Traumatic Brain Injury and Youth Crime

A British report just published  makes some surprising and  alarming claims. Apparently, 60% of young people in the British justice system custody say they have experienced a traumatic brain injury. The report cites the fact that brain injury is more prevalent in the under 25 age group.This does not mean that brain injury turns those youths into criminals.
The report,  was written by Professor Huw Williams and commissioned by the Barrow Cadbury Trust for the Transition to Adulthood (T2A) Alliance. There is a prevalent belief in UK and US legislative authorities that once a person becomes 18 years of age he or she are mature individuals and therefore are responsible for their actions. This is at best unhelpful and at worst a tragedy of the criminal justice system. It can actually prolong the criminal behavior of an individual.
There is a basic misunderstanding of age boundaries. Age limits and restrictions rarely correspond to scientific evidence. A 16-year-old isn’t any more resistant to the damaging effects of smoking than a 14-year-old. As soon as someone reaches a legally determined age, they don’t automatically mature overnight. There is no internal  switch that gets flipped.
 “Underage pregnancy” is somewhat of an oxymoron – if a female is physiologically capable of becoming pregnant, then she is old enough to reproduce as far as nature is concerned. But society rightly recognizes that just because someone is biologically capable of doing something, they are not necessarily mentally capable of doing it without causing damage to themselves or others. Ensuring an individual is mature enough to understand and handle the consequences of potentially damaging actions is why age restrictions exist.
But this concept of “maturity” is where problems arise.  The criminal justice system works under the assumption that, once an individual is 18, they are mature enough to be considered a typical adult.The argument made is that this is not the case, and that young adults should be recognized as a separate group by the criminal justice system, and their cognitive development maturity and socioeconomic factors should be considered fully when processing them, up to and including the court sentencing the individual.
 Scientific evidence  and a literature review by Birmingham University  supports this view. Studies into post-adolescent brain development reveal that  brains continue to develop well into our 20s, and these developments are concerned with more complex abilities like: executive functioning and inhibition. The latter  overrule our need for immediate reward, moderate our impulsive actions and regulate our emotions. That is what the majority of people would consider signs of maturity.
There is  another factor that has a serious impact on  cognitive development and behavior of young adults and that is brain injury and trauma.
Head injury is  very serious . A concussion is serious, even if it does not cause lasting damage. Any injury to the head that causes even a short period of unconsciousness should be taken seriously, as it could result in a  long-term injury. Because of the complexity of the brain and uncertain nature of brain injury, the eventual consequences of traumatic brain injury can vary, potentially leading to  disorders such as schizophrenia. Many “criminals” are imprisoned who suffer from schizophrenia. Should they be in prison or under treatment elsewhere?
In younger people brain injury is potentially more damaging, as it can potentially disrupt cognitive development.  These disruptions could lead to an increased tendency for criminal behaviour.
Those without a TBI [traumatic brain injury] are more likely to grow out of an immature and antisocial behavior by the time they get to the mid-twenties but those with TBI are likely to continue to grapple with these issues throughout young adulthood and beyond.
There can be no generalization, however, that all youths who suffer from TBI will graduate into a criminal life. Most do not. But in young adults, brain injury increases the likelihood of eventual criminal behavior.
However since there is a tendency for a relationship between criminal behavior and TBI this should be considered when making decisions about sentencing and rehabilitation. Today young people aren’t screened for brain injury and thus it is  rare that there would be necessary rehabilitation. As a result, the main contact that many young people with TBI have with those that provide services is via the criminal justice system, which  obviously can’t deal with and treat brain trauma.
It is strongly suggested, though, somewhat impractical at this time, that young offenders should be screened for TBI and treated which would then cut the rates of a reoffense and save the taxpayer costs in the criminal justice system.
Interestingly, work is already under way on some tools for determining the mental state and maturity of the offenders, such as targeted questionnaires. But ironically, this would be predicated  on the fact that offenders would be  honest with those responsible for prosecuting them. This would require a degree of maturity and control. The point made above is that they may lack the trait of honesty.
We should be aware how damaging it can be to demand certain types of behavior from teenagers (and then punishing them based on this) without considering the physiological and cognitive changes they are undergoing.
No one is suggesting that young offenders get away with their crimes but it is necessary to take into account the aspects of developmental maturity and brain injury which can affect their behavior and maybe reduce the likelihood of future crime and punishment.
When Brain injury occurs and there is paresis in a particular limb the most effective physical therapy solutions should be found when the patient is sufficiently recovered.
The newly developed HANDTUTOR and its sister devices (ARMTUTOR, LEGTUTOR, 3DTUTOR) have become a key system in neuromuscular rehabilitation for patients recovering from brain and spinal injuries, Parkinson’s disease, MS, CP and other limb movement limitations. These innovative physical therapy products implement an impairment based program with augmented motion feedback that encourages motor learning through intensive active exercises and movement practice. The TUTORs consist of wearable gloves and braces that detect limb movement showing the patient how much active or assisted active movement they are actually doing. The rehabilitation software uses special  games to set a new target for this movement in terms of the patient’s ability to move their limb. The devices then measure the limb movement and give feedback on the success of the patient in trying to gain this new movement objective. In this  way the TUTOR system provides exercises that are challenging and motivating and allow for repetitive and intensive exercise practice.
 The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR are now part of the rehabilitation program in leading U.S. German, Italian, French, UK and other country’s hospitals and clinics. The TUTORs are available for adults and children from the age of 5 and up and are fully certified by the FDA and CE. They can also be used in the patient’s home through telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.

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