According to the Brain Injury Association of PA, when people involved in the criminal justice system have a brain injury, the effects of the brain injury can appear to be a lack of cooperation or disrespect. The client may exhibit:
* failure to respond quickly to directives
* inconsistent attention
* difficulty following directions
* difficulty learning routines
* difficulty expressing needs
* impulsivity and emotional dyscontrol
As a result, these clients are especially in need of connections to supports in the community.
For case managers, parole officers and others who work with clients who may have experience a brain injury, the Brain Injury Association of PA makes the following general recommendations about working effectively with the client:
* Be sure you have the person's attention before providing information
* Simplify information
* Be clear and concise
* Reduce the amount of information the client has to remember
* Check for understanding
* Check for cognitive overload
* Help the client to organize information
The Brain Injury Association of PA suggests the following resources for persons with brain injury and their supports:
Telephone Information Lines:
* PA Department of Health Brain Injury Helpline - 1-866-412-4755 (toll free)
* BIAPA Brain Injury Resource Line - 1-800-444-6443 (toll free)
BIAPA also recommends the CDC publication "Traumatic Brain Injury - A Guide for Criminal Justice Professionals" which can be found online at:
This publication provides the following additional information
Common TBI problems and strategies for management
(from the publication Traumatic Brain Injury: A Guide for Criminal Justice Professionals, by the Centers for Disease Control and Prevention (October 12, 2009; full publication available online at http://www.corrections.com/articles/22373-traumatic-brain-injury-a-guide-for-criminal-justice-professionals)
Issue: Attention deficits may make it difficult for the person with TBI to focus on a required task or respond to directions. Either situation may be misinterpreted, thus leading to an impression of deliberate defiance on the part of the inmate.
▪ Ask the person to repeat what you have said to confirm that he or she has heard and understood your directions
▪ Encourage the person to write down steps for the task
▪ Allow extra time for the task to be done
▪ Clear or reduce environmental distractions
Issue: Memory deficits can make it difficult to understand or remember rules or directions, which may lead to disciplinary actions.
▪ Explain rules or directions slowly, step-by-step
▪ Ask the person to repeat the steps and encourage him or her to write down the information
▪ Provide examples and ask the person to provide his or her own
▪ Teach the person to ask questions when he or she doesn't understand
Issue: Slowed verbal and physical responses may be interpreted as uncooperative behavior.
▪ Give directions, or ask questions, slowly; repeat if necessary
▪ Allow the person additional time to respond
Issue: Irritability or anger may be difficult to control which can lead to an incident with another person. Such incidents can lead to further injury for the person with TBI and others.
▪ Avoid arguing with the person
▪ Try re-phrasing the problem, breaking it down into parts
▪ Reinforce positive behaviors
Issue: Uninhibited or impulsive behavior, including unacceptable sexual behavior, may provoke others or result in disciplinary action.
▪ Tell the person calmly that the behavior is unacceptable
▪ Seek assistance from mental health professionals