Lorenzo Mauldin IV Story, II

By Jean Rhodes November 16, 2015Read More →

Anchors, webs, and the triumph of Lorenzo Maudlin

 By Jean Rhodes

In a recent NYTimes Magazine feature, journalist Ben Shpigel describes the network of caring adults, including a foster mother, coaches, guidance counselors, formal mentors, and teachers, who helped NY Jets player, Lorezo Maudlin III, overcome overwhelmingly difficult circumstances. According to Shpigel:

“His mother, Akima Lauderdale, an alcoholic with a penchant for selling cocaine, has been in and out of prison in Georgia. His father, Lorenzo Mauldin III, served nearly 12 years in a California prison. He and his four siblings shuffled between relatives and foster homes. So many foster families. A dozen, maybe more. Faces, he recalls. Names, he does not. Every day, he regulated and managed crises. Scrounging for food. Absorbing taunts for wearing the same clothes. Being yanked out of class by the police because Lauderdale had been arrested again, then thrust back into the care of the state. In college, he was rushed to the hospital after hurting his neck at practice, and again after a car hit him while he was riding his moped. “I’m telling you,” said Maurice Hart, his position coach at Maynard H. Jackson High School in Atlanta. “That’s the toughest man I’ve ever met in my life.””

Indeed,  defying the odds, especially for youth in foster care, Mauldin managed to complete high school and earn a bachelor’s degree from the University of Louisville where his speed as a pass rusher let to being drafted by the New York Jets.Maudlin had rare athletic talent, but it might not have been discovered and devleoped were it not for a foster mother, Monique Gooden, who took the time to throw him passes and enroll him in programs and leagues. There was also the”the choir teacher he called Mama, the house parents he called Grandma and Auntie and Uncle, the football coach he called Pops. With their help, Mauldin defied expectations.”

In a recent report by America’s Promise Alliance, is “Don’t Quit on Me,” authors at the Center for Promise note that young people need a range of relationships. As they note, they need:

• “One anchoring relationship with a stable and trustworthy caring adult (not a family member) is often necessary, but not sufficient to help young people thrive.
• 
  
• An anchor can be a gateway to illuminating an existing web of supportive relationships that can provide additional information and resources.
• 
  
• The web of support is a collection of individuals within and outside of the family that provide a young person with varying levels and types of support. “

Maudlin had different anchors at different time, depending on his developmental, educational, and professional needs and goals. And it’s unlikely that any one of them could have single handedly shepherded him from middle school through the pros. Instead, each of whom played critical roles and critical points in his development that created a safety net around him. As America’s Promise Jonathan Zaff noted,  “It’s not fair to mentors or to parents to put it all on their shoulders. When you put it all on one person, you break that person’s back, and the student won’t succeed.”

In his introduction to the report, APA President and CEO notes that caring relationships “are powerful vehicles for growth, particularly for young people living in challenging circumstances. And yet, too many young people don’t have enough relationships with stable, caring adults who can help them get what they need to stay on track toward graduation and career. Relationship poverty is not a lack of love or family, but a lack of access to additional sources of support that can lead to a more promising future.”

http://chronicle.umbmentoring.org/anchors-webs-and-the-triumph-of-lorenzo-maudlin-iii/?utm_source=Chronicle+Subscribers&utm_campaign=fa1c3efbf2-November_19_201511_19_2015&utm_medium=email&utm_term=0_afc94e8372-fa1c3efbf2-116180833&ct=t(November_19_201511_19_2015)&mc_cid=fa1c3efbf2&mc_eid=c7177e3427

Ret. 11-20-15

Career Mentoring Need

By Dawn October 22, 2015Read More →

Foster care youth speak: We need career mentoring!

Hudson, A. (2013). Career mentoring needs of youths in foster care: Voices for change. Journal of Child and Adolescent Psychiatric Nursing, 26, 131-137.

Background
Once young adults age out of the foster care system they are more likely than their non-fostered peers to experience homelessness, poverty, incarceration, and a variety of mental health issues. According to previous research, youths in foster care “want and need mentoring.” The purpose of this study was to engage youth in foster care in focus group conversations about what characteristics they prefer to see in a mentoring program. 27 youth participated in four different focus group sessions.

Findings
A major theme emerged from the focus group sessions: participants reported pressing need for career mentoring. They stated a desire for an authority figure who acts as a role model (eg. models positive attributes that lead to college and career success: social skills, work ethic). According to Hudson, “career mentoring might support foster youths’ goals for college attainment, reward achievement, and enhance their overall health-related quality of life.”

