Select Committee on Education and Skills Written Evidence


Memorandum submitted by the Royal College of Speech and Language Therapists (RCSLT)

EXECUTIVE SUMMARY

  1.  People with communication disorders have difficulty with:

    —  understanding the spoken or written word, or other non-verbal communication;

    —  expressing themselves through speech or writing or other non-verbal communication;

    —  language functions affecting their ability to express all they want to get over in a meaningful and appropriate way; and

    —  interacting with others in socially accepted ways.

  Communication difficulties have a large impact on the formation of relationships and can often lead to behavioural problems. These preventable and treatable difficulties have determining role on an individual's life course, with a significant impact on education attainment, employability, mental health and offending behaviour.

  There is significant evidence that juvenile offenders and prisoners are far more likely to be at risk for language impairment than the general population.

  2.  Speaking and listening skills are essential for offenders to cope with the demands the prison regime, and participate fully in educational provision and behaviour programmes designed to reduce re-offending.

Speech and language therapy intervention uses an individualised goal setting approach and focuses on enabling young people with speech, language and communication problems in coping with the verbal and communication demands of prison. For young offenders, speech and language therapists can meet developmental difficulties to avert a persistent association with crime throughout their lifespan.

  3.  There are currently very few speech and language therapists employed within the prison service to fully support all people with communication needs.

  RCSLT recommends that speech and language therapy should be available within all Young Offender Institutions.

INTRODUCTION

  1.  Communication difficulties can greatly affect the formation of relationships and can often lead to behavioural problems. These preventable difficulties have a major impact on the individual's life chances and pose a financial burden on the organizations and agencies that support the children, young people and eventually adults including the criminal justice system and mental health services.

  2.  Evidence emerging over the last decade indicates that juvenile offenders are likely to be at significant risk for previously unrecognized language impairment (Bryan 2004) but oral language competence has not been systematically investigated in the UK prison population. Speaking and listening skills are necessary for offenders to cope with the demands of education provision and offending behaviour programmes designed to reduce re-offending. It is also important that specific disabilities and special education needs including difficulties with speech are recognized in order to comply with the Disability Discrimination Act (2005). Both the Youth Justice Board and the DfES recognize that identification of needs and provision for special educational needs is important (www.dfes.gov.uk/sen).

  3.  A national study carried out in 2001-02 showed that the recidivism rates were reduced by as much as 50% for prisoners who are supported to improve their oral language skills in their first year after release (Moseley 2006). There are currently very few speech and language therapists employed within the prison service to implement such a programme nationally.

  4.  The Government has provided an estimated £130 million budget for prison education to improve literacy skills (Lee 2006). While this is extremely welcome, recent studies show that up to 60% of offenders are unable to benefit from these programmes because of their low level of language skills (Ryan 2002). The money would be more efficiently used if SLTs were able to identify timely and appropriate support for offenders whose language skills are below those needed to access current programs. The identification of this group can be efficiently carried out using a screening tool, such as the Communication Assessment for Adults in a Forensic Setting (CAAFS: Barber, Holden and Hotham 2001).

RISK OF LANGUAGE IMPAIRMENT IN THE UK PRISON POPULATION

  5.  Whilst studies of offenders speaking and listening skills have used populations of young people in different countries over various age ranges, research consistently indicate that oral language difficulties for young people who are failing at school or who are often labelled as having "behaviour" problems.

  5.1.  Humber and Snow (2001) used a group of 15 male adolescents in Australia aged 13-21 serving community orders and showed that inferences and understanding metaphor were significantly lower for the offender group than for the age and education matched control group. None of the sample was receiving intervention for language difficulties.

  5.2.  Snow and Powell (2004) used the same tests on a larger sample of seventy 13-21 year olds serving community orders and found that they were on average functioning two years below their peer group even when matched for years of schooling. Snow and Powell 2004, 2005 suggest that high-risk adolescents whose conduct disturbances bring them into contact with the law are likely to display difficulties in understanding and using abstract language (eg idioms, metaphor), using narrative discourse to organize and convey new information to a listener, word finding difficulties, and grammatical immaturity relative to their non-offending peers. Similar findings were apparent in a population of UK juvenile offenders described later in this paper.

