Guest editorial

Autism and offending behaviour

Sometimes, people with autism end up detained within prison and secure hospitals. While a very vulnerable group, with particular health care needs, there is often a misconception that this population is at increased risk of committing crime. This special issue aims to focus on the social, biological and psychological factors relevant to our understanding of criminal offending behaviour and autism.

It starts with a conceptual paper and literature review from Chester and Langdon that describes a previously developed social information processing model and whether it helps to explain some of the specific difficulties faced by those with an autistic spectrum disorder who have had difficulties with criminal offending behaviour. Pearce and Berney, well known clinician researchers with a track record of providing services in this area, write a thoughtful and reflective account of how ASD brings out the limitations of the Criminal Justice Service and suggest some remedies. Dobbinson in her paper on systemizing and empathy offer an interesting take on the E-S theory in offenders with ASD and a novel approach using qualitative analyses. Her suggestion that front line staff would benefit from training in accommodating to the needs of patients with ASD in terms of their social, communication, and information processing deficits in the context of therapeutic conversations is particularly interesting. Unlike previous prevalence studies that have focussed on specialist forensic mental health settings, Bates presents arguably the first study of its kind to examine prevalence of autism in a general community forensic sample. Alexander et al. describe how, notwithstanding anecdotal accounts, the diagnosis of an autistic spectrum disorder does not necessarily become a significant variable in predicting the length of stay or success of treatment within secure hospital settings. The authors describe different variables including the presence of callous and unemotional traits, psychosis and the intensity and frequency of problem behaviours which give rise to different typologies of ASD within the forensic hospital system and introduce an ongoing study to explore this issue further.

This special issue ends with a first person account from the mother of a young man with an autistic spectrum disorder and severe aggression. Writing under the pseudonym Sue Larch, the author offers an unflinching account of her experience as a parent in the interface between the health and criminal justice system. Disturbing as it is, the picture that she paints is one that many would recognise. Going beyond the searing personal detail of that account, the author raises a number of issues that warrant careful reflection. They include the need to balance the policy of mainstreaming with the equally valid need for specialised expertise, the need to appreciate that equity of treatment access is meaningless if there is no equity of treatment outcome and the need to realise that for new ways of working to be effective, professionals delivering services should be competent in what they are delivering. In their invited commentary on the paper, Chaplin and McCarthy set out some of the policy areas that need particular attention.

We think the papers in this special edition are thought provoking and hope they stimulate your interest in this fascinating area.