Implications
Incorporating career mentoring into existing programs for youth transitioning out of foster care is essential. These young adults strive for higher education and “the good life,” knowing all too well the difficulties that former foster care youth face. Adults in mentoring roles should continuously engage these young adults in conversations about their educational and career aspirations, in addition to modeling attributes of career success.

http://chronicle.umbmentoring.org/voices-for-change-career-mentoring-can-make-or-break-outcomes-for-vulnerable-foster-youth/?utm_source=Chronicle+Subscribers&utm_campaign=fc893fdeab-October_29_201510_29_2015&utm_medium=email&utm_term=0_afc94e8372-fc893fdeab-116180833&ct=t(October_29_201510_29_2015)&mc_cid=fc893fdeab&mc_eid=c7177e3427 

Ret. 10-30-15

Mentor Mini-Training Docs

Useful resources for mentors of older mentees, many of these should be customized for different towns or cities.  Note that more will be added each month on the Friends for Youth website. 'Clever!

Friends for Youth, located in Centennial, Colorado, specializes in working with youth involved in the corrections, the juvenile justice, and child welfare systems. http://friendsforyouth.nationbuilder.com/   Ret. 5-22-15


http://friendsforyouth.nationbuilder.com/training

Resources and Trainings  

Friends for Youth has many different resources available to you to help best equip you on your mentoring journey....

Our Mini-Training series - 

Each month we are 

developing a mini-training 

for mentors on the go!  

Mini-Trainings:

Personal Hygiene

Job Hunting

Transportation Tips

Gearing Up for Summer

Money Management

Buying a Car

Healthy Boundaries

Dangers of Marijuana Use

Healthy Goodbye

Encouraging Higher Education

The Meaning of the Holidays

Social Media and Mentoring

​

Mentoring At-Risk Postsecondary Students

amazon.com

For assisting at-risk college students--low-income, first-generation and underrepresented minorities...

Thanks to Kerri Kearney, M.B.A., Ed.D., associate professor, Higher Education & Student Affairs, Oklahoma State University, for directing us to a new book. Below is part of an interview posted on the Amazon website. Note our emphasizing points in blue font.

The Hidden Curriculum

August 4, 2014

By

Charlie Tyson

In recent years, many colleges and universities have turned to mentoring programs in an attempt to retain underperforming students. Federally supported mentoring programs have been around since the Higher Education Act of 1965, which created student services programs such as Upward Bound, said Stephanie Gordon, vice president for professional development of the National Association of Student Personnel Administrators. But as colleges and universities face more scrutiny on retention rates, more institutions have launched or expanded mentoring efforts, Gordon said.

Buffy Smith, an associate professor of sociology and criminal justice at the University of St. Thomas, in Minnesota, says many institutions see mentoring programs as cheap, quick ways to boost recruitment and retention of at-risk students. But for mentoring programs to succeed, they need money and clear objectives, she warns.

In her recent book Mentoring At-Risk Students through the Hidden Curriculum of Education (Lexington Books), Smith offers suggestions for how colleges and universities can guide at-risk students – low-income students, first-generation students and underrepresented minorities – through what she calls higher education’s “hidden curriculum.” The hidden curriculum, Smith writes, consists of the “norms, values, and expectations” that govern interactions among students, faculty, staff and administrators. To excel in college, at-risk students must navigate a world of new social norms – typically those of the white middle class, she argues.

Smith responded by email to questions about her book.

Q: What are some norms and values to which at-risk students often have trouble adjusting?

A: One common college norm is that students have to become comfortable with asking questions when they do not understand something and seeking help when they need academic support. Students often suffer in silence because they do not want to give the impression that they are stupid or do not belong in college.

Another college norm is that students should take the initiative to build social capital with their professors because strong faculty and student relationships are highly valued and rewarded in higher education. If students develop a great rapport with their professors, they are more likely to have access to privileges such as research opportunities and internships.  

Q; Do some kinds of institutions need robust mentoring programs more critically than do other kinds of institutions? Is the need for a mentoring program geared toward unveiling a “hidden curriculum” as pressing at a historically black college or a community college as it might be at a wealthy, predominantly white institution?

A: All institutions have a formal curriculum and a hidden curriculum. Since students are either rewarded or penalized based on their knowledge of the hidden curriculum, it is important to unveil the hidden cultural codes and norms to students at all institutions.

I do not believe wealthy predominantly white institutions are the only institutions that struggle with how to systematically unveil the hidden curriculum to their student populations. For instance, an African-American male, first-generation college student would face difficult challenges decoding, interpreting, and understanding the hidden curriculum at historically black colleges and universities. Although a black male might face less racial prejudice and discrimination at a HBCU, he would still need mentors to help him translate the hidden rules of his school in order to maximize his privileges, opportunities, and resources on campus.

Q: You write that “some scholars are very concerned that good-hearted white mentors will encourage underrepresented protégés to replace their home culture with the majority culture in order to succeed in higher education.” How does a mentor go about giving a student the social tools to succeed in college without tacitly encouraging that student to adopt the majority culture?

