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PSYCHOLOGY: Attention Deficit Hyperactivity Disorder – Legal Implications

The legal community frequently encounters individuals who are suffering from Attention Deficit Hyperactivity Disorder (ADHD). Unfortunately, because ADHD is one of the most misunderstood disorders in the psychological system, attorneys don’t always unde

By Dr. M.P.B., Psy.D.

 

The legal community frequently encounters individuals who are suffering from Attention Deficit Hyperactivity Disorder (ADHD). Unfortunately, because ADHD is one of the most misunderstood disorders in the psychological system, attorneys don’t always understand its implications, especially as they may relate to mitigation or other important legal issues.

The DSM-IV-TR describes ADHD as a combination of symptoms involving inattention, hyperactivity, and impulsivity. As a result, individuals diagnosed with this disorder may display some or all of the following: making careless mistakes in their work or school, forgetfulness, always “on the go,” blurting out answers before questions have been completed, talking excessively and interrupting or intruding on others. In addition, some of the symptoms listed in the DSM-IV-TR must be present by age 7. Furthermore, the symptoms must result in a significant impairment in functioning, and must be evident in two or more settings (i.e., school, work, home). Unfortunately, the DSM-IV-TR criteria do not adequately address the possible symptoms of ADHD in adulthood. For example, in adulthood, this disorder is most likely to be displayed through symptoms such as poor planning, numerous unfinished projects, disorganization, underemployment, multiple automobile accidents, poor frustration tolerance, constantly late for appointments, impaired judgment (due to distractibility), and possible substance abuse.

In the legal context, children with ADHD might be encountered in both custody and dependency proceedings. In those cases, the children may be unable to provide accurate and precise information to evaluators due to their distractibility, inattentiveness, and immaturity. In addition, their ability to provide information within an appropriate time perspective (i.e., amount of time parents spend with them, time left alone, time between visitations) is likely to be impaired due to the difficulties encountered by this disorder. This may be particularly frustrating to the legal professionals when attempting to reconcile conflicts in a child’s self-report or in corroborating negative accusations by a parent. Children and adolescents with ADHD are also frequently encountered in criminal proceedings due to their poor impulse control, immaturity, and difficulty in anticipating the consequences of their actions. Further exacerbating their difficulties within the legal system is the high incidence of co-occurring conditions, such as Oppositional-Defiant Disorder, Conduct Disorder, and substance abuse disorders.

Juveniles with ADHD are often evaluated due to concerns over their competence to stand trial and their competence to waive Miranda rights. Although these individuals might be of average intelligence and in their teenage years, numerous research studies have estimated a decrement as high as thirty percent in maturity levels for children diagnosed with ADHD. In addition, the symptoms of ADHD often place them at a considerable handicap in various legal situations. For example, juveniles diagnosed with ADHD may have difficulty controlling their impulse to give a statement to police officers, anticipate that statement as potentially damaging to them, properly attend to the nuances of a criminal proceeding, and rationally appreciate the time constraints in various legal dispositions (such as Probation or Community Control).  It also should be noted that even juveniles who are being properly treated for ADHD with the appropriate medication might experience many of the above deficits in a legal setting.

Adults with ADHD are likely to encounter many of the same (and several additional) difficulties as juveniles in the legal system. In custody cases, parents with ADHD might be forgetful, disorganized, and chronically late for visitation or important appointments. Moreover, they might arrive late or forget scheduled psychological evaluations and it may appear as if they are bored or disinterested in the examination process. As a result, they may be viewed by the Court and evaluators as irresponsible, unreliable, and possibly uncaring. Through proper treatment interventions, such as the prescription of medications (possibly stimulants) and behavioral counseling, parenting skills can increase dramatically in brief periods of time.

Adults with ADHD also come into contact with the criminal justice system due to their increased likelihood of involvement in automobile accidents, abuse of drugs and alcohol, and engagement in impulsive actions involving violence. Although most adults with ADHD do not commit legal offenses, a growing proportion of adults charged with criminal offenses are being diagnosed with this disorder. Moreover, adults with ADHD often have concurrent diagnoses, such as personality disorders, depression, and anxiety. Adults with ADHD differ from juveniles with this disorder in that competency to proceed or competency to waive Miranda rights are rarely considered by attorneys as legitimate reasons to request an assessment by mental health professionals. 

The diagnosis of ADHD is not sufficient for an insanity defense due to the lack of a cognitive (thought) component to the disorder (inability to know the nature and consequences of the act or the wrongfulness of the act). However, the proper diagnosis of this condition might be explanatory for ongoing problems with illicit substances, frequent poor judgment, violations of court-imposed sanctions, and impulsive actions (e.g. “road rage,” domestic violence, leaving the scene of an accident). In certain situations, the Court may also consider mitigating a sentence for adults diagnosed with ADHD in order for them to receive the appropriate treatment interventions for this disorder.

For these reasons, a proper assessment and diagnosis of ADHD may be directly and/or indirectly relevant to a multitude of legal issues that may arise for individuals who suffer from this disorder.