Speech & Language Therapy in Criminal Justice

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Speech and Language
Therapy in Criminal
Justice: A Pilot Study
Rachel Iredale, Harriet Pierpoint & Beth Parow
Speech and Language Disorders
Speech disorders:
• Articulation disorders, e.g. difficulties in producing
sounds in syllables or saying words incorrectly to the
point at which other people cannot understand what
is being said
• Fluency disorders, e.g. stuttering
• Voice disorders, e.g. problems with the pitch, volume
or quality of a person’s voice that distract listeners
from what is being said
Language disorders:
• Difficulties in understanding or processing language
• Difficulty in putting words together
• An inability to use language in a socially appropriate
way
Background
• Communication disorders are positively associated with:
•
•
•
•
•
low attainment
behavioural problems
mental health issues
poor employment prospects
criminal behaviour.
• To date, research studies have focussed on basic skills
needs and conditions such as dyslexia and attention
deficit/hyperactivity disorder
• The majority of available research has utilised
quantitative methodologies, focussing on convicted
offenders
Aims of Study
• To pilot methods and assessments that could
be used in a larger study in a community
setting
• To identify offenders who may have speech
and language difficulties
• To identify what specific problems are
experienced by offenders with speech and
language difficulties moving through the
criminal justice system
Original Intentions
• Explore possible impact of S&L difficulties by interviewing
offenders to find examples of times when they had
difficulty understanding the language used, or had
difficulty expressing themselves
• Bring together Magistrates Courts, Youth Offending
Teams and the Probation Service
• Begin data collection in Magistrates’ Courts
• Assess 80 offenders to identify 20 with communication
difficulties
• Follow up assessments with face-to-face interviews
• Hold a focus group to discuss communication difficulties
in the criminal justice system and what can be done to
address these issues
Getting Started …..
• 18 months ago very few people discussing this
issue
• No SLT at Glamorgan. Secondment from NHS
necessary
• Difficulties in attracting funding for communitybased research
• Six months to apply for necessary approvals
• Approval was granted by the Faculty Ethics
Committee at UoG and NOMS
• Local permissions were obtained from
Pontypridd Probation Service
Study Design
• Secondment to UoG from NHS (Beth Parow)
• Focus only on Probation Service (Pontypridd)
• Project explained to managers and staff at the
Lifelong Learning Centre
• Information sheet emailed to all probation
workers
• Accessible information sheet/consent form
written for offenders
• Assessment and interview would take place at
the same time
Recruitment
• On the recommendation of staff
• Opportunistically
• Observation by the SLT of their interaction
with staff or peers
• 10 participants
• 7 males and 3 females
• Aged 21-49, average age 31
What We Learnt about Recruitment?
• Time and effort required
• Effect on researcher
• Area that is new to SLTs (limited
knowledge; reliance on staff that
offenders trust)
• Participants unlikely to attend prearranged appointments
• Vouchers help
Choosing the Assessments
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Mount Wilga assessment
Pool table narrative assessment
MCLA vocabulary assessment
Observation of communication skills
(Broadmoor)
• The language assessments took 30-45
minutes to complete
Aspects of the Assessments:
1.
2.
3.
4.
5.
6.
7.
8.
Vocabulary naming skills: naming pictures, e.g. aerial.
Re-telling a sequence of events “Tell me how to set up
an pool table for a game of pool and tell me how you
win”.
Explaining the meanings of idioms, e.g. ‘turn over a
new leaf’, ‘butterflies in your stomach’.
Listening to, and answering questions about a story.
Making sense of complex sentences, e.g. ‘I had
breakfast after I spoke to Kate. What did I do first?’
Make a sentence with given words, e.g. left, became,
work.
Social communication skills (assessed by observation).
Speech clarity (assessed through observation).
Interview Questions
 Can you remember a time when you couldn’t
understand what people were saying at
court/ probation?
 Can you remember a time when you couldn’t
explain what you wanted to say at court/
probation?
 Who and what would have made it easier for
you to understand/ explain what you wanted
to say in court/probation?
