Speech and Language Therapy in Criminal Justice: A Pilot Study Rachel Iredale, Harriet Pierpoint & Beth Parow
Apr 01, 2015
Speech and Language Therapy in Criminal Justice: A Pilot StudyRachel Iredale, Harriet Pierpoint & Beth Parow
Speech and Language DisordersSpeech 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 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
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 pre-arranged 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. Vocabulary naming skills: naming pictures, e.g. aerial.
2. 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”.
3. Explaining the meanings of idioms, e.g. ‘turn over a new leaf’, ‘butterflies in your stomach’.
4. Listening to, and answering questions about a story.
5. Making sense of complex sentences, e.g. ‘I had breakfast after I spoke to Kate. What did I do first?’
6. Make a sentence with given words, e.g. left, became, work.
7. Social communication skills (assessed by observation).
8. 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 FindingsComprehension 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 findingsWhat 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 [email protected]
Dr Harriet Pierpoint [email protected]
Ms Beth [email protected]