Abstract
High numbers of juveniles involved in the U.S. legal system have sustained a traumatic brain injury (TBI) and/or experienced adverse childhood experiences (ACEs). Developmentally, TBI and ACEs often affect brain maturation and brain network efficiency. They are also associated with a myriad of negative criminal, behavioral, communication, adjudication, and mental health outcomes. Therefore, juveniles entering the legal system with a history of TBI and/or ACEs are at a significant disadvantage during legal proceedings and while engaged in treatment and intervention efforts. This review discusses how TBI and ACEs are independent risk factors of reduced capacity, are often co-occurring with possible synergistic effects impacting capacity, and have a strong likelihood of affecting brain network development and function. A pragmatic five-step approach to screening, assessment, treatment, capacity restoration, and education aimed at mitigating any potential harm for youth in the juvenile justice system is presented.