Royal College of Speech and Language Therapists Communicating Justice Problems, solutions and practice

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Royal College of Speech and Language
TherapistsCommunicating JusticeProblems,
solutions and practice

• Kim Hartley, RCSLT Scotland Officer
• kim.hartley_at_rcslt.org
• Jan Green, SLT
• jangreen_at_nhs.net

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Speech, Language and Communication Needs (SLCN)
means...

• A person has
• Difficulty understanding the spoken or written
  word or other non-verbal communication
• Difficulty expressing themselves through speech,
  writing or other non-verbal communication.
• Difficulty with language function they cant
  get over all they want to get over in a
  meaningful and / or socially acceptable way
• Difficulty interacting with others in socially
  acceptable ways.

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Invisible, disguised or missed

• Can be invisible
• Can be masked
• Can look like and be labelled as behaviour
  problems which are in fact a symptom
• Identified as literacy difficulties ... related
  but not the same
• Current screening not picking SLCN up

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Descriptions to look out for ...

• disinterested, disengaged the teenage grunt
  communicates clearly when he wants to
  selective hearing

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Labels to look out for ...

• challenging behaviour literacy difficulties
  ADHD attachment disorder brain damage head
  injury punch drunk substance misuse learning
  disability autistic spectrum disorder mental
  illness dyslexia stammering hearing or visual
  impairment cleft palate
• childhood disadvantage
• special school
• truancy

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SLCN and Literacy

• You need a range of fundamental SLC skills to
  learn to read and write.
• SLC skills are the foundation of literacy and
  numeracy.
• Reading and writing difficulties can often belie
  more fundamental, underpinning SLC difficulties
• So...
• More literacy classes without the fundamental SLC
  skills wont and dont work

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Read this....

• Literacy and all learning first needs speech,
  language and communication skills to be there

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• Literacy most learning
• first needs speech, language and communication
  skills

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Early 30 million words catastrophe...

• ...by age three, there was a 30 million word
  gap between the linguistic exposure of children
  in the poor households and that typically
  experienced by children in wealthier households.
  
• USA study, 2003

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7 times more banged heads

• ...8.5 of the general population experience
  traumatic brain injury compared to
• 60.25 prevalence of Traumatic Brain Injury in
  the overall offender population
• (Statistical Review, 2010)

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10 x more learning disability

• 20-30 of offenders have learning difficulties
  compared to 2 of general population
• Estimated 50-90 of people with learning
  difficulties also have communication impairment.
  

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SLCN in the general population

• General Population
• 5-7 of children and young people have SLCN
• 1 -2 of the population have severe SLCN
• 20 may experience difficulties at some point

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CJS Population

• NOT WHO HAS but WHO HASNT?
• Over 60 in the CJS have SLCN ,
• 46-67 of these poor or very poor skills
• 74 accessing youth offending team
• 65 of young people accessing Intensive
  Supervision and Surveillance Programme - 20
  severely delayed

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So what?

• Behind criminal / challenging behaviour in the
  first place ... at a huge cost to all
• 66 of 7 -14 years olds with severe behaviour
  problems have communication needs
• children with language impairment experience
  social and behavioural problems at secondary
  school age, these increase over time as they
  become increasingly frustrated

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So what?

• More likely to be a victim at a huge cost
• Greater risk of harm than others because...
• Difficulty reporting what has happened.
• Difficulty understanding what has happened.
• Difficulty recognising harmful behaviour.
• Lack of access to information about rights and
  support.
• Social isolation.

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So what?

• Barrier to effective and equal justice
• PRT found SLCN in children within the CJS added
  to their vulnerability in navigating the court
  system
• CYP with SLCN lack the language skills to
  understand what is happening to them or the
  implications of what is being asked of them e.g.
  understanding words such as victim and
  breach.

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So what?

• Barrier to routes out of offending at repeated
  huge costs to all
• Home Office found mismatch between the literacy
  demands of programmes and skills level of
  offenders, -particularly significant with respect
  to speaking and listening skills
• CYP with SCLN rarely indicate that do not
  understand or need help instead, they gave up

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SLC and Your Reducing Reoffending Objectives

• Improving communication within CJS we suggest
  would contribute to
• Whole System Approach
• Preventing offending by young people
• Reducing reoffending
• Enhancing Efficiency
• Supporting victims and witnesses

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Discussion

1. Descriptions familiar?
2. Labels to look out for familiar?
3. Whats your experience of communicating with
   offenders?
4. SLC an issue for the people you work with?

