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Neurodiversity Assessment In Forensic Contexts

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This is a lay summary of Chapter 19 ‘Neurodiversity Assessment In Forensic Contexts, by Nancy Doyle, Lorraine Hough, Karen Thorne & Tanya Banfield’ – which appears in G.C., Fisher, M.J., & Jones, L.F. (Eds.) (2022). Challenging Bias in Forensic Psychological Assessment and Testing: Theoretical and Practical Approaches to Working with Diverse Populations (1st ed.). Routledge. 

Who was this chapter written for?
This Chapter was written for Forensic Psychologists working with neurodivergent people in prisons. Drawing on a proposal by Judy Singer, the authors agree that that there is nothing inherently disabling about ADHD, Autism, Dyslexia, Dyspraxia, and that diversity in the way we think is a natural feature for humans.

Problems with umbrella terms
We noted that the UK Criminal Justice Joint Inspectorate Neurodiversity Review (CJJI, 2021) used Neurodiversity as an umbrella term referring to the group of conditions falling under the category of neurodevelopmental disorders (NDDs). We suggested it is better to use ‘neurominorities’ or ‘neurodivergence’ as umbrella titles, because neurodiversity itself includes everyone. There are more neurominorities in prison than there should be, considering how many there are in the population in general. This means that Forensic Psychologists should be aware that lots of people in their care may be neurodivergent, as the following summary shows:

(CJJI, 2021) Over 50% of the prison UK population is dyslexic.
(McNamara, 2012) Up to 80% of people in a UK prison have some kind of speech, language or communication difficulty.
(Young et al., 2018) Approximately one quarter of people in prison in the UK would meet diagnostic criteria for ADHD.
(CJJI, 2021) Approximately 5-7% of those meeting Liaison and Diversion services in the UK have Autistic traits, with around 16-19% of those in prison showing signs of Autism.
(Prison Reform Trust, 2021) Approximately 34% of people in custody in the UK have a Mild Intellectual Disability (MID) or Borderline Intellectual Functioning (BIF).
(Prison Reform Trust, 2021) 49% of women and 23% of men in custody in the UK have been diagnosed with anxiety or depression.
(Shiroma et al., 2010)

 

 Estimated brain injuries amongst Criminal Justice System populations vary significantly based on the populations being studied and the assessment method, but analysis of international studies suggests that rates of brain injury in convicted populations is approximately 60%.

Diagnosis
Many neurodivergent people in prisons do not know that they are neurodivergent, or don’t have a diagnosis. Does this mean that Forensic Psychologists should try to make diagnoses using specialist tests? We explained that neuropsychology is not finding strong evidence for neurominorities as separate diagnoses. In fact, there is more in common across the different conditions than there are features to separate them. Because of this, it is hard to make accurate diagnoses.

We also explained that diagnosis is made difficult because of intersecting identities, such as those in this table, which are affected by biased definitions and tests:

Gender
  • Definitions, tests and questionnaires make it easier for boys to be diagnosed. This is because they ask for examples of behaviour that is more normal for boys.
  • Also, girls get stronger messages about sitting still, being sociable, reading and writing. Boys get stronger messages about being physically active and good at maths.
  • Transgender communities have fewer differences between male and female diagnosis rates.
Race and Ethnicity
  • Definitions, tests and questionnaires make it easier for white people to be diagnosed. This is because they are based on things that are more usual for white people, such as the way we make eye contact and talk.
  • It is also because teachers, psychologists and medics are already making too many snap judgements about people from non-white communities, such as Black people, Roma people, Asian people. They are often seeing white people as less ‘difficult’ and calmer, so they think if there is a difficulty, it must be medical, whereas for Black or Brown people they are assumed to be ‘bad’.
Poverty
  • Wealthy families can afford private diagnosis and are more likely to be diagnosed if they need to.
  • Wealthy families can afford private tutors and private schools so their children are less likely to need help at school.
  • Wealthy families are more likely to have time to help their children with homework and being organised. They are also more likely to jump in to resolve social and emotional difficulties.
  • A family’s wealth makes a difference to how people get diagnosed and when

When we added together the differences for different types of people, and how unreliable testing is, we advised psychologists working in prisons to focus on needs rather than labels. We advised working with different types of testing (see following table) to assess neurodivergent people in prisons.     

