After the Webinar The Worst of Both Worlds: Q&A with Dr. Sandra Antoniak

Webinar presenter Dr. Sandra Antoniak answered a number of your questions after her presentation, The Worst of Both Worlds: Risk-Taking and the Transitional Age Brain. Here are just a few of her responses.


Audience Question: So, Sandy, I think we captured this a little bit, but maybe you can explain a little bit more. How does this understanding of how kids’ brains develop? And it seems even well beyond the legal age of 18 to 21? What are some key things we should be rethinking, or keeping in mind when a young person engages with the justice system? And I know that was probably a large part of the second half of your presentation. A couple of key things that we should be keeping in mind about that young person who may technically be 18, or technically be 21. So, they are technically illegal, but should we still keep in mind.

Dr. Sandra Antoniak: Great question and it goes to the heart of the talk. It boils down to balancing the two sides of the equation: balancing the neurodevelopmental status of the juvenile, or young person, with the judicial needs of the Court. On one side we have a young person who is in the process of maturing. They do not make legal decisions in the same way as an adult. Undiagnosed or untreated neurodevelopmental (autism, ADHD, learning disabilities), substance use, or mental illness (depression, PTSD) may also be at play. Were they coerced? All these things should be considered. But does that stage of neurodevelopment make the person less culpable for their actions than an adult? That is the question. Part of the answer is having the juvenile evaluated by experts who are trained in neurodevelopment such as forensic child and adolescent psychiatrists or psychologists who will be able to look at the person in their neurodevelopmental context. When the person is 18 or older, they are technically an adult according to the law but may not be neurodevelopmentally mature or may be susceptible to coercion. Again, your mental health professionals can help you identify neurodevelopmental factors that may be at play.



Audience Question: Can you speak about where to find more information about brain growth and moving kids out of ADHD by adulthood? 

Dr. Sandra Antoniak: There are a lot of good websites out there for additional information. I recommend the CDC’s website and the American Academy of Child and Adolescent Psychiatry (search for Facts for Families). This is a good summary article of the stages of development we discussed titled Brain Development and the Role of Experience in the Early Years by Tierney and Nelson.



Audience Question:  I know you said this early on, that somebody who has ADHD as a kid may not have it as an adult. Is it possible to not have it as a kid, but to have it as an adult? 

Dr. Sandra Antoniak: That is one of the most common questions I am asked. And the answer is yes, it is possible for an adult to have undiagnosed ADHD, but it is uncommon. Concentration, memory, and focus issues in adults are more likely due to anxiety or depression and not ADHD. In some cases, there are adults who have ADHD who were not diagnosed with ADHD as children, but they are rare. It is important to have the person evaluated by a psychiatrist or psychologist to have the testing necessary to determine if the person has anxiety/depression, ADHD, or both.



Audience Question: Next question, you talked about cannabis exposure, that’s not just the person’s smoking it, correct? It could also be being around somebody who is smoking cannabis. So, if you were a child and your parents are smoking, that has an effect, as well, Is that what you are also getting up? 

Dr. Sandra Antoniak: People have studied the effects of secondhand cigarette smoke and it is considered a health risk for children. Although secondhand cannabis smoke has not been studied as in depth as secondhand cigarette smoke, there is some evidence that people who are exposed to secondhand high potency marihuana smoke can develop sedation, a contact high, and positive urine tests.

NIDA provides information on this topic in a summary and a pdf report.



Audience Question: In working with the juvenile court for over 25 years, we found that parents were dysfunctional, and not only behavioral issues were identified in the parents, but obviously copying a parent’s attitude towards the police. Children learned behaviors from their environment. So, how do we identify this in the family court? 

Dr. Sandra Antoniak: This is the age-old nature versus nurture question. Helping the Court understand that there may be neurodevelopmental factors at play is important when the Court is considering sentencing or mandating services. It is important to help the Court understand if there are undiagnosed or undertreated neurodevelopmental factors at play e.g. Autism or ADHD. We know that people in the transitional age are susceptible to parent and peer influence so it is important to help the Court understand if there are factors at play that may unduly influence the young person’s behavior. I suggest you have the young person evaluated by a forensic child and adolescent psychiatrist or psychologist. They would be able to bring all the factors (neurodevelopmental, environmental, personality) together to help inform the Court as it makes decisions.


Click Here to Watch a Recording of The Worst of Both Worlds: Risk-Taking and the Transitional Age Brain.  



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