A: The goal of academic mentoring is to provide students with the knowledge and skills they need to thrive in school. Mentors have to be mindful not to “groom” students to become like them, regardless of their racial/ethnic, gender, or social class backgrounds. The primary focus of mentoring is transmitting information and knowledge to students, not replacing their cultural identities.

One way mentors can avoid the cloning process is to be intentional and explicit about affirming and validating their students’ home cultures in words and actions. Mentors and mentees should have honest conversations and decide together on the most effective approach for integrating home culture with school culture. Good mentors never implicitly or explicitly encourage mentees to ignore or replace their multiple cultural identities; rather, mentors empower students with the necessary skills to adapt to and succeed in their academic environment. Simply put, mentors should promote acculturation (i.e., adapting to the culture of higher education) not assimilation (i.e., adopting another group’s cultural identity). For example, mentors should teach mentees how to talk with professors in a polite and respectful tone without implying that students need to change their dialect or style of speech.

Q: Where do current mentoring programs fall short?

A: The major challenge that many mentoring programs encounter is that they do not have well-defined objectives that can be measured and directly connected to the mentoring process. For instance, it is difficult to argue that a student’s improvement in grades is directly related to her mentoring relationship when the student could have also benefited from tutoring and other support services. In order for mentoring programs to become more robust, they should incorporate assessment plans that actually link mentoring activities with desired education outcomes.

Q: You develop a mentoring model that has three cycles: advising, advocacy and apprenticeship. Tell me about these three cycles.

A: An example of how the mentoring cycles work is the following. A student who earned a “D” grade on his exam is told by his mentor to go talk with the professor about the exam (advising cycle). The mentor might also use her social capital to connect with the mentee’s professor to talk about test strategies that could help the mentee on future exams (advocacy cycle). Finally, the mentor will share the test strategies and role-play with her mentee about how he should talk with his professor to get the best education outcomes and build social capital with the professor (apprenticeship cycle).

As educators, we usually do a good job at the advising cycle, but it is important that we not stop there. We should advocate for our students, and more importantly, we need to empower our students to become advocates for themselves. A simple way of thinking about the mentoring cycles is that advising is telling students what to do, advocacy is doing things on behalf of the students, and apprenticeship is empowering students by showing them repeatedly how to be confident and proactive in their own education and build meaningful relationships with administrators, staff members, and faculty.

Q: How important is it for a mentor to be of the same race, class or gender as the mentee? You say there’s inconclusive evidence on this point. Yet your fictional mentor draws on her own experiences as “a faculty of color” in order to validate her mentee’s feelings.

A: Research suggests that matching mentors and mentees on the basis of race, ethnicity, social class, or gender is not the best way to produce successful mentoring relationships. Instead of trying to match individuals based on socially constructed identities, mentoring program directors should encourage mentors and mentees to establish clear expectations and norms, have honest conversations, and provide quality feedback that fosters trusting and meaningful relationships with one another.

Q: What are some best practices for mentoring programs?

A: One best practice for mentoring programs is to develop a mentoring curriculum that explicitly focuses on topics related to the hidden curriculum. For instance, all mentors in the network would teach the same topics (e.g., the importance of adhering to deadlines and showing up for scheduled appointments, and how to pose certain questions to demonstrate intellectual curiosity) to their mentees. The mentors would have varied teaching styles, but the hidden curriculum content would be similar.

I believe colleges should reform their existing mentoring programs to include unveiling the hidden curriculum as a major objective, and create a uniform standard for teaching the knowledge and skills necessary to decode, interpret, and understand the hidden curriculum. Once a mentoring curriculum is established, it will be easier to evaluate learning outcomes of the mentoring process.

Q: You write that a college “cannot run a successful mentoring program without a full-time mentoring program director, full-time administrative assistant, a medium-size private office space that is designed exclusively for mentoring services … and a budget line that is comparable to similar programs at the college." In addition, you say that program directors should not assign more than two students to a mentor. Is this financially realistic?

A: University administrators have to make difficult decisions as to how they will allocate their resources. I recognize there are more good initiatives than financial endowments. However, I have learned that programs considered essential to promoting the university’s values and mission receive institutional funds and are not perceived as “administrative bloat.”

Therefore, colleges have to decide if mentoring represents a core value of their institution. If schools perceive mentoring programs as a cheap and quick remedy for improving “diversity” issues on campus, they will not provide the institutional staff and support that I recommend. However, if universities redefine the mentoring process as a crucial component for students’ learning and excelling in the formal curriculum, they are more likely to provide adequate funding.

This interview has been edited and condensed.

https://www.insidehighered.com/news/2014/08/04/book-argues-mentoring-programs-should-try-unveil-colleges-hidden-curriculum  

Ret. 3-19-14

Note: Dr. Kearney is the impetus behind Oklahoma's R is for Thursday Project for foster alumni.