Tests Important facts Strengths Limitations
Cognitive ability testing (standardised)

 

 MUST be validated with data analysis and approved by a peer review publication. Gives very accurate information about how well a person thinks using different areas of thinking – verbal skills, memory etc Expensive, takes time. Not always immediately helpful to a person who wants to know what to do next.
Self-Report  questionnaires (standardised)

 

 Must be validated with data analysis to check how reliable the answers are.

Good ones will also be approved by a peer review publication.

 Makes sense to people taking the tests.

Useful for thinking about what to do next.

 Can be affected by how the person feels on the day. They might answer differently at a different time or on a different day.
Testing that has not been standardised (whether self-report or ability testing) These provide information about a person’s experience. They cannot be used to make predictions about what people might need.

 We then explained what types of help are useful for different challenges, rather than recommending help based on a label.

Challenge Recommendations for potential strategies and reasonable adjustments
Executive functions – working memory and processing speed
  • Memory aids /strategies – little and often; rehearsal; recency and primacy issues, so structure key messages; mnemonics; visual imagery; internal aids; external memory aids – post-its, alarms, to-do lists etc. Chunking.
  • Concentration techniques such as anchoring, visualisation and hunger / time of day, self-awareness
Executive functions – planning, time management and organisation
  • Environmental aids such as signposts; labels; orientation boards; colour doors; wayfinding lines showing routes; use of daily routines.
  • Errorless learning: break down tasks into smaller steps; build in opportunities for success; graded activities to ensure success.  Teaching functionally equivalent or functionally related skills.
Language – verbal
  • Simplify complex instructions and avoid abstract tasks.  Promote learning by doing. Repeat if needed.
  • Practice role play conversations that come up frequently; develop exercises to assist offenders during questioning. This might include supporting them to self-advocate with comments such as “sorry I can’t process that all at once, can you ask me just one question at a time?”
  • Develop packs of prompt cards for asking for help / more detailed instructions to support people in daily interactions within the prison and through the gate, such as above or:
    “Can I stop you there? It would work for me if you allow me to practice while you talk, I remember better that way.”
    “I’m sorry, I find it hard to process lots of words, could you possibly slow down?”
  • PQRST – preview, question, read, study, test – this is a useful structure to support individuals with learning new information.
Language – written
  • Advocate for education departments to have access to assistive technology to meet demands of the modern world through the gate.
  • Avoid temptation to replace 12 years of education with a 2-week literacy course, often not adapted for neurominorities. For example, phonic tuition alone may not correct spelling and reading difficulties; new strategies should be applied if these have failed repeatedly.
  • Literacy support charities might offer a more specialised programme and can help with providing differentiated material that inspires engagement.
Motor control and balance
  • Train techniques for managing state and dealing with panic. Support individuals to avoid self-shame, slow down and take time with tasks that they find difficult.
  • Advocate for education departments to have access to assistive technology – handwriting is reasonably obsolete in modern workplaces. Touch typing may be more appropriate to learn.
  • Planning and practising movements and journeys before starting.
  • Rehearsal of frequently required motor control tasks.
Sensory Sensitivity

