Forensic rehabilitation in Asperger syndrome: a case report
| Date | 01 January 2013 |
| Pages | 60-64 |
| Published date | 01 January 2013 |
| DOI | https://doi.org/10.1108/JIDOB-03-2013-0007 |
| Author | Marlene Kelbrick,Jane Radley |
| Subject Matter | Education,Health & social care,Sociology |
Forensic rehabilitation in Asperger
syndrome: a case report
Marlene Kelbrick and Jane Radley
Marlene Kelbrick, Specialty
Trainee 5, General Adult
Psychiatry, Leicester NHS
trust, the clinical leadership
fellow, St Andrews,
Leicester, UK.
Jane Radley is a Consultant
Psychiatrist at the Low Secure
ASD Men’s Service,
St Andrew’s Hospital,
Northampton, UK.
Abstract
Purpose – People with Asperger syndrome are at increased risk of co-morbid mental health problems. The
core features underlying autism are likely to play an important role in offending behaviour amongst
this population. Forensic rehabilitation includes a multidisciplinary approach and combination of therapeutic
interventions. However there is limited evidence in the literature of what constitutes effective treatment
within this setting, and how the process of rehabilitation is experienced by patients. The purpose of
this paper is to describe a case of Asperger syndrome with co-morbid psychosis and offending behaviour
and the process of forensic rehabilitation.
Design/methodology/approach – The authors briefly review the literature related to Asperger syndrome,
offending in this population and co-morbidity. The authors then describe and reflect on a case of a young
man with Asperger syndrome, sexual offending and the process of forensic rehabilitation, and offer an
insight from the patient’s perspective.
Findings – Co-morbid mental illness, when detected early, can be successfully managed with limited
additional disability.The process of forensic rehabilitation includes a multidisciplinary approach. Therapeutic
interventions specifically aimed at addressing core features of autism, risk and offence-related factors are
effective in promoting recovery amongst those with autism and offending behaviour.
Originality/value – The paper highlights how core features of autism can lead to offending behaviour, the
importance of early recognition and treatment of co-morbidity,and the process of forensic rehabilitation and
recovery. Also included are quotes from the patient’s perspective on what it is like to have Asperger
syndrome, and what has been the key learning from the rehabilitation process.
Keywords Intellectual disabilities, Cognition, Individual behaviour, Offendingbehaviour,
Asperger syndrome, Autistic spectrum disorder, Cognitivebehavioural therapy, Cognitive analytic therapy
Paper type Case study
Introduction
Asperger syndrome, is a pervasive developmental condition and considered at the higher
functioning end of the autistic spectrum, is characterised by a clinically significant impairment
in social interaction and communication, with restricted, repetitive and stereotyped patterns of
interest and behaviour (Toth and King, 2008; Wing, 1981; Barnhill, 2007).
It was first described by Hans Asperger in 1944, later modified and formally introduced in
English by Lora Wing (Wing, 1981; Woodbury-Smith and Volkmar, 2009). Those with Asperger
syndrome, unlike classic autism, do not exhibit delayed language development (Wing, 1981),
and their intellectual ability is usually within the normal range (Barnhill, 2007).
Autistic spectrum disorder is present in 1 per cent of the adult population, and is more common
in men compared to women (1.8 vs 0.2 per cent, respectively) (National Health Service
Information Centre for Health Social Care, 2007). Reporting rates have increased over the last
two decades, probably owing to increased awareness of and interest in the condition amongst
the public and mental health professionals.
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VOL. 4 NO. 1/2 2013, pp. 60-64, CEmerald GroupPublishing Limited, ISSN 2050-8824 DOI 10.1108/JIDOB-03-2013-0007
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