R is for Thursday Project: R is for Thursday is a collaboration of higher education professionals, community members, and foster alumni college students working toward increased understanding and support of former foster youth who attend, or who have graduated from, Oklahoma colleges or universities.

Link to more information: http://education.okstate.edu/risforthursday

Aging Out of Foster Care, Prospects

Annie E. Casey Foundation report about youths aging out of foster care...a must read! Oklahoma has over 9,000 youths in foster care, and over 4,500 exiting foster care. 
Kids Count, Oklahoma, updated July 2014.

http://www.aecf.org/resources/youth-who-age-out-of-foster-care-troubled-lives-troubling-prospects/

Thanks to Jean Rhodes, Ph.D., for mentioning this her Chronicle of Evidence-Based Mentoring, http://chronicle.umbmentoring.org/mentors-corner-mentoring-youth-in-foster-care/   Ret. 3-16-15

Foster Alumni & the Holidays

OSU's Dr. Kerri Kearney shared this with the R is for Thursday network. Read it, and think what you can do in your community.

When There's No Going Home

Susan Kools, RN, PhD, FAAN
The University of Virginia School of Nursing's Madge M. Jones Professor and Director of Diversity, Inclusion and Excellence.
Posted: 11/17/2014 10:51 am EST  Updated: 11/17/2014 10:59 am EST



It's that time of year when many young people head back into the comforting orbit of their parents' home -- home for the holidays, home from college, home from work, back into old rooms, clean laundry and the protection of family, food and familiarity.

But for some young people, there is no going home, not ever. For them, the place just doesn't exist.

And their ranks increase every year, when some 23,000 foster children become too old for our social services system at age 18 without ever having found a secure place to call home.

What happens to this group -- nearly a quarter million individuals over the past decade alone - should concern the lot of us. These are children that we as a society have decided can have a better chance away from their family of origin, but the fact is when they don't have meaningful and sustained social connections during their adolescent years, things don't go well as they emerge into adulthood.
Everyone should know and care about this, because like it or not, we all pay for it. And there are incredible and disquieting costs -- social, financial and human -- as a result.

A Midwest study found that of 600 young adults who'd aged out of the foster care and child welfare system, less than half were employed by age 24 with an annual income of just $8,000. More than a quarter had been homeless. Twenty-five percent had no high school diploma and just six percent had earned either a two- or four-year degree -- educational attainment thought to be the entry ticket for a decent-paying job and a chance at a financially stable life. The majority of these young women and men had already had children and received needs-based government assistance. Forty-two percent of the young men had been arrested and 23 percent had been convicted of a crime.

The costs of aging out of foster care drain our collective, taxpayer-funded coffers, too. The Jim Casey Youth Opportunities Initiative found that taxpayers and communities pay roughly $300,000 for the public assistance, incarceration and lost wages for each young person who ages out of the foster care system. That's close to $7 billion spent every year on this group of vulnerable adolescents in the U.S.
With National Adoption Day soon to arrive, we'll hear a lot about American families that generously open their hearts and doors to children in need, as well as heart rending statistics about how many more children are still waiting for a permanent home. But behind the gleam of adoption lies a darker truth about its sister social program, foster care, and the often debilitating results of children who -- most often plucked from their biological families for a host of good reasons -- never find a place to call home, the right kind of support, or a level of stability and constancy and end up 18, on their own, and entirely lost right at the moment when they're supposed to be finding themselves.

These are young people who are bright and open and determined but wholly unprepared for life in ways that the average, family-fortified youth cannot fathom. Without connection to one or two -- or more -- consistent, positive, connected adult role models in their communities, these adolescents will continue to flounder.

It's high time that we understand the lost human capital of this group and be proactive in our approach to to usher them into adulthood -- really, just another three to five years -- the right way.

That means fostering meaningful social connections with supportive adults, facilitating their educational attainment and job training, and providing transitional housing, health and mental health care.

Of course having a family matters. It shapes the raw, malleable stuff in us that lies between our genetic material and our circumstances. But where one's family comes from, and who can comprise it, is truly open and diverse. If we rally to support children aging out of foster care with the kinds of support they need, they will flourish as those with permanent and stable families have had the opportunity to do.

The great Nelson Mandela asserted that "there can be no keener revelation of a society's soul than the way in which it treats its children." In our celebration of National Adoption Day, let us not forget society's children -- our children -- those who grow up in foster care.

Susan Kools is the Madge M. Jones Professor of Nursing at the University of Virginia School of Nursing. A long-time advocate of adolescents, she has studied the health and development of adolescents in foster care, and aims to improve the outcomes of young people aging out of foster care.
Follow Susan Kools, RN, PhD, FAAN on Twitter: www.twitter.com/uvason

Information about & Resources for Foster Alumni

Oklahoma currently has over 10,000 youths in foster care. At age 18, foster kids age out of the system. RisforThursday, derived from "R is for Thursday," is reaching out as a statewide network with multiple functions for foster alumni and much information upon which Oklahomans can act. 

