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ATTENTION DEFICIT HYPERACTIVITY DISORDER
In reply to Hon. IAN GILFILLAN (25 March).
The Hon. K.T. GRIFFIN: The Minister for Police, Correctional Services and Emergency Services has been advised by the Department for Correctional Services that the honourable member has raised a number of issues concerning the treatment of ADHD, many of which, as he rightly pointed out in his question, are of relevance to a range of human service delivery agencies, and importantly those agencies include education and health. The report to which he refers, produced by the National Health and Medical Research Council, indicates that, at present, the recognition and understanding of adult ADHD is rudimentary. Quite rightly, the focus of research concerning ADHD is in the area of childhood and adolescent intervention and treatment.
The body of knowledge pertaining to the treatment of ADHD is relatively new and evolving. This is particularly so in the area of adult ADHD and indeed, there is considerable debate as to the existence of this condition into adulthood. Notwithstanding the ongoing debate, there is little doubt that anti-social behaviour, substance abuse and other co-morbidities of ADHD frequently exist into adulthood for those who have been identified as experiencing the condition during childhood and adolescence. It is accepted, therefore, that there are a percentage of prisoners, and indeed offenders who are supervised by officers of the Department for Correctional Services in the community, whose offending behaviours may be a manifestation of inadequately treated or poorly managed childhood ADHD. To that end, and in answer to the honourable member’s first question, it is accepted that ADHD, or more particularly its co-morbidities, represent a significant issue for the Department for Correctional Services.
The inter-agency working group referred to was convened in 1996 and its brief was to investigate methods of teaching and managing school students with poor attention, impassivity or hyperactive behaviour. The group consisted of school principals, other senior officers of the Department for Education and Children’s Services (DECS), representatives of Child Adolescent and Medical Health Services, Child and Youth Health, Women and Children’s Hospital, and representatives of the medical profession, including child Psychiatrists and Paediatricians. The working group sought feedback from University Departments of Psychology, individual Psychologists and parent groups.
The result of the extensive consultation process undertaken by the group was the production of a package of discussion papers for teachers and practitioners, and a brochure for parents. The topics in these publications incorporate information relating to the understanding of various terms used to describe the condition, such as hyperactivity and hyperkinesis, diagnosis of the condition, which is a matter for doctors and other medical experts in consultation with parents and teachers, the implications of an ADHD diagnosis for a student’s school program, teaching and classroom management strategies, help for parents, and an outline of the range of community resources. These papers are subject to ongoing review and are widely available. Implicit in these information publications is the need for a multi-modal approach for the treatment and management of ADHD. I am advised that contemporary modes of treatment of ADHD are not restricted to pharmaceutical methods and that the range of intervention approaches informed by the developing body of knowledge are widely disseminated, encouraged and implemented in South Australia.
The preceding information is provided in order to highlight that the bulk, if not all, of the research which has been conducted into ADHD, both national and international, identifies the disorder as one which is, first and foremost, a childhood and adolescent manife-tation. As the body of knowledge relating to ADHD develops, so too will the effectiveness of childhood and adolescent intervention.
I turn now to the role that the Department for Correctional Services plays and will continue to play in response to the manifestations of ADHD which present themselves in the adult correctional environment.
As you identify in your question, the co-morbidities which may develop with the disorder in childhood and adolescence, can lead to adult offending behaviour. These co-morbidities include substance abuse problems, marked cognitive deficits, limited literacy, numeracy and vocational skills and impulsivity and anger problems.
The Department has implemented a range of core intervention programs for prisoners and offenders. These core programs include drug and alcohol intervention programs, including a therapeutic community at Cadell Training Centre. A number of correctional officers and community based staff members provide a cognitive skills training program to prisoners which addresses the range of cognitive deficits which extensive national and international research recognise as being common among long term offenders. Literacy and numeracy educational programs are available throughout the prison system as are anger management and victim awareness programs.
Prison industries (PRIME) provide opportunities for prisoners to develop vocational skills.
Regarding the issue of research, there are a range of potential areas of criminological study which have been underfunded due to other economic imperatives. In order to address this largely neglected area, the Department has, in 1998, commenced the sponsorship of the Chair of Forensic Psychology at the University of South Australia. It is envisaged that the development of this position, and the School of Forensic Psychology, will provide the opportunities for Honours and Post Graduate students to conduct research into a range of criminogenic and offending behaviour areas, including ADHD, for which there has previously been limited resources.
In summary then, the issue of ADHD crosses the boundaries of a range of government agencies and community groups. The Department for Correctional Services provides a number of core programs designed to address offending behaviours which are exhibited by the prisoner and offender population, a percentage of whom may have experienced ADHD during their childhood and adolescence. The growing body of knowledge concerning ADHD should continue to inform models of best practice in intervention and treatment of this condition.