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 • • • • 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: • • • • 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