The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling

Abstract

Purpose: Paediatric traumatic brain injury (TBI) can have resultant ongoing significant impairments which can impact life outcomes. The primary aim of this research was to explore whether TBI contributes to the relationship between poor educational outcomes and offending trajectories.

Materials and methods: Through analysis of a dataset consisting of self-reported health, educational, and offending histories of 70 incarcerated young males, structural equation modelling was used to explore the mediation of educational outcomes and patterns in offending behaviour by chronic symptoms following TBI.

Results: Symptoms related to TBI significantly mediated the relationship between decreased educational attainment and more frequent convictions. It did not mediate any relationships involving age at first conviction.

Conclusions: Traumatic brain injury appears to have more influence over frequency of offending patterns than age at first conviction. However, TBI remains a pervasive factor in both higher rates of offending and poorer educational attainment. In order to tackle this effect on adverse social outcomes, greater attention to the impact of TBI is required in education and criminal justice systems.

IMPLICATIONS FOR REHABILITATION

• Highlights traumatic brain injury as a contributory factor in some education to offending pathways, suggesting that greater focus on rehabilitation within the education and criminal justice systems is required.

• Reinforces that greater understanding of educational pathways post-injury is needed to better facilitate rehabilitation within the school system.

Keywords:

• Brain injuries
• post-concussion syndrome
• educational status
• schools
• crime
• criminals

Disclosure statement

The authors report no conflicts of interest.

Notes

1 The RMSEA estimated the lack of fit compared to the saturated model, and a fit of <0.08 was considered adequate fit [71].

2 A cut-off of 0.90 and above on the TLI can be used to interpret adequate fit on this index [72].

3 The CFI compared the model to the independence model. Scores range from 0 to 1, and generally scores of 0.95 or higher are used to indicate good fit. This fit index is reported to perform well even with a smaller sample size [72].