Competencies for Training Juvenile Services on Justice-Involved Youth with Traumatic Brain Injury

Abstract

Research indicates young individuals with traumatic brain injuries (TBI) in juvenile justice settings lack essential support, mainly due to staff members' insufficient knowledge and skills in TBI-related areas stemming from a lack of relevant professional development. This study aimed to improve services for justice-involved youths with TBI in juvenile correction facilities by establishing empirically validated core competencies tailored to their needs. Through a Delphi study involving experts in juvenile services, juvenile corrections, TBI, transition services, and professional development, we identified and refined a set of 44 competencies distributed across six domains: knowledge (12 competencies), screening (6 competencies), eligibility (3 competencies), assessment (4 competencies), intervention (10 competencies), and community reentry (9 competencies).

Keywords

Traumatic Brain Injury, Corrections, Juvenile, Staff, Training, Competencies

INTRODUCTION

Training of staff in the management of traumatic brain injuries (TBI) within juvenile correction facilities holds a pivotal role in safeguarding the welfare, rehabilitation, and safety of incarcerated young individuals grappling with TBI. TBI is a neurological injury that occurs when an external force causes damage to the brain. TBIs can result from various incidents, including accidents, falls, sports injuries, physical assaults, or any other event where the head sustains a blow, jolt, or penetrating injury. These injuries can range from mild (commonly referred to as concussions) to severe, and they can have a wide range of physical, cognitive, emotional, and behavioral effects on the individual (Centers for Disease Control, 2023).

Extensive research has highlighted the heightened vulnerability of justice involved youth to TBI, primarily attributed to the impulsive and risky behaviors frequently exhibited within this demo-graphic (Browne et al., 2018). Additionally, TBI can amplify preexisting behavioral issues, impair cognitive development, and elevate the risk of repeat offenses (Arciniegas et al., 2015). Astonishingly, rates of brain injuries among incarcerated youth range from 12% to 82%, significantly surpassing those in the general population (Hughes et al., 2015; McKinley & Albicini, 2016; Nagele et al., 2021). TBI has also been associated with heightened aggression and behavioral dysfunctions, which introduce distinctive learning and behavioral traits that likely contribute to the disproportionately high incarceration rates among youth with TBI (Ryan et al., 2015). Many of these individuals tend to engage in risky behaviors and struggle to control their emotions, factors that can lead to delinquent behavior (Ganesalingam et al., 2006).

Moreover, youth with TBI often encounter communication challenges that hinder their effective participation in legal proceedings (Thompson et al., 1994; Wszalek & Turkstra, 2015). Their cognitive struggles can result in aggressive behavior and criminal acts (Max et al., 2005a). Alarmingly, young adults with TBI are four times more likely than their non-disabled peers to develop concurrent mental disorders associated with offending (Orlovska et al., 2014). Post-release, community reentry outcomes for previously incarcerated youth with TBI significantly lag behind those of their non-disabled counterparts (Bullis et al., 2004). These youth exhibit higher conviction rates and a greater likelihood of re-offending (Ray & Richardson, 2017). Cognitive deficits, particularly in executive functioning, learning, and attention, contribute to poor academic performance, school dropout, and impaired decision-making—three prominent risk factors for delinquent behavior (McCord, 1992; Wolfgang et al., 1987). The adverse repercussions of TBI consistently manifest in various domains, including general cognitive performance (Slater & Kohr, 1989), deterioration in language function (McInnes et al., 2017; Rowley et al., 2017; Wszalek & Turkstra, 2015), memory and attention deficits (Loken et al., 1995; Max et al., 2004; Max et al., 2005a; Max et al., 2005b), reduced processing speed (Mathias & Wheaton, 2007), compromised executive function (Rode et al., 2014), and impaired visual-motor skills (Thompson et al., 1994).