Data Analysis
Assessments
• Were analysed using scoring guidelines
• Scores were classified as ‘within normal limits’ or
‘moderately low/severely low’
• Offenders were identified as having difficulties with
expressive language and comprehension
Interviews
• Were analysed for emerging themes
• Themes included:
•
•
•
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Type of communication difficulty
Communication partners/ location
The impact of communication difficulties
Suggestions for addressing these difficulties
Preliminary Results: Assessments
• All participants scored below average on
three or more of six subtests
• 5 scored below average on four or more
subtests
• 7 had difficulties with comprehension subtests
• 4 had difficulties with all expressive language
subtests
• 3 had difficulties with both comprehension
and expressive language
Preliminary Results: Assessments
Non verbal skills, conversational skills and
speech
• 5 had at least one low score for their non-verbal
communication skills (gesture, eye-contact)
• 5 had at least one low score for their conversational skills
(topic maintenance, relevance)
• 2 had speech sound difficulties (intelligibility, volume)
• 1 had a stutter (mild)
• Only 3 had skills that would be expected in the general
public
Interview Findings
Expressive language difficulties (n=4)
• ‘I get muddled on my words terrible. I do. I'm
like… like yesterday, I had to say things and I
mean it different. It comes out wrong, so
wrong’
• ‘I just can’t get … you know, I can’t use the
words and get the words out what I want to
use, you know it is hard, awful hard’
• ‘But when I’ve had to explain something and I
can’t remember it, because I’ve been drunk
half the time like …’
Interview Findings
Comprehension difficulties (n=8)
• ‘Sometimes it’s easier to switch off’
• ‘The judge was speaking to me in their
language, which I couldn’t understand …. I
couldn’t understand what he was saying’
• ‘I can remember he went on and on for about
half an hour on his summing up and I didn’t
have a clue what he was on about’
• ‘There were times I wasn’t sure if I was going to
jail; or not when they said suspended sentence’
Interview findings
What would help?
• ‘Be a lot more patient with different people.
Explain the different ways instead of using big
massive words, so people can understand
them’
• ‘You feel stupid sometimes but I mean that is
what you have got to do if you don’t
understand, you have got to ask haven’t you’.
• ‘And ask the person “Are you sure you
understand me?” “Do you want me to explain
it in a different word way?”’
Interview findings
Being understood
• ‘I did have a barrister at the time, and he was
right on the ball like. He turned around and
said ‘Yeah, she is a bit slow and different
things, but she does understand people if you
talk to her properly’, innit’
• ‘And my probation officer, I feel like I can talk
to her…… so it makes a big, big difference’
Interview findings
The impact of communication difficulties (n=6)
• ‘If I’m too quick with my words, or I get… if I can’t get
something out I’ll get nastyish and then…’
• ‘Do you know what I mean, and you just get agitated
then do you know what I mean? That’s when you find
yourself in trouble then like’
• ‘And then you think ‘Oh God, I had better turn around
and say can you explain it in a different way’’
• ‘I shout .. Oh yeah …I don’t mean to .. But I say ‘Fuck
this’ … and made it worse for me, haven’t I by doing
that like …’
Vocabulary Assessment
• Words Tested: Bail, Adjourn, Concurrent, Alleged,
Breach, Comply, Suspended, Licence ……..
• Reparation: Only 1 person attempted to define this
word
• Compensation: 70% thought it was money they should
receive. Only 30% viewed it in terms of compensating
victims of crimes
• Remorse: 30% did not understand this word
• Revocation: 30% understood what it means to have an
order revoked
• Custodial: 40% did not understand this word, despite
one having been in prison
Tentative Conclusions
• Existing evidence suggests many offenders have
communication disorders
• Crudest measures reveal problems with comprehension
and expression
• Consequences for all criminal justice agencies
• Sentences in the community often predicated on
understanding, explaining and discussion
• SLTs may have a role to play in future service delivery,
e.g. helping offenders complete their orders
• Low levels of awareness in criminal justice agencies
about speech and language disorders sentences and
reducing re-offending
Project Limitations
Methodology
• Length of time to get approvals
• Small number of participants
• Range of recruitment methods
Assessments
• Lack of assessments available for this age group
• Some incomplete assessments
• Brief assessments. More detailed assessments
needed to give diagnoses
What next?
• Sharing findings with others
• SLT community
• Magistrates’ Courts (all users)
• Trainers (JPs and legal advisors)
• Probation services (relationship between
S&L disorders and completion of orders)
• Future projects
• Bigger sample sizes
• Different assessments
• Comparisons
Contact Details
Dr Rachel Iredale
riredale@glam.ac.uk
Dr Harriet Pierpoint
hlpierpo@glam.ac.uk
Ms Beth Parow
beth.parow@cardiffandvale.wales.nhs.uk
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