  5.3.  Some studies have examined language abilities in children at risk of offending. Cohen and co-workers in Canada (Cohen et al 1993; Vallance et al 1999) have reported that around 50% of children and adolescents receiving services for a range of adjustment disorders (eg behaviour disturbances, anxiety disorders) actually display language impairments when specifically tested. Cohen has speculated that the combination of language and behaviour disturbance results in a disproportionate "favouring" of behaviour when allocation and delivery of intervention services is considered. This means that high-risk children may receive services aimed at ameliorating their behaviour problems, but there may be little or no attention paid to development of language comprehension and expression. This in turn reduces the likelihood of school engagement, thus lessening the access that high-risk young people have to the protective effects of academic achievement.

  5.4.  Beitchman et al (1999) suggests that communication difficulties tend to be misinterpreted as non-compliance and conduct problems in the classroom environment, and Whitmire (2000) suggests that adolescents with language disorders are vulnerable to problems in developing peer and family relationships, as well as in meeting the expectations and demands of school.

  5.5.  Sanger et al (2003) suggested that language difficulties were not being recognised and that communication problems tended to be labelled within terms such as "lazy" or "out of control". They also suggested that language and communication skills should be investigated in adolescents who are experiencing social and/or schooling difficulties. Sanger et al 2001 recommend that SLT's are represented on teams planning for adolescent offenders.

  5.6.  A recent study of juvenile offenders in the UK is reported in detail in Appendix 2.

  6.  The link between disadvantage in the early years and language difficulties later affecting school performance has been highlighted (Locke, Ginsborg and Peers 2002). Persistent difficulty with language development has been linked with a greater chance than normal of the development of both mental health problems and involvement in criminal activities although this remains a contentious area for research. A longitudinal study by Clegg, Hollis and Rutter (1999) showed that a third of children with developmental language disorders studied, developed mental health problems with resulting criminal involvement in some cases.

  7.  There is an urgent need for evidence-based interventions with young people within the wider criminal justice system (including those who have offended as well as those deemed at risk of offending), so that unmet developmental difficulties can be addressed to maximise opportunities for gainful participation in society and to avert the adoption of an ongoing adult "lifestyle" associated with persistent crime (Ward and Stewart 2003).

EXPLORATION OF THE ROLE OF SPEECH AND LANGUAGE THERAPY

  8.  It is already recognised that attempting to improve literacy and social skills is essential to prevent further offending (Venard et al 1997). Speech and language therapy interventions can help prevent and reduce the re-offending rate by increasing their oral communication skills (Crace 2006) in order to access a wider range of rehabilitation programmes and education, and subsequently are empowered to change their offending behaviour.

  9.  Speech, language and communication reflect complex sets of skills, which are developed and refined through life in first language speakers. There are many reasons why a child or young person may have difficulty in acquiring these skills or in using them. The relationship between oral and written language skills is also complex and it should not be assumed that limited skills in one denote limited skills in the other, although this may be the case (Bryan, in press).

  10.  SLT intervention used an individualised goal setting approach and focussed on enabling young people with speech, language and communication problems to cope with the verbal demands of the regime. Young people with very low levels of language ability are likely to particularly struggle with verbally mediated interventions and may need access to SLT if their education and skill development programme is to address their individual needs. Increasingly juveniles and young offenders are recognised as being people with complex and multifaceted problems, as the Government's Green Paper on Reducing Re-offending Through Skills and Employment (2006) suggests.

  11.  Lack of communication skills appears relevant to concerns about the effectiveness of interventions for juvenile offenders (Youth Justice Board 2004) and the high levels of withdrawal and non-attendance in relation to educational provision (HMSO 2006).

  12.  Pilot services established that SLT could be successfully delivered within the context of a young offender institution and that the value to the regime could be demonstrated (Bryan et al 2004). However, more research is needed to establish the most effective ways of delivering SLT to the juvenile offender population. (See case examples in Appendix 1.)

  13.  Prison education needs to move from general group provision to a form of educational provision that addresses individual profiles of difficulties. Speech therapists are able to assess individuals, in order to address communication skills and identify ways to enhance engagement through this route to learning.

  14.  Speech therapists can provide prison staff with skills to communicate with young people with low language abilities, which is essential in order to deliver effective care. Skills for Life staff may also require training and support to enhance their awareness of these language and communication issues, and to enable them to manage these difficulties within the provision offered. Support from speech and language therapy to tailor programmes and to offer specialist input in some cases should be available within Skills for Life provision.

  15.   We therefore suggest that SLT should be available within all YOI's. This would support staffing education to extend their provision to young people with specific learning disabilities and to those with pervasive developmental disorders. It would also enable the wider prison staff to achieve effective communication with the young people they care for. Increasing oral communication competency would also facilitate increased engagement in programmes intended to prevent further offending, which are verbally mediated.


 
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