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Under these circumstances those with FASD will perseverate on processes that bring relief but are in conflict with the psychiatrist or prison authority, such as self harming or what is seen as damage to the cell. The implications of stuck in set perseveration and its different presentations and roles in the lives of individuals with FASD extends to all aspects of society. They are crucial in respect to the application of the law. This is especially the case in criminal law where lengthy incarceration, or even execution, may occur. > Z., a 14year old native girl with severe cognitive, memory, information and sensory disabilities had a repetitive alcohol problem. Her father called for help from the police. She was placed alone in a cell with no stimulation. She found comfort in picking the paint of the wall of the cell. She was requested to stop picking at the paint. When she did not do so she was tasered and placed in a straight jacket. The correct approach would have been to provide her with something to occupy her mind. In some cases it is possible to introduce and utilize positive perseveration. This will no doubt require a history of mitigating factors. > C.. was sixteen. He had significant cognitive disabilities but had not had psychological testing or a school individual education plan [ I.E.P. ] when I first saw him. This had resulted in loss of motivation and interest in schooling, which he skipped. With a deterioration in his behavior, seen as oppositional and defiant, his mother sought help. By this time we had made the diagnosis of FASD [ ARND ] but it had made no significant impact on his schooling. This was because of his attitude due to the late age of diagnosis, and the inability of the teachers to adapt to his needs. C. was placed in a residential group home with the aim of correcting his antisocial and disruptive behavior. He continued to behave in the same way refusing to go to school etc. Loss of privileges etc had no effect. In spite of all the problems at home he missed his family very much. I suggested that his mother explain to him that he needed to think continuously that if he did exactly what he was told he would be able to return home. Fortunately he was able to do this. It worked dramatically and he was home within a few weeks. The group home was of the opinion that their therapy had changed him. In fact after returning home he reverted to his previous behavior. The situation did improve somewhat when the school was finally persuaded to address his learning disabilities. I have many times asked “ If you were placed in a dark room, no windows, no sound, no one to talk to, nothing to listen to or play with, nothing to do- what would happen?” The answers from those with FASD are always similar. “ I would go mad or I would kill myself.
Yet isolation is still practiced in psychiatry and our prison system, and we know that many inmates have FASD. Successful therapeutic and correctional services will never be developed until the generalized executive dysfunction and stuck-in-set perseveration of FASD are understood, and the connection between the two acknowledged; as in the three executive functions described by Miyake and Friedman. Knowledge of the neuropsychological and sensory profiles of the individual will always be necessary. While safety of the public is paramount it should not exclude successful interventions based upon knowledge of generalized executive dysfunction, set shifting and stuck-in-set perseveration. Barry Stanley. Vienna, July 2015. For all those who live with the disabilities of FASD and in memory of Ashley Smith; born, New Brunswick, 29th. January, 1998; died alone, by her own hand, in isolation at the Grand Valley Institution for Women, Kitchener, Ontario, Canada. 19th. October, 2007. “She [Ashley Smith] had indicated to the staff that she was bored and was looking for attention and she wanted staff to enter into her cell so that she could fight with them”- ‐ Ms. Grafton, Security Intelligence Officer, Grand Valley Institution for Women, Kitchener, Ontario, Canada. “My life I no longer love I’d rather be set free above Get it over with while the time is right Late some rainy night Turn black as the night and cold as the sea Say goodbye to Ashley Miss me but don’t be sad I’m free, where I want to be No more caged up Ashley Wishing I were free Free like a bird” -From the Ashley Smith Report, New Brunswick Ombudsman and Child and Youth Advocate, June 2008.
Page 1 and 2: XXXIVth International Congress on L
Page 3 and 4: The Stuck-in-set perseveration rela
Page 5 and 6: Heart rate goes up, cannot be still
Page 7: The diagnosis was eventually made.

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