability to inhibit impulsive behaviour,” Ms Bowskill said.

An excerpt from Dr Perkins’ report concluded that, “sadly, BXY was not diagnosed with FASD as a young child, and his severe level of pervasive brain dysfunction has been a major factor in his school failure, aggressive behaviours … ongoing offending behaviour”.

Mr Nicholls said FASD required a community approach spanning the health, education and family sectors.

“There are issues around the availability of alcohol … around public education in respect to it,” he said.

“And there are issues in relation to disadvantaged communities that all need to be addressed if we’re going to if we are going to attack this problem.”

Mr Nicholls added the Queensland government was not considering restricting alcohol access.

“It’s not something that the government is particularly looking at,” he said.

“I think it’s a conversation that as a community, we more broadly, need to have.”

FASD is a disorder caused by prenatal alcohol exposure.

It is a form of brain injury and can cause a range of physical, behavioural and cognitive abnormalities.

Originally published as Recent youth case provides insight into link between FASD and offending