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What can be done?
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UNIVERSAL Action

• Reaches everyone without you needing to first ID
  SLCN
• Doesnt have to be complicated or expensive
• Outcomes
• Raised awareness
• Reliably identifying SLC need
• Quality Inclusive Communication practice. -
  skills and resources to respond to SLCN 24/7

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RCSLT - The Box

• On line Awareness Raising training
• Face to face two day training
• Screening tool
• East Lothian and UK wide pilots ongoing
• Evaluation Report, May 2013

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Inclusive Communication Resource
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Targeted Action

• Reaches people with known or high risk of SLCN
• SLT assessment of individuals SLCN
• Enhanced SLC support where it is needed
• Outcome
• Getting and sustaining engagement with and access
  to the CJS process, rehabilitation programmes,
  services
• Improving key relationships.

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Targeted Action

• Example
• Training and support to rehabilitation programme
  providers to adapt programmes and services for
  known AND unidentified SLC needs
• Development and sharing of SLCN adapted materials
  on line

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Specialist level action

• Detailed SLT specialist assessment, report and
  guidance
• Direct Speech and Language Therapy to those that
  can benefit
• Specialist Programmes focussing on SLCN delivered
  via those living and working with the person
  (Indirect SLT)

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Specialist Level Action

• Outcomes (for example)
• Individual gains improved insight in to
  difficulties and reasons for difficulties etc.
• Improved SLC skills and competences to deal with
  social interaction challenges etc.
• Individualised guidance, training and support to
  staff and families working and living with
  person.

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The impact of speech and language therapy

• Leeds Study (Gregory, 2009)
• Impact on Young People
• Of the young people who completed the intensive
  supervision and surveillance programme with
  identified SLCN
• 88 made significant gains on standardised
  assessment following SLT intervention - despite
  often chaotic lives, substance misuse and years
  away from formal education
• at an individual level gains in communication
  skills led to wider gains in the young peoples
  engagement with education and training.

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The impact of speech and language therapy

• Impact on staff teams
• Staff made significant gains in their knowledge
  and confidence working with young people with
  SLCN. ... (and) were able to incorporate
  communication aims and activities into their
  sessions (Gregory, Bryan, 2009).
• 17/19 YOT practitioners rated SLT at the highest
  level for critical impact on the management and
  outcome of YOT cases (Brooks, 2011).

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The impact of speech and language therapy

• I culd hardly remember stuff that I was doing..
  I didnt really communicate with people that I
  didnt know cause I didnt feel comfortabl. But
  since I have worked with SLT things have
  changed. Plus (SLT)helped me to read and write
  better and helped me a lot with my spelling and
  remembering things... I got a better
  understanding of how to doo my work for my
  programmes.. Plus I culd help my kid with his
  school work.

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Video
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• Coffee time

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(No Transcript)
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Sharing Information

• A new employability group is running in your
  area. A colleagues asks for your opinion on the
  poster they have designed. Can you improve the
  poster?

• Consider
• Language Levels.
• Layout.
• Font size and selection.
• Use of imagery.

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Case Study - James

• What are the main challenges in this case? What
  are the main strengths?
• What do you think should be considered when
  someone with CSN arrives in a new workplace or
  training situation?
• What are the advantages and disadvantages in
  disclosing CSN?
• You decide to make a referral to SLT. How could
  this help you work James?

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Skills Changing your language

• You are working with James. He seems
  uncooperative and disinterested.
• You ask him if there is a problem, and he
  tells you that the work you are doing with him is
  boring and that he doesnt know what youre on
  about.
• As a group, re-write the examples from the
  Changing Your Language worksheet. Is there
  anything else you need to do or say? Consult the
  communication profile as you fill in the sheet.

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Help!

• Contact your local SLT service
• Communicating Justice Coalition resources
  www.rcslt.org
• Adult Protection Resources / Workshop
  http//www.rcslt.org/asp_toolkit/adult_protection_
  communication_support_toolkit/welcome
• Look out for The Box roll out