Speech and Language Therapy in Criminal Justice: A Pilot Study

1. Speech and Language Therapy in Criminal Justice: A Pilot Study Rachel Iredale, Harriet Pierpoint & Beth Parow

2. 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

3. 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

4. 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

5. 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

6. Getting Started ….. 18 months ago very few people discussing this issue No SLT at Glamorgan. Secondment from NHS necessary Difficulties in attracting funding for community-based 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

7. 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

8. 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

9. 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 pre-arranged appointments Vouchers help

10. 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

11. Aspects of the Assessments: 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).

12. 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?

13. 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

14. 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

15. 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

16. 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 …’

17. 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’

18. 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?”’

19. 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’

20. 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 …’

21. 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

22. 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

23. 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

24. 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

25. 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