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For further information on our project, or to get in touch with the research team, please contact Carol Bower


FASD rates in incarerated youth


  • Professor Carol Bower: Senior Principal Research Fellow, Telethon Kids Institute, The University of Western Australia
  • Professor Rhonda Marriott: Professor Aboriginal Health and Well Being, Murdoch University
  • Dr Rochelle Watkins: Senior Research Fellow, Telethon Kids Institute, The University of Western Australia
  • Associate Professor Raewyn Mutch: Clinical Research Fellow, Telethon Kids Institute, The University of Western Australia
  • Dr James Fitzpatrick: McCusker Clinical Research Fellow in Aboriginal Child Health, Telethon Kids Institute, The University of Western Australia
  • Associate Professor Carmella Pestell: Director Robin Winkler Clinic, School of Psyhology, The University of Western Australia
  • Professor Steve Zubrick: Senior Principal Research Fellow, Telethon Kids Institute, The University of Western Australia
  • Mr Peter Collins: Director Legal Services, Aboriginal Legal Aid WA
  • Professor Jonathan Carapetis: Director, Telethon Kids Institute, The University of Western Australia

Project Staff

  • Noni Walker, Senior Research Officer
  • Jacinta Freeman, Research Officer
  • Sharynne Hamilton, Research Officer (Qualitative)
  • Carmen Condon, Research Officer (Data)
  • Hayley Passmore, Research Assistant and PhD Candidate

Clinical Team

  • Dr Raewyn Mutch, Paediatrician
  • Dr Emma Argiro, Paediatrician
  • Natalie Kippin, Speech Pathologist
  • Bernadette Safe, Occupational Therapist
  • Candy Cheung, Vicki Bothma, Helen Shield, Jasmine Taylor and Alex Springall, Psychologists

Our project was conducted at Banksia Hill Detention Centre, the only youth detention centre in WA. Young people aged 10 to 17 years can be held at Banksia Hill on remand, or on a sentencing order.

We worked with approximately 100 young people during 2015 – 2016, who voluntarily participated in comprehensive health and neurocognitive assessments.

The assessments were conducted by a paediatrician, a neuropsychology team, a speech pathologist, and an occupational therapist. A research officer conducted interviews with the young people and their circles of care to obtain rich case-histories, including information on prenatal alcohol exposure.

The clinical team met to discuss the results and to develop an assessment and recommendations report for every young person they saw.

Reports included:

  • assessment results
  • strengths and difficulties of the young person
  • recommendations to support and promote the young person’s health and wellbeing, as well as information for referrals to other health specialists where required.

Reports were shared with the young people using simple verbal and written language, as well as with their family/caregivers.

Where consent was given, the reports were also provided to Youth Justice Services to enrich their care and management while in detention, and to inform plans for the young person’s transition back to community.

Secondary aims

  • A workforce development initiative that aims to support staff in caring for young people with neurodevelopmental impairments has also been developed and implemented, and is currently being evaluated.
  • Qualitative evaluation of this project has occurred. The study found young people who participated in the prevalence study valued the assessments, particularly receiving knowledge of their individual strengths. Data continue to be analysed for other participants and results will be available in the near future.
  • Development and evaluation of a FASD screening tool. The data collected are being analysed to assess whether a simple and useful screening tool can be identified for use in the justice system.


Publications from this research

Fetal Alcohol Spectrum Disorder (FASD): Knowledge, attitudes, experiences and practices of the Western Australian youth custodial workforce. Hayley M Passmore, Raewyn C Mutch, Sharyn Burns, Rochelle Watkins, Jonathan Carapetis, Guy Hall, Carol Bower.  International Journal of Law and Psychiatry. Volume 59, July-August 2018, pages 44-52.

Study protocols for screening and diagnosis of fetal alcohol spectrum disorders (FASD) among young people sentenced to detention in Western Australia. Hayley M Passmore,  Roslyn Giglia, Rochelle E Watkins, Raewyn C Mutch, Rhonda Marriott, Carmela Pestell, Stephen R Zubrick, Candice Rainsford, Noni Walker, James P Fitzpatrick, Jacinta Freeman, Natalie Kippin, Bernadette Safe, Carol Bower.  BMJ Open 2016,6:e012184.

