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Understanding the complexity of neurodevelopmental profiles of females in prison

Amanda Kirby (Do-IT Solutions Ltd, Cardiff, UK.)
W. Huw Williams (College of Life and Environmental Sciences, University of Exeter, Exeter, UK.)
Betony Clasby (Department of Sociological Studies, The University of Sheffield, Sheffield, UK and Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia.)
Nathan Hughes (Department of Sociological Studies, The University of Sheffield, Sheffield, UK and Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia.)
Mary Ann Megan Cleaton (Do-IT Solutions Ltd, Cardiff, UK.)

International Journal of Prisoner Health

ISSN: 1744-9200

Article publication date: 18 December 2020

Issue publication date: 17 November 2021




This paper aims to examine the relationship between patterns of functioning in four domains (attention and concentration; social and communication; coordination and organisation; and literacy and numeracy) in women in prison. Also, to consider potential associations between functioning and previous Neurodevelopmental Disorder (NDD) diagnoses, previous mental health diagnoses and history of head injury, self-harm and attempted suicide.


Women in one Scottish prison were invited to participate; 87 consented. Women were screened for functional difficulties and asked about their relevant educational and medical history.


Half of participants reported difficulties in one or more domains. All possible combinations of functional difficulties were found. Only eight women reported previous NDD diagnoses. Functional difficulties were significantly associated with history of self-harm, history of attempted suicide and mental health diagnoses. In total, 32% of women reported at least one head injury, but this was not significantly associated with functional difficulties.

Research limitations/implications

The sample was comparatively small and questions were self-report. Analyses were based on within-cohort comparisons due to a lack of appropriate general population data.

Practical implications

There is a clear need for timely, practical and comprehensive profiling of females in the Justice System. Current systems do not appear to adequately identify women with functional difficulties or other adversity. Greater use of interdisciplinary working and shared training is indicated, as is a move from categorical diagnostic systems towards dimensional approaches.


This study is the first to investigate associations between difficulties associated with NDDs, mental health difficulties and head injury in women in prison.



AK conceived the study and worked with SPS to deliver the screening programme; AK, WHW, BC, NH and MAMC planned the analyses; MAMC performed the analyses; AK and MAMC wrote the manuscript; AK, WHW, BC, NH and MAMC edited the manuscript. All authors approved the final manuscript. The authors thank Ms Alyson Peters for uploading the questionnaires to the Do-IT Profiler system and Dr James Tonks for proof-reading the manuscript.Funding This research was part-funded by an ESRC Impact Accelerator Award – an institutional award given to Exeter University with a sub-award given to WHW. Do-IT Solutions Ltd. was paid by SPS to design and deliver a LDD screening programme but was not paid to carry out the secondary research described in this manuscript.Declaration of interest WHW, NH and BC have no potential conflicts of interest to disclose. AK is the parent of an adult with NDDs, the chair of Movement Matters UK, patron of the Dyspraxia Association of New Zealand, a past advisor to the Dysraxia Foundation in the Republic of Ireland, Medical Advisor to the Dyspraxia Foundation in the UK and is on the Hidden Impairment National Group for the Department of Work and Pensions, UK. She is also the CEO of Do-IT Solutions Ltd., a company providing person-centred assessments and support for people with NDDs and related difficulties. MAMC is an employee of Do-IT Solutions Ltd.


Kirby, A., Williams, W.H., Clasby, B., Hughes, N. and Cleaton, M.A.M. (2021), "Understanding the complexity of neurodevelopmental profiles of females in prison", International Journal of Prisoner Health, Vol. 17 No. 4, pp. 425-438.



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