Developing an autism specific framework for forensic case formulation

Abstract

Purpose The purpose of this paper is to outline the initial development of a framework to assist in clinical case formulation for individuals diagnosed with autistic spectrum disorder (ASD) who have been convicted of violent and other offences. Design/methodology/approach The proposed framework obtains information on the presence of ASD features from an individual’s developmental history, index offence and offence paralleling behaviours. Through obtaining information across these three domains the framework helps the practitioner make an informed assessment of the possible contribution of ASD to offending. Findings The framework aims to assist the practitioner to develop a clinical formulation based on hypothesised linkages between these domains for use in forensic assessment reports and to aid treatment planning. The use of the proposed framework is illustrated through a reference formulation based on a fictive case example. Research limitations/implications The framework is still in the early stages of development and has not been tested. The next stage is to utilise case information data to assess the validity of the items. This does not preclude the use of the framework by practitioners as an aid to generating clinical hypotheses about the possible link between autism and offending as the development of the tool has been informed by research on ASD and offending. Practical implications The framework may be used in conjunction with structured professional judgement tools. For example, the recently published third version of the HCR-20 includes pervasive developmental disorders as a historical risk item. This possible relevance of this item in terms of forensic risk could be presented using information obtained from the framework outlined in this paper. This in turn could be used to inform the formulation section of the HCR-20 and in the generation of treatment plans. In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning. Social implications In the longer term, the framework may help inform our understanding of possible relationships between violence risk and ASD and therefore aid effective assessment and treatment planning. Originality/value Although there is an emergent body of research on ASD and offending this has not yet been translated into a tool to help practitioners. This paper sets out an approach to do this and therefore makes an original contribution to the literature.