Fetal alcohol spectrum disorder and youth justice: a prevalence study among young people sentenced to detention in Western Australia. Carol Bower, Rochelle E Watkins, Raewyn C Mutch, Rhonda Marriott, Jacinta Freeman, Natalie R Kippin, Bernadette Safe, Carmela Pestell, Candy SC Chung, Helen Shield, Lodewicka Tarratt, Alex Springall, Jasmine Taylor, Noni Walker, Emma Agiro, Suze Leitao, Sharynne Hamilton, Carmen Condon, Hayley M Passmore, Roslyn Giglia. BMJ Open 2018;8:e019605.

Assessing motor skills to inform a Fetal Alcohol Spectrum Disorder diagnosis focusing on persons older than 12 years: A systematic review of the literature. Bernadette Safe, Annette Joosten, Roslyn Giglia.  Journal of Population Therapeutics and Clinical Pharmacology. Vol 25 No 1 (2018)

Challenges in accurately assessing prenatal alcohol exposure in a study of fetal alcohol spectrum disorder in a youth detention center. Freeman J, Condon C, Hamilton S, Mutch RC, Bower C, Watkins RE. Alcoholism: Clinical and Experimental Research 2018; DOI: 10.1111/acer.13926.

Language diversity, language disorder, and fetal alcohol spectrum disorder among youth sentenced to detention in Western Australia. Kippin NR, Leitao S, Watkins R, Finlay-Jones A, Condon C, Marriott R, Mutch RC, Bower C. International Journal of Law and Psychiatry 2018; 61: 40-49.

Comparison of the Motor Skills of Young People in a Youth Detention Centre with Diagnosed Fetal Alcohol Spectrum Disorder, Prenatal Alcohol Exposure, and a Reference Population. Safe B, Joosten A, Bower C, Condon C, Watkins R, Mutch R, Giglia R. A  Journal of Fetal Alcohol Spectrum Risk and Prevention 2018; 1(1), e17-e32.



Almost every young person in WA detention has a severe brain impairment. Passmore HM, Bower C, Mutch R.   The Conversation 2018 


There are currently three PhD and one Masters candidates continuing work using data from the Banksia Hill Detention Centre project:

Talking, Hearing, Understanding, Knowling: A qualitative exploration of the experiences of justice-involved youth undergoing assessment for Fetal Alcohol Spectrum Disorder in a juvenile detention centre

Improving the management of young people with fetal alcohol spectrum disorder (FASD) in detention

Young people in detention in Western Australia: An examination of motor skills and the effect of prenatal alcohol exposure

Communication, fetal alcohol spectrum disorder, and youth justice



Our research has received national and international recognition for identifying that 1 in 3 young people in youth detention in WA are living with FASD, the highest known estimate among justice-involved youth world-wide. Our study also revealed that 9 out of 10 young people in detention are living with at least one severe impairment in a neurodevelopmental domain.

Findings have, and will continue to contribute to the understanding of the broad range of factors which influence contact with the law, youth justice services and incarceration for both Aboriginal and non-Aboriginal youth.

Our team are using the research findings to help influence policy and practice of how Youth Justice and related services work with, and support young people in their care. We inform future program and service delivery, which will help to build evidence-based programs and services for young people in youth justice living with FASD or other impairments in a range of neurodevelopmental domains.

Our research project aligns with the WA 2015-2018 Youth Justice Framework, building the evidence base to support transformational change through a greater understanding among the Youth Justice workforce, and in the implementation of person-centred care. It is also building future capacity of Child Protection and Family Support staff in their therapeutic care for young people in WA involved with the Youth Justice Services.

Given the considerable resources expended in the management of youth in WA juvenile detention (around $1,00 per person per day), improved identification and care of individuals with FASD in the justice system has the potential to be cost-effective and improve wellbeing.