 
  • Training awareness of sensory trigger and strategies for avoiding these within the Justice System. For example, planning days and wall chart reminders of which events happen in which order can help identify where sensory triggers are and how to avoid / reduce them.
  • Advocate for adjustments like ear defenders wherever noise disruption is an issue; or wearing of sunglasses, reducing glare from strip lighting, as well as general notes on temperature, smell, touch and taste sensitivities.
  • Touch is particularly of relevance during shutdowns, when any attempt to physically approach a neurodivergent person may exacerbate defensive aggression rather than calm or control an outburst.
  • Psychologists can strongly advocate for decompression time and space for those who are sensory sensitive.
Emotional dysregulation
  • Regular reflective, coaching-based sessions to increase self-awareness are essential for most neurominorities.
  • Unhelpful or frightening behaviours can be supported by reinforcing positive behaviours; use of TOOTS, (Time Out On the Spot)
  • Structure sessions / session plans; anticipate hot spots.
  • People frequently exhibit warning signs, such as knee jiggling or nail biting, or breath holding, which indicate a pre-shutdown.
  • Developing self-awareness of triggers can facilitate self-advocacy before a shutdown.
  • Verbal communication is compromised during intense emotions. To counter, role-play short effective phrases to help attract support rather than control from staff. For example:
    “Can I self -isolate please, I am going into autistic meltdown?”
    “Help, fight or flight response happening.”
    “Help, trauma flashback happening.”
  • Adopt a coaching response, predictability / stability; create consistency across staff groups; use planners; set goals; use checklists, enable individuals to plan and structure their day.

We hope that this information helps people working in prisons to make a positive difference for neurodivergent people in prisons.

References

CJJI. (2021). Neurodiversity in the Criminal Justice System: A review of evidence (pp. 1–77). Criminal Justic Joint Inspection.

McNamara, N. (2012). Speech and language therapy within a forensic support service. Journal of Learning Disabilities and Offending Behaviour, 3(2), 111–117. https://doi.org/10.1108/20420921211280097

Prison Reform Trust. (2021). Bromley Briefings Prison Factfile (p. 66). Prison Reform Trust.

Shiroma, E. J., Ferguson, P. L., & Pickelsimer, E. E. (2010). Prevalence of traumatic brain injury in an offender population: A meta-analysis. Journal of Correctional Health Care : The Official Journal of the National  Commission on Correctional Health Care, 16(2), 147–159. https://doi.org/10.1177/1078345809356538

Young, S., González, R. A., Fridman, M., Hodgkins, P., Kim, K., & Gudjonsson, G. H. (2018). The economic consequences of attention- deficit hyperactivity disorder in the Scottish prison system. BMC Psychiatry, 18, 1–11. https://doi.org/10.1186/s12888-018-1792-x

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What do we know about age stereotyping in personnel decisions?

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Dr Lisbeth Drury and Dr Keely Jo Frasca share insights from a new commentary paper published in Work, Aging and Retirement with co-authors Maaike Schellaert and Prof Eva Derous (Ghent University).

Do age stereotypes influence personnel decisions? While there is a wide body of research exploring age stereotyping in the workplace, a recent commentary paper by Murphy & DeNisi (2021) has questioned the validity and usefulness of lab studies in this area. In the commentary paper ‘Age Stereotyping in Resume Screening: Don’t Throw the Baby Out With the Bathwater’, we explore the implications and validity of research in this area and suggest some avenues for future research.

Why stereotypes matter in resume screening

Stereotypes are widely held, over simplified ideas about the characteristics and behaviour of particular social groups. We know from impression formation theory (Fiske & Neuberg, 1990) that we revert to stereotypes when meeting a stranger, but that we consider people on an individual basis when more detailed information is provided, for example through conversation.

Many personnel decisions are made once staff are known on an individual level, for example performance reviews, promotion decisions, or offers of employment following an interview. In these instances, knowing the person on an individual level is more likely to influence decision-makers’ thinking than stereotypes.

However, when it comes to external hires, the process of reviewing resumes can be viewed as a ‘stranger-to-stranger’ interaction, which is more likely to lead to stereotyping because of the lack of wider knowledge about the candidate. While we cannot exclude the impact of bias at interview, we expect age stereotypes to have the greatest influence at resume screening stage. It is, therefore, important to examine the effects of age stereotypes in resume screening separately from other types of personnel decisions.

