Memory mix-ups in youth with FASD

When individuals interact with the justice system, their ability to remember and report events accurately is crucial (Nadelhoffer et al., 2013). For adolescents with fetal alcohol spectrum disorder (FASD), this recall may be challenging. Many individuals with FASD experience difficulties with memory and the ability to undertake goal-oriented behavior (Mattson et al., 2019) and also may be easily manipulated (Brown et al., 2011; Gilbert et al., 2024) due to brain damage from exposure to alcohol in the womb. These challenges raise the risk of giving inaccurate or misleading accounts—not because they intend to deceive but because of a phenomenon called confabulation.

Confabulation occurs when gaps in memory are unintentionally filled with distorted or invented details. Despite frequent anecdotal references to confabulation in FASD, no previous experimental study had tested it directly. Our research has now filled this gap.

In a study published in the Journal of Pediatric Neuropsychology, David Junior Gilbert and colleagues recruited 52 adolescents ages 11–16 years (27 with FASD, 25 without FASD). All participants completed the Gudjonsson Suggestibility Scale 2 (GSS–2), a well-established tool that measures memory recall and the extent to which individuals distort stories or add new untrue parts when retelling a story. The research measured confabulation immediately, after a 50‑minute delay, and 1 week later, as well as assessed participants’ intelligence and ability to regulate their behavior (executive function).

Key findings from the study include the following:

• No differences occurred at immediate recall: Immediately after hearing the story, young people with and without FASD showed similar levels of confabulation.
• Significant differences emerged with time delay: After 50 minutes, adolescents with FASD confabulated more overall than those without FASD. After 1 week, they produced far more fabrications—new details not present in the original story.
• Memory difficulties predicted confabulation: In the FASD group, poorer memory consistently predicted more confabulation.
• Lower intelligence and poorer executive functioning increased risk. These cognitive vulnerabilities were linked specifically to fabrications over time.

Importantly, these results emerged in a calm, non-threatening research environment. Real‑world investigative interviews may involve greater pressure, which may further increase the risk of unreliable testimony.

The findings show that confabulation is a real and measurable vulnerability in adolescents with FASD, becoming more pronounced over time. Key study implications indicate that

• Individuals with FASD have issues that may sometimes affect their testimonies.
• Testimony from individuals with known or suspected FASD should always be corroborated, and testimonies about individuals from parents or caregivers should be considered.
• Interviewers should minimize interrogative pressure; use clear, nonleading language; and recognize that memory errors are unintentional, not signs of dishonesty.
• Professionals across health, education, justice, and social care should understand that “making things up” may reflect brain injury rather than lying.
• Screening tools for FASD can help identify vulnerable individuals early and prevent miscarriages of justice.

This article is in the Clinical Psychology topic area.

Brown, N. N., Gudjonsson, G., & Connor, P. (2011). Suggestibility and Fetal Alcohol Spectrum Disorders: I'll tell you anything you want to hear. The Journal of Psychiatry & Law, 39(1), 39-71. https://doi.org/10.1177/009318531103900103opens in new window

Gilbert, D. J., Allely, C. S., Gudjonsson, G., Mukherjee, R. A., & Cook, P. A. (2024). Immediate and repeat interrogative suggestibility in a sample of adolescents with fetal alcohol spectrum disorder. Diversity & Inclusion Research, 1(1), e12007. https://doi.org/10.1002/dvr2.12007opens in new window

Gilbert, D. J., Allely, C. S., Mukherjee, R. A. S., Gudjonsson, G., Brown, J., McGinn, V., & Cook, P. A. (2025). An empirical examination of confabulation in adolescents with fetal alcohol spectrum disorder (FASD). Journal of Pediatric Neuropsychology, 11(4), 150–158. https://doi.org/10.1037/jpn0000016

Mattson, S. N., Bernes, G. A., & Doyle, L. R. (2019). Fetal alcohol spectrum disorders: A review of the neurobehavioral deficits associated with prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research, 43(6), 1046-1062. https://doi.org/10.1111/acer.14040opens in new window

Nadelhoffer, T., Gromet, D., Goodwin, G. P., Nahmias, E., Sripada, C., & Sinnott-Armstrong, W. (2013). The mind, the brain, and the law. Oxford University Press.

David Junior Gilbert, PhD, is a university fellow in FASD and the justice system at the University of Salford. His research focuses on suggestibility, confabulation, compliance, and other related vulnerabilities in individuals with FASD. Contact David Junior Gilbert.

Clare S. Allely, PhD, is a professor of forensic psychology at the University of Salford. Her research is focused on FASD and autism spectrum disorder, and she contributes to the evidence base on psychology and law through her research.

Raja A. S. Mukherjee, PhD, is an honorary professor at the University of Salford and also an adult learning disability consultant psychiatrist at the Surrey and Borders Partnership NHS Foundation Trust, specializing in developmental disorders across the lifespan.

Gisli Gudjonsson, PhD, is an emeritus professor of forensic psychology at University College London and also a developer of the GSS tool and an internationally recognized expert witness.

Jerrod Brown, PhD, is a professor, trainer, researcher, and consultant with multiple years of experience teaching collegiate courses. He is also the founder and CEO of the American Institute for the Advancement of Forensic Studies and founder and co-editor-in-chief of Forensic Scholars Today.

Valerie McGinn, PhD, is a clinical neuropsychologist and the clinical director of the FASD Centre, Aotearoa in Tāmaki Makaurau, Auckland. She is also a founding member of FASD-CAN.

Penny Cook, PhD, is a professor of public health at the University of Salford. She leads the United Kingdom’s largest academic research group focused on FASD, specializing in prevalence, impact, and effective interventions.