There is a growing knowledge about the prevalence and manifestations of autism spectrum disorder (ASD) in adults. However, major diagnostic problems are encountered in a forensic evaluation of persons from different social and cultural backgrounds.

At the conclusion of this presentation, the participant should be able to

1. 1) apply diagnostic criteria for ASD in a forensic evaluation,

2. 2) recognize cultural differences in signs and symptoms presentation,

3. 3) apply risk assessment methods in non-native persons diagnosed with ASD.

I performed a MEDLINE search of English-language literature from 1980 to 2009 to identify reports on autism and criminal behaviour in adults with emphasis on the role of ethnicity. Furthermore, I evaluated cultural differences in a series of illustrative vignettes of persons from different social and cultural backgrounds who met diagnostic criteria for ASD in a forensic evaluation.

Very few studies examined whether environmental factors predict later outcomes of ASD. IQ is the strongest predictor of outcome. Psychiatric and somatic comorbidity, and poor accessibility of mental health services are associated with negative outcomes. The lack of empathy is a core symptom that accounts for a higher risk for criminal behaviour. The diagnostic process, as well as risk assessment, in non-native adults with ASD is affected by cultural factors.

More cross-cultural research on ASD is needed to further our understanding of forensic problems related to this disorder during the life course.