Issues with lab studies

Lab studies have been criticised because scenarios where participants judge fictitious workers ‘on paper’ are not deemed realistic (Murphy & DeNisi, 2021). This may be true in the case of performance evaluations or promotion decisions, where a written vignette may not feel true to life. However, for job applications, which are in an ‘on paper’ format in real life, such studies may offer greater validity.

Furthermore, there is criticism about the use of student participants to judge resumes, rather than HR personnel or assessors with experience. However, most studies include a combination of both types of participants and decisions are similar across these two groups.

Triangulating the findings of age stereotype research

It is important to note that resume screening research does not always report age bias towards older workers. This could be for several reasons, for example how the study has been designed and whether age cues in the resumes are implicit (e.g. an older sounding name) or explicit (e.g. date of birth). More research is needed to understand the conditions that cause disparities in findings, by decreasing or increasing bias.

Age stereotypes are complex and research in this area uses a wide range of methods and theoretical approaches. While each study alone may not give a full picture, together they provide a wealth of evidence that is greater than the sum of their parts. By combining what we know from different methodologies, disciplines and theories, we can reach greater insight.

Instead of ‘throwing the baby out with the bathwater’ by discounting particular types of research, we should conduct more research in both the field and lab, triangulating the results, to gain a holistic understanding of how and to what extent age stereotypes affect the outcomes of resume screening.

Further Information

 

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How analysing co-creation during the Covid-19 pandemic offers insights on the simultaneous generation of academic, social and business value

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Dr Muthu de Silva from the department of Management gives an overview of the findings of two recent Organisation for Economic Co-operation and Development reports, published with her co-authors, about the role co-creation played during the Covid-19 pandemic, and how it can shape innovation going forward.  

Co-creation is a mechanism of simultaneously generating academic, business and social value. During co-creation actors of the innovation ecosystem – such as businesses, universities, governments, intermediaries and society – act as collaborators to integrate their knowledge, resources, and networks to generate mutual benefits. The idea behind co-creation is that the joint efforts towards change or impact can lead to lasting and effective innovation.  

As an institution, Birkbeck is committed to delivering theoretically rigorous research with real-terms, practical impact, and a concept like co-creation is a really great way to facilitate this. Co-creating with non-academics enables academics to integrate needs and resources of both academic and non-academic communities, enhancing the reach and usefulness of their research.   

Over the years, I’ve published about 20 journal articles on the topic of co-creation and received eight best paper awards for these publications. In 2019, I was invited by the Working Party on Innovation and Technology Policy of the Organisation for Economic Co-operation and Development (OECD) to develop a conceptual framework on co-creation between science and industry. This meant publishing a high quality journal article and leading their 2021 – 2024 co-creation project that directly influences the strategies of innovation agencies, and ministries of 37 countries who belong to the OECD, and a wider audience that benefits from OECD publications.  

This work resulted in two reports and a journal article designed to influence innovation strategies of OECD member states. It has also resulted in leading another project regarding the importance of university and industry co-creation for a societal and economic green transition.  

Based on evidence gathered from 30 COVID-19 co-creation initiatives from 21 countries and three international cases, the two reports showed that co-creation was widely used to respond to the challenges raised by the COVID-19 pandemic. What was evident through the reports was that existing co-creation networks enabled the rapid emergence of new initiatives to address urgent needs, while digital technologies enabled establishing new – and, where necessary, socially distanced – collaborations.  

For instance, co-creation of medical innovation relied on substantially larger existing networks due to the complexity of medical discovery and manufacturing processes involved in developing these innovations. The COVID-19 Türkiye Platform, the transnational Exscalate4CoV, and the UK’s Oxford-AstraZeneca initiatives are examples of this. Digital tools were also used in numerous ways. As an example, the COVID Moonshot project which aimed to develop antiviral drugs against COVID-19 by identifying new molecules that could block SARS-CoV-2, involved three scientists who organised a hackathon inviting researchers/virologists to submit molecules, donations and assays (testing) via Twitter, resulting in over 4 000 submissions.  