Given these multifaceted challenges faced by incarcerated youth with TBI, staff within juvenile correction facilities must be equipped with the knowledge and skills required to identify, assess, and address TBI-related issues effectively. On any given day, over 60,000 youth are incarcerated and cared for by a diverse array of staff in juvenile facilities (Gagnon et al., 2012). These professionals encompass therapists, counselors, corrections staff, correctional education personnel, and healthcare providers. Adequate staff training serves as a crucial instrument for early TBI detection, resulting in timely interventions that improve outcomes for affected youths. Through proper training, staff can discern the subtle signs and symptoms of TBI, including cognitive impairments, emotional dysregulation, and hindered social skills, often masked by disruptive behaviors (Bigler et al., 2013). This recognition paves the way for appropriate referrals for medical assessment and rehabilitation services, ensuring justice involved youth receive the essential care they require.

Pre-service and In-service Training

Unfortunately, existing research paints a concerning picture, indicating that youth with TBI in juvenile correction settings often do not receive the requisite support for positive outcomes (Williams & Chitsabesan, 2016). Surveys of correctional staff have revealed that fewer than two-thirds had received any training concerning students with disabilities in general (Kvarfordt et al., 2005). Many staff members in juvenile settings did not receive pre-service training and had limited relevant in-service professional development related to youth with disabilities (Hughes et al., 2015). Furthermore, research suggests that most correctional staff receive minimal professional development specifically tailored to youth with TBI (Gagnon et al., 2013; Mathur et al., 2009; Platt et al., 2015). The current training programs within the juvenile correction system often fall short in addressing common challenges associated with TBI (e.g., empathy, self-monitoring of behavior) and how to support youth development of skills for successful reintegration and employment (Ray & Richardson, 2017). As a result of this training deficit, many staff members in juvenile settings lack the knowledge and skills needed to effectively address the impacts of TBI and support positive outcomes for youth with TBI (Ernst et al., 2016; Ettel et al., 2016; Graff & Caperell, 2016; Jordan & Linden, 2013).

Given these pressing challenges, there exists a critical imperative to provide counselors, residential staff, educators, administrators, and other support staff with professional development rooted in evidence-based practices to enhance the prospects of positive community integration, health, and employment outcomes for youth with TBI (Hughes et al., 2015; Ryan et al., 2015). Staff trained to employ evidence-based strategies for addressing the behavioral and cognitive issues of young individuals in juvenile correctional settings are pivotal for robust re-entry planning and the future success of these youth (Kvarfordt et al., 2005). Emerging evidence suggests high-quality staff training forms the foundation of interventions associated with improved outcomes for adults with TBI within justice settings (O'Rourke et al., 2016).

Professional Training Competencies

Professional training competencies reflect a desired performance level against which a professional’s performance can be compared. The main purpose of competencies is to develop a thorough understanding of the types of skills and knowledge that various personnel need to perform their jobs. Although professional competencies have been identified specifically for correctional facilities (i.e., Correctional Education Association Standards Commission, 2019), they do not include working with justice involved youth with TBI. For example, the Correctional Education Association Standards Commission recommends that correctional staff receive a total of 40 hours of in-service training on: (a) personnel and education department policies and procedures; (b) alternative, neglected, and delinquent education; (c) basic security training; (d) emergency plans, procedures, and responsibilities; (e) teaching the juvenile justice student; (f) behavior modification; (g) crisis intervention, and (h) learning disabilities (p7). Although these competencies include topics that might be relevant to youth with TBI (e.g., behavior modification, learning disabilities), they do not specifically address the unique needs of youth with TBI (e.g., deficits in executive functioning, communication skills, memory and attention, processing speeds). There is a critical need to identify TBI-specific competencies that could guide specific professional development to improve the knowledge and expertise of corrections professionals and drive programmatic changes for the youth with some of the poorest outcomes.

Recognizing the need to develop professional competencies that support incarcerated youth with TBI, we conducted a Delphi study to collate and refine expert opinions, pinpointing core competencies across various correctional personnel roles. Our primary research inquiry was: What competencies are necessary in staff training to ensure justice-involved youth with TBI receive evidence-based services aimed at improving their re-entry and life outcomes?

METHODOLOGY

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