Foster youths and foster alumni need mentors, too.

Watch the video Re-moved below. Utilize the resources. Subscribe to the RisforThursday network.

The RisforThursday Statewide Network of Oklahoma

Website: education.okstate.edu/risforthursday

Email: risforthursday@okstate.edu

To be added to our direct email list or to find our public Facebook page: Go to the link available on the front page of our webpage.

Contact information for the people in our network (advocates, DHS educational specialists, etc.): http://education.okstate.edu/risforthursday/network

To attend our annual July RisforThursday Conversation (statewide meeting/update): http://education.okstate.edu/risforthursday/conversation

A fun little video on how we got the RisforThursday name: http://youtu.be/EUGxYdkFX9o

What It Is Like to be a Foster Kid

Please take time to view this painfully accurate (per RisforThursday students) video 

Re-Moved: removedfilm.com

[http://youtu.be/lOeQUwdAjE0 - Alternate link]

Pathways to College

Concurrent enrollment in Oklahoma: 

http://ok.gov/sde/sites/ok.gov.sde/files/Concurrent%20Enrollment%20Brochure.pdf; see also individual college/university websites

Cooperative Alliance Programs: http://www.okcareertech.org/students/cooperative-alliances

Paying for College

Oklahoma Independent Living (for questions, information, etc.): http://www.okil.ou.edu/

Oklahoma Independent Living Tuition Waivers: http://www.okdhs.org/library/policy/oac340/075/06/0110000.htm

Educational Training Voucher (ETV): http://www.nrcyd.ou.edu/etv

Application form for ETV: https://www.surveymonkey.com/s/ETVApp

Oklahoma’s Promise: http://www.okhighered.org/okpromise/

Oklahoma Youth with Promise Scholarship: https://occf.academicworks.com/opportunities/177

Casey Family Services Foster Care to Success: http://www.fc2success.org/programs/casey-family-scholars/

Contact individual colleges and universities about campus-based dedicated funds for foster alumni

Tutorial for completing the FAFSA (to qualify for Pell Grants, loans, etc.):  

http://www.okil.ou.edu/fafsa-tutorial

Tips for completing the FAFSA for foster youth:  http://www.nasfaa.org/students/Student_Aid_Tips_for_Unique_Student_Populations.aspx

Application form for FAFSA:  https://fafsa.ed.gov/

From Foster Care to College: Facilitating the Journey

Oklahoma School Counseling Association Annual Conference 2014

Special thanks to Dr. Kearney for her tireless efforts on behalf of Oklahoma's foster alumni through creation of and expansion of the RisforThursday network.

kerrikearney, Oklahoma State University,
& the RisforThursday statewide network

Personal communication 11-12-14

ADHD and Crime

The entire article may not be helpful to mentoring or juvenile justice practitioners; however, the connection between ADHD and the prison population is worthy of note. That connection action, if and when possible in a variety of ways.

From Medscape Education Psychiatry & Mental Health

ADHD and Crime: Considering the Connections

Joel L. Young, MD

CME Released: 04/12/2010 ; Valid for credit through 04/12/2011

INTRODUCTION

Jim, age 18, was just hanging out in the neighborhood with his younger cousin, when he happened upon a very hot-looking red sports car a few blocks from home. Amazingly, the keys were in the ignition, seemingly just waiting for someone to come along. Without much thought, the adolescents jumped in the car and drove off. Several hours later, the very chagrined Jim was apprehended by the police, who were entirely unsympathetic to his explanation that he had just wanted to experience the ride; he didn't think it counted as stealing. The Court was also unconvinced, and although he had no prior criminal convictions, Jim was sentenced to 9 months in jail and 2 years probation.

As part of his sentence, the court demanded that Jim obtain a full mental health evaluation. The psychiatrist learned of Jim's chronic struggles, including poor school performance, intermittent marijuana use, and regular conflicts with authorities. After a thorough examination, the psychiatrist diagnosed attention-deficit/hyperactivity disorder (ADHD), predominantly hyperactive-impulsive type, and prescribed treatment. Within weeks, Jim noted improvements in his focus and concentration. Jim's family reported that he was decidedly less moody and impulsive. After a few months on treatment, Jim's gains solidified, and the family was convinced the intervention had averted further encounters with the criminal justice system. This case highlights the complicated relationship that individuals with ADHD have with their impulsivity and the criminal and societal implications of this disorder.