Aside from funding initiatives, governments engaged actively in co-creation by granting access to their networks, advising on initiative goals and offering support to improve quick delivery.  The role of civil society was important as well, and the socially impactful nature of research and innovation was a motivating factor for engagement. For example, the Austrian COVID-19 Pop-up Hub initiative; the Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology co-developed the themes (Digital Health, Distancing, Economic Buffers and State Intervention) for public virtual discussion and participatory policy idea development taking place via the Hub.  

What emerged from the reports, were the following lessons for the design and implementation of future policy programmes for co-creation:   

  • Purpose is the strongest driver of co-creation; incentives to support co-creation should go beyond facilitating access to funding.  
  • Crisis-specific programmes may not be needed out of the crisis, but networks and infrastructures should be strengthened during “normal” times. 
  • There is room for building new collaborations between researchers and producers to accelerate innovation during “normal” times.  
  • Policy should support wider development and use of digital tools for co-creation.  
  • New approaches should be leveraged more to tap into the large pool of diverse and readily available capacities in the economy.  
  • Governments’ involvement in co-creation activities as network builders can help speed up solutions; enhanced agility in their operations should be encouraged.  
  • Public engagement in co-creation can help market uptake of new solutions. 

  Further information 

 

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Birkbeck mathematician receives EPSRC grant to explore Critical Groups

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Dr Steve Noble has been awarded an EPSRC Mathematics Small Grant entitled ‘The critical group of a topological graph: an approach through delta-matroid theory’. The grant of £31,231 was part of a  joint application with Professor Iain Moffatt, Royal Holloway, University of London. Dr Noble explains the background for the project.

Dr Steve Noble on a country walk

The Sandpile Model is a widely studied model in physics and used in economics to model the consequences for a network of banks when one of them defaults. It has a simple intuitive description as follows. Suppose we pile up grains of sand on a number of sites. At some point one pile becomes too large to stay upright, it topples, an avalanche occurs and sand gets transferred to adjacent sites. What happens next? Is the amount of sand transferred to the adjacent sites enough to make them topple? For how long does the process continue until all the sites become stable again and what configuration of grains of sand do we end up with? What are the systems and patterns underlying this situation?

Now suppose we have a network (comprising, for example, computer servers or wind farms connected by cables). How many cables must fail before the network becomes disconnected? If each cable has a certain probability of failure, what is the probability that the network becomes disconnected? What are the systems and patterns underlying this situation?

It turns out that the patterns underlying these two situations and many others are closely related to algebraic structures called ‘Critical Groups’. Networks are modelled in mathematics by objects called ‘graphs’. Each graph has a Critical Group associated with it. Critical Groups arise in many different ways and in many different applications of graphs in mathematics and physics; for example, through Chip-Firing or the Sandpile Model, Flow and Cut Spaces, counting spanning trees and even mathematical models of car parking.

In the situations we have described so far there is no geometry: all that matters is adjacency and which sites receive extra sand when another topples and which pairs of computers are linked by a cable. The way that the networks look is not important for the models we have described.

However, in many settings a graph comes equipped with geometric structure provided by an embedding of it in a surface (for example, a network may come drawn on a torus), and the geometric structure as well as the adjacencies determine the key properties of the graph. Examples include graphs that model the actions of enzymes or certain forms of DNA strands.

Some recent work has hinted at the possibility that there are deep links between the geometric structure of graphs and Critical Groups. When one moves away from graphs that can be drawn on a plane, some of the fundamental objects associated with the graph change profoundly: specifically one studies spanning quasi-trees rather than spanning trees. So far, the study of Critical Groups for graphs embedded on surfaces has not taken into account these changed fundamental structures.We aim to explore this space, realising the full potential of the geometric structure by developing a theory of the Critical Group that takes into account the embedding.

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