Neurodisability & Social Exclusion: A Need, and a Way, to Reduce Risk of Detention and Displacement of Young People with Brain Disorders


Huw Williams


James Tonks
Nathan Hughes



Neurodisability, through Traumatic Brain Injury (TBI) is the biggest cause of death and disability in children. The World Health Organisation and UNICEF have called for better systems for accounting for children and young people who have “fallen out” of family care and being detained - and they may be at risk of both having had injury, or being injured. Defence for Children (DFC) and LUMOS (major Charities) have advocated for research in this area, with the UN set to run a study on “Global Picture” of children in detention in 2017.

We have shown that many children with TBI end up in the Criminal Justice System (CJS). We have provided the UK Government and other agencies with advice on TBI in vulnerable populations (e.g. young people in custody). In New Zealand new systems have been put in place to identify ND such as TBI so that community based approaches rather than detention are used with young offenders. This model was provided to the UN Convention on the Rights of People with Disability in 2016.

TBI and other NDs (such as Zika) have significant burden in developing world context. Moreover, there's a "youth bulge" of significant numbers of young people in such areas. Half of 7.5 million people globally who are refugees are children - mostly from low resource zones. Many exposed to significant trauma by fleeing terror, being displaced by war. Children and young people outside of family care are often without protection and cultural and language barriers make it difficult to access support and help promote resilience. We wish to present research and clinical/policy initiatives that may be of benefit children with ND who are at risk of detention of various forms.

We are working with Lawyers in Children's Right to work with such groups as young refugees who are at risk of adversity, trauma and - in particular - brain injury - so that we can better understand their needs, and how they can be met. Both in UK, in other host countries, in transition environments and in home countries.
Current work in the area would suggest a high level of chronic traumatic experience (seeing people die), concerns over one’s own safety and high risk of exploitation, in refugee groups. With rates of Post -Traumatic Stress Disorder (PTSD) at anywhere between 30-70% of civilians caught up in war-zones. There are also likely high rates of Traumatic Brain Injury (TBI) (from bombs and IED (improvised explosive devices), and from beatings, e.g. from people traffickers and torture)). Its estimated that about 40% of refugee coming through services in the West (e.g. torture survivor clinics) having had TBI. We are currently piloting measures for ND in young adults who are refugees.

We envisage that, with greater awareness of trauma factors and ND in such vulnerable populations, more efforts could be made to bring law, policy and practice initiatives to improve outcomes for such hitherto marginalised and neglected children.


Learning Objectives:

  1. Understand the risk of displaced and detained children and young people (CYP) having form of neurodisability.
  2. How NDs may contribute to forms social exclusion of vulnerable CYP. 
  3. What avenues there are for bringing about chanage at: individual, social and political levels to enhance chidrens' rights and ability to access neuro-rehabilitation  - such as through linking legal and neuropsycholgical /social screening systems for identifying vulnerable CYP.