People with ADHD commit crimes for many of the same reasons as those without ADHD: Some want money or property that belongs to others and have little motivation to acquire the loot honestly. Those with ADHD also have other triggers for crimes; adolescents and adults with untreated ADHD are often bored, sensation seeking, or simply impulsive, and this combination of attributes leads them to react with poor judgment. A desired item appears, they want it, so they take it.^[1] It also appears that when individuals with ADHD commit violent crimes, these acts are more likely to be crimes of spontaneous and "reactive" aggression rather than carefully plotted out offenses. Such crimes are generally impulsive acts driven by a provocation or conflict that triggers an outburst. Research with adult male offenders seems to bear out this hypothesis.^[2]

Studies show that at least 25% of prisoners in the United States have ADHD. The recidivism rate among all felons is high, and an estimated two thirds are rearrested within about 3 years.^[3] These statistics have important implications for society at large.

WHY SHOULD WE CARE ABOUT UNTREATED CRIMINALS WITH ADHD?

ADHD among prisoners is a problem, not only for the offenders with ADHD but also for their victims who were misused violently and nonviolently. Evidence suggests that the diagnosis and treatment of ADHD could have an impact on crime rates. In 2009, the National Bureau of Economic Research^[4] sought an explanation for a decline in violent crimes starting in the 1990s; they hypothesized that there was a relationship between the increase in prescribing of newer-generation antidepressants for depression (such as bupropion) and also in the prescribing of stimulants for ADHD.

The researchers compared the rates of prescriptions for these psychiatric medications to rates of violent crimes in the United States from 1997-2004 with a statistical regression analysis.^[4] They found a significant inverse correlation; that is, as prescriptions went up, violent crimes came down. As a comparison, the authors also looked at the prescription rate of statins for cholesterol treatment and found no relationship between the number of prescriptions for statins and the crime rate.

The researchers stated, "Our evidence suggests that, in particular, sales of new-generation antidepressants and stimulants used to treat ADHD are negatively associated with rates of violent crime." They added, "To put this in perspective, doubling the prescription rate [of antidepressants] would reduce violent crimes by 6%, or by 27 crimes per 100,000, at the average rate of 446.5 crimes per 100,000 population. A similar calculation with stimulants would decrease crimes by a range of 30-38 crimes per 100,000. While doubling the prescription rates seems like a large change, it has been estimated that 28% of the US adult population in any year has a diagnosable mental or addictive disorder, yet only 8% seeks treatment."^[4]

The researchers noted that the crime rate in Canada also fell during the same time period.^[4] As in the United States, Canada was among the world leaders in treatment with new psychiatric medications. This finding asserts that identifying and treating ADHD is a win-win situation: Individuals with the condition experience the benefit of treatment, and the public is less likely to become their victims.

STUDIES ON ADHD AND CRIMINAL BEHAVIOR

In ADHD in Adults: What the Science Says,^[5] Russell Barkley and colleagues report on the Milwaukee Study, a longitudinal outcome assessment of crime and other activities of hyperactive children through the life cycle. According to Barkley, there were too many medication variations to account for treatment, but the majority had not received medication treatment for their ADHD (Barkley RA, personal communication, 2008). The authors reported on 2 separate groups of adults with hyperactivity: those diagnosed with ADHD with hyperactivity as children (H+ADHD; n=55) and those not diagnosed with ADHD until adulthood (H-ADHD; n=80). These groups were compared with a community control group (n=73). In most cases, the 2 groups of adults with ADHD had significantly higher rates of crime than the community control group, although the H+ADHD group fared worse than both other groups in terms of stealing property, selling drugs, assaulting others, and several other categories. For example, 40% of the H+ADHD group had carried a weapon illegally, compared with 20% of the H-ADHD group and 8% of the control group. Among the H+ADHD group, 58% had ever been jailed, compared with 46% of the H-ADHD group and 24% of the control group (Table 1).^[5] Clearly, ADHD is a factor in the commission of crimes.

Table 1. Crime Categories for Each Group in the Milwaukee Study

	H+ADHD (%) (n=55)	H-ADHD (%) (n=80)	Community (%) (n=73)	P Value
Stole others' property	74	58	45	.004
Stole others' money	47	42	28	NS
Robbed someone of money	7	2	1	NS
Breaking and entering	14	15	3	.021
Assaulted with fists	42	33	16	.004
Assaulted with a weapon	29	6	3	< .001
Set fires intentionally	11	9	5	NS
Carried a weapon illegally	40	20	8	< .001
Forced sexual activity	2	0	0	NS
Possessed illegal drugs	67	61	48	NS
Sold drugs illegally	40	27	19	.026
Engaged in disorderly conduct	47	34	24	.022
Arrested	73	52	33	< .001
Jailed	58	46	24	< .001

H+ADHD = adults diagnosed with ADHD with hyperactivity as children; H-ADHD = adults not diagnosed with ADHD until adulthood; NS = not significant
Adapted from Barkley RA, Murphy KR, Fischer M. ADHD in Adults: What the Science Says. New York, NY: Guilford Press; 2008:313.

