An evaluation of the screening process for autism spectrum disorder within youth justice services and alternative screening tools
Rachel E. Woodward, Paige Milburn, Eleanor Officer, Charlotte Lowery, Victoria Roberts, Patrick John KennedyPurpose
Youth justice populations have an elevated prevalence of autism spectrum disorder (ASD), with some ASD traits suggested as vulnerability factors for offending. Justice involved individuals with ASD also face increased risk of mental health difficulties. This finding likely extends to youth populations, making this a particularly vulnerable group. Youth Justice Services (YJS) use a subsection of the AssetPlus assessment framework to screen for ASD traits in young people open to the service. However, this subsection has not been specifically validated. Therefore, the purpose of this study is to evaluate the utility of the AssetPlus in ASD screening and compare this to the utility of other widely used screening tools, with the aim of determining the most effective approach to ASD screening within a Youth Justice population.
Design/methodology/approach
This cross-sectional study used a convenience sample of 57 young people (48 male, 8 female) aged 11–18 years open to case managers at two YJS in the North of England. Case managers completed the AssetPlus, Social Communication Questionnaire (SCQ) and Autism Spectrum Quotient-10 (AQ-10) for each young person. The sensitivity and specificity of each measure was calculated. Sensitivity (how effectively a screening tool identifies young people with an ASD diagnosis) and specificity (how effectively it excludes those without an existing diagnosis) were calculated to evaluate screening accuracy.
Findings
The AssetPlus had 100% sensitivity but low specificity overall (6.3%). The SCQ showed high specificity (85.4%) but low sensitivity (33.3%), while the AQ-10 had a more balanced sensitivity (87.5%) and specificity (70.8%). Notable variation was observed between YJS areas.
Originality/value
Current ASD screening tools in YJS show high sensitivity but low specificity, risking over-identification of ASD traits. There is a clear need for a more accurate, youth-justice-specific tool and staff training in neurodevelopmental, trauma-informed and formulation approaches to better support young people’s needs.