© child brain injury trust 2011 youth offending and acquired brain injury - a practical approach...
TRANSCRIPT
© Child Brain Injury Trust 2011
Youth Offending and Acquired Brain Injury
- a practical approach
Louise WilkinsonInformation & Learning Manager
Child Brain Injury Trust
© Child Brain Injury Trust 2011
After birth
Illness, accident, stroke, tumour, poisoning, lack of oxygen, non surgical intervention
Thinks, feels and responds to situations
WHAT IS AN ACQUIRED BRAIN INJURY (ABI)?
© Child Brain Injury Trust 2011
Typical characteristics of a young person with an ABI
Acquired Brain Injury
Poor memory
Poor social awareness
Poor planning and organisation
ability
Inability to learn from
consequences
Poor verbal comprehension
Poor attention and
concentration
© Child Brain Injury Trust 2011
Circumstances
Adolescence
ABIFamily
Support Networks
© Child Brain Injury Trust 2011
Young people affected by ABI have a higher likelihood of entering the criminal justice system
24% - 32% general public (McKinley et al, 2008; McGuire et al, 1998)
65% - 72% of inmates in a young offenders institution (Williams et al, 2010; Davies et al, 2012);
……….and once there, their neurological needs are frequently poor or indeed appropriately supported.
© Child Brain Injury Trust 2011
Demographics of Acquired Brain Injury
• 40,000 children per year – accidents alone, resulting in head injury– Road accidents 39%– Falls 28%– Sport / play 17%
• Incidence– Girls 132/100,000 per year– Boys 235/100,000 per year
© Child Brain Injury Trust 2011
The vision of the Youth Justice Board is of an effective youth justice system, where:
• more offenders are caught, held to account for their actions, and stop offending
• children and young people receive the support they need to lead crime-free lives
• victims are better supported
• the public has more confidence in the youth justice system.
© Child Brain Injury Trust 2011
SLC and the brain
• Sense of balance and coordination of movement
• Verbal dyspraxia
• Visual shapes and colours
• Reading/writing• Picture/object
recognition
• Sense of touch, taste, smell• Hearing• Speech recognition• Abstract reasoning/language processing• Short term memory• Facial recognition
• Emotional control centre• Initiation/goal setting• Body movement• Motor Speech• Problem solving• Monitoring and self
correction• Impulse control• Integrating information• Long term memory• Social interaction• Word fluency
• Reading• Writing• Processing/calculating• Naming
© Child Brain Injury Trust 2011
© Child Brain Injury Trust 2011
Adult acquired brain injury
Acquired brain Injury
Rehabilitation
Normal trajectory
© Child Brain Injury Trust 2011
Childhood acquired brain injury
Acquired brain Injury
Post injury development
Normal trajectory
© Child Brain Injury Trust 2011
THE FUNNEL EFFECT
Children with an ABI have a higher
likelihood of being excluded from school because of their
behaviour
Children who are excluded from school are more likely to offend
Better support in Education could reduce Youth Offending rates
© Child Brain Injury Trust 2011
Childhood acquired
brain injury
Environmental factors
(family, housing etc)
Education(Rehabilitation) Youth Offending
Well supported
Poorly supported
Poorly supported
Well supported
Maximum outcomesachieved
Poor Neuro and
Cognitive rehab
Good Neuro
and Cognitive
rehab
Impact of Education on the life outcomes for children and young people affected by
childhood acquired brain injury
© Louise Wilkinson 2011
© Child Brain Injury Trust 2011
School is rehab!
© Child Brain Injury Trust 2011
THE EVIDENCE
Research that proves:• the definite link between ABI and offending• a higher number of offenders affected by
ABI than we may realise
© Child Brain Injury Trust 2011
Incidence of ABI in prison
Prof Huw Williams and his team (in prep) on study of HMP Exeter – sampled 453 prisoners and found 60% reported head injury – much higher than community rates
Any tbi?
YesNoMissing
Co
un
t
140
120
100
80
60
40
20
0
estimated:
• 10% Severe
• 5.6 % Moderate
• 49.4% Mild
© Child Brain Injury Trust 2011
Huw Williams et al 2010
Average age at first imprisonment:21 Years – Non-TBI offenders16 years –TBI offenders
Self reported head injury • 65% may have TBI.
• 10% Severe• 5.6 % Moderate• 49.4% Mild
© Child Brain Injury Trust 2011
Reoffending
Is this your first time in Prison?
Any TBI?
No
Yes
No Yes
The number of participants that were re-offenders differed significantly according to whether they had reported “head injuries”
150
100
50
0
Count
© Child Brain Injury Trust 2011
© Child Brain Injury Trust 2011
…now add a brain injury!
• Loss of IQ (12 points on average)
• Poor short term memory• Disinhibition
– Reduced awareness of consequence– Inappropriate behaviours– Rewards of fight or flight
= Increased likelihood of
offending behavioursDr Andrew Curran (2009)
© Child Brain Injury Trust 2011
© Child Brain Injury Trust 2011
Appropriate interventions
• Restorative Justice– What if young person has lack of empathy
and consequential thinking?
• Community Orders– Meeting YOT workers at the right time/place– But what if th etyoung person has poor
organisation and planning skills?
© Child Brain Injury Trust 2011
Complexity of offenders with ABI
‘It’s not only the kind of injury that matters, but the kind of head’
C. Symonds 1937
Rehabilitation for Cognitive
Deficits
Rehabilitation for Offending
Behaviour
(Dr Ivan Pitman - Consultant Clinical Neuropsychologist, June 2008)
© Child Brain Injury Trust 2011
PRACTICAL APPROACH
• Prevention better that cure – programme of “Educating the Educators”
• Youth Justice or Rough Justice?” Workshops
• Criminal Justice/ABI National Interest Group –
developing awareness and encouraging change
© Child Brain Injury Trust 2011
Members of CJABIIG
© Child Brain Injury Trust 2011
SCREENING & ENHANCING REHABILITATION
• Improved screening for head injury at pre-sentencing and on admission to prison/custodial services
• Better understanding of risk, and for rehabilitative purposes – Esp. those with executive & socio-affective difficulties who may
have difficulty in changing behaviour patterns in response to contingencies
• Rehabilitation interventions in custodial systems – targeted at impulse control and socio-emotional processing eg empathy