In a study of 198 prisoners in a Scottish prison,^[6] Young and colleagues found that 48 subjects (24%) met the criteria for childhood ADHD. Of these 48 prisoners, 11 (23%) still exhibited fully active ADHD symptoms as adults, while 16 (33%) had partial symptoms. Thus, 55% (27 inmates) had identifiable symptoms of ADHD that persisted from their childhood into adulthood. The researchers found that these 27 prisoners with continued ADHD symptoms had perpetrated significantly more aggressive incidents than the other prisoners.^[6] Nonsymptomatic prisoners averaged 0.46 acts of physical aggression compared with 2.48 incidents among those with ADHD symptoms. The symptomatic group was also more verbally aggressive and was responsible for more incidents of property damage (Table 2). The researchers noted that the severity of aggression was nearly 12 times greater for the ADHD group.^[6]

Of interest, adults in the ADHD group appeared to externalize their anger and were less likely to be self-injurious than their non-ADHD cohorts. The study did not control for treatment, and it is unknown if appropriate intervention could have altered the findings.

Table 2. Means, Standard Deviations, Medians, and Range of Scores for Critical Incidents Within the Prison for the Nonsymptomatic and the ADHD Symptomatic Group

Critical Incidents	Nonsymptomatic Group (n=171)				Symptomatic Group (n=27)
	Mean No. of Incidents	SD	Median No. of Incidents	Range	Mean No. of Incidents	SD	Median No. of Incidents	Range
Verbal aggression	5.05	13.2	1.00	0-90	18.26	28.1	4.00	0-100
Physical aggression	0.46	0.95	0.00	0-6	2.48	5.8	1.00	0-30
Damage to property	0.39	1.2	0.00	0-7	1.59	4.7	0.00	0-20
Self-injury	0.09	0.55	0.00	0-5	0.15	0.4	0.00	0-1
Total critical incidents	6.41	13.9	2.00	0-95	23.5	33.8	8.00	0-120
Severity of aggression	0.68	1.5	0.00	0-10	4.7	12.1	1.00	0-62

SD = standard deviation
Adapted with permission from Young S, et al. Personality Individual Differences. 2009;46:267.^[6]

Adolescents and Children and Criminal Acts

Children and adolescents derive their self-esteem through succeeding in school and pleasing the adults around them. Children with ADHD are struggling with chronic symptoms of inattention, distractibility, hyperactivity, and impulsivity and frequently do not realize this satisfaction. They can become alienated or friendless, and to avoid this outcome, they learn that outlandish behavior can earn them the respect of their peers. To them, negative attention is more desirable than no attention whatsoever, and befriending "bad kids" is preferable to having no friends.

Punishment for impulsive and criminal actions can begin a cascade of decline. A young offender's introduction to the juvenile justice system exposes them to increasingly troubled adolescents who can readily offer further education about wayward activities. Preventing this destructive cycle is the fundamental reason for early identification and treatment of this population.

ADHD That Persists Into Adulthood

Until recently, ADHD was thought to be "outgrown" by the time children reached adulthood; we now know that for many, ADHD symptoms persist. Indeed, the National Comorbidity Survey Replication found that 4.4% of American adults have ADHD.^[7]

In a longitudinal study, Mannuzza and colleagues^[8] studied 207 white boys (ages 6-12 years) with ADHD.^[8] Follow-up visits were obtained at ages 18, 25, and 38 years. The analysis compared subjects with ADHD vs non-ADHD probands, revealing trouble for the afflicted group. Men with ADHD were nearly twice as likely to have been arrested (47% for the ADHD subjects vs 24% for the probands) and more than 3 times more likely to be convicted for crimes (42% for the men with ADHD vs 14% for the probands). Their rates of incarceration (15% vs 1%) were also pronounced.^[8]

Mannuzza reported other disturbing trends. Seventeen percent of the men with ADHD had committed aggressive violent offenses such as murder, rape, robbery, and arson whereas none of the probands had committed any violent acts. Given the long duration of the study, the researchers were unable to control for treatment exposure.

In a retrospective study of more than 14,000 subjects with ADHD,^[9] Fletcher and Wolfe analyzed the relationship between childhood ADHD and the commission of crimes in adulthood. The previous treatment status of the subjects, now young adults ages 18-28, was not known. Subjects were separated into the 3 subtypes of ADHD: hyperactive, inattentive, and combined. The findings were clear: compared with the general non-ADHD population, the likelihood of committing any crime was 11 points higher for those with hyperactive ADHD, 6.5 points higher for those with inattentive ADHD, and 5 points higher for those with the combined subtype.^[9]

ADHD symptoms presenting early in life carry an ominous prognosis. Individuals with ADHD symptoms evident between ages 5 and 12 years, regardless of subtype, were significantly more likely to engage in criminal activities as adults compared with those without ADHD.^[9] Individuals with the hyperactive subtype were the most likely to be arrested and convicted of a crime.^[9] Robbery and theft were associated with this subtype. By contrast, those with the inattentive subtype of ADHD were more likely than those without ADHD to commit crimes that required planning, such as burglary or selling drugs. For unknown reasons, individuals with the combined subtype had the weakest links to adult criminal behavior.^[9]

Female Criminals With ADHD

The prevalence of ADHD among incarcerated men and women far exceeds the rates among men and women in the general population. A study of 320 prisoners in Iowa found that 14.3% of the female prisoners and 23.1% of the male prisoners met the diagnostic criteria for ADHD.^[10]

In an analysis of 110 female offenders with ADHD in a German prison,^[11] Rösler and colleagues found a 24.5% lifetime prevalence of ADHD and a 10% prevalence of persistent ADHD. The inmates with ADHD were significantly younger at their first conviction (19.2 years, compared with 27 years for the non-ADHD women). In addition, the rate of diagnosis of ADHD was higher with younger age; for example, the prevalence of ADHD was 17.9% among the female inmates ages 25 and below and fell to just 10% among inmates ages 26-45 years.^[11] Why the older inmates were less symptomatic is unclear. Perhaps they were more experienced at dealing with their symptoms.

IMPLICATIONS FOR MENTAL HEALTH PROFESSIONALS

The presumption that treatment for ADHD will positively affect outcomes drives clinicians to address this population. In a meta-analysis of studies of adolescents followed for 4 years,^[12] Wilens and colleagues showed that treating adolescents with ADHD with methylphenidate significantly reduced their risk of developing a substance use disorder. Similar data regarding risk reduction are sparse in the ADHD/crime literature, but some preliminary findings are encouraging.

A Norwegian study of adults with ADHD determined the subjects' "index of burden" (IOB).^[13] The IOB is a composite of scores evaluating alcohol abuse, substance abuse, criminality, and other items. Stimulant treatment in childhood and adolescence was found to contribute significantly to a higher level of psychological and social functioning in adulthood. For example, 48% of the group that had received treatment had a 0 score on the IOB (lower scores are better). This compares favorably with the 18% of the untreated group that scored 0. This trend continues if criminality is assessed alone. Two out of 14 of the treatment group (14%) had criminal records, compared with 14 out of 59 of the nontreatment group (24%).^[13]

The Need for Continued Treatment of ADHD

While the need for chronic treatment is apparent, many factors contribute to the fall off in treatment rates as patients age. Adolescents often lack the ability to assess the positive impact that treatment offers, and they tend to devalue parental input. Adolescents and young adults have less contact with their pediatricians and suffer from this professional void. As the individual transitions into the third and fourth decades of life, Medicaid and private insurance benefits are less well-protected, and cost becomes an obstacle to access to ADHD medications and treatment. All evidence suggests that the absence of treatment is correlated with increased rates of criminal behavior.^[5,6,8-10]These findings have clear implications for public policy makers interested in criminality.

Our collective ambivalence extends to the issue of how to treat incarcerated individuals with ADHD. Prison officials may find it logically inconsistent that, on one hand, some prisoners are incarcerated for their misuse of addictive or illicit substances while, on the other hand, controlled agents are indicated for ADHD treatment. Despite this inherent paradox, more prison officials are recognizing the importance of treatment, if for no other reason than maintaining calm among closely quartered, impulsive inmates. The introduction of the nonstimulant atomoxetine, a US Food and Drug Administration-approved agent for treating adult ADHD,^[14] has also been helpful. The long-acting OROS (osmotic-release oral system) methylphenidate also has a low risk for abuse.^[15] Most recently, the introduction of the pro-drug lisdexamfetamine offers an effective, long-acting amphetamine that is activated after absorption in the gastrointestinal tract and has little potential for nasal or intravenous abuse.^[16] These novel agents and delivery systems significantly reduce the risk for stimulant misuse.

CONCLUSION

ADHD is a significant factor relating to both crime and punishment. The condition increases the risk of committing a crime, and once the individual is incarcerated, the conundrum develops regarding appropriate treatment. Evidence suggests that proper treatment may reduce the risk for criminal behavior and the rate of recidivism among afflicted criminals.

Coherent approaches to treating youth with ADHD both in and out of the criminal justice system need to be developed. Additional study will further enlighten these difficult issues. For the present, it is important for psychiatrists to consider ADHD as a valid factor in crime and the treatment of ADHD as a potentially preventive measure against the commission of violent and nonviolent criminal acts. Resolving or improving ADHD symptoms can bring relief to the individual as well as to society at large.

Supported by an independent educational grant from Shire.

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