Select Committee on Education and Skills Written Evidence


APPENDIX 1

CASE EXAMPLES—THREE CASES REFERRED TO SPEECH AND LANGUAGE THERAPIST WITHIN A JUVENILE YOI

  The first is a relatively well educated young man who has difficulty in using language in social situations. His difficulties were sufficient to affect his ability to cope within the regime.

  M was 18 years old and prior to his custodial sentence had lived with his family. He was serving a 10 month Detention and Training Order and had a history of violence and aggressive behaviour. He was referred to SLT for poor language and social skills. M had attended mainstream school and had achieved four GCSEs. He had then attended college, and gained further vocational qualifications. In prison, he attended education part time and had a part time job in the "paving" workshop. M was frequently involved in confrontation or fighting with other young people and staff. He had no history of substance misuse and an IQ test showed that he was "within the average range".

  SLT assessment showed that M did have poor descriptive language skills (expressive language), limited social skills with particular difficulties in non-verbal aspects of communication, rigidity in his thoughts, difficulty using language to expand his explanations and limited verbal reasoning skills, some memory and comprehension (understanding) difficulties and also low self esteem regarding his academic abilities. Formal assessments showed that his understanding was equivalent to age 11 years and his speaking and listening skills were considerably below the average range for his age group.

  M was motivated to attend SLT and jointly agreed to the following goals:

    —  to understand about non verbal communication eg eye contact, facial expression;

    —  to understand people's body language;

    —  to understand how communication changes in different situations; and

    —  to be more aware of his own non-verbal communication skills.

  M accessed the following SLT care pathways: receptive language, expressive language, and social skills to address his difficulties over 12 sessions. M successfully met all of his SLT goals, and the gains were evident in his day to day conduct. The number of incidents relating to aggressive, confrontational behaviour decreased and staff commented on his ability to deal with difficult situations more effectively ie he was able to recognise when someone was "joking" with him and was able to stop and think about a situation before reacting. As a result of the decrease in his aggressive behaviour he was perceived by others more positively, which also helped to develop his self esteem.

  The next case illustrates the problem of managing a young person with a pre-existing problem that includes language and communication difficulty within the context of residential provision for young people.

  L was 16 and looked after by Social Services under a full care order with diagnoses of attention deficit hyperactivity disorder (ADHD), Asperger's Syndrome and marked conduct disorder. He was sentenced to a 10 month Detention Training Order, as a second time in custody. In prison, L was attending education for basic skills, and was also working towards a qualification in woodwork.

  L presented with literal understanding of language, lack of empathy and tactlessness, impaired non-verbal communication, difficulty focusing on relevant stimuli and difficulty in understanding large amounts of information. He also had difficulty differentiating between different types of objects. For example, in woodwork he could never work out why there were different types of saws. Information on L's language and communication difficulties was given to all staff involved with him. An SLT intervention programme was devised to support L in his woodwork course. This involved categorising objects by their features and functions, in order to aid his understanding of the difference in tools and to support him in using the correct tools for specific jobs. The learning support assistant who worked in the woodwork area conducted this programme.

  The SLT was also asked to advise on L's behaviour in his residential area. L frequently misused the cell bell, shouted abusive comments from his cell and repetitively kicked his door. This behaviour reflected L's incomplete understanding and his use of inappropriate strategies to attract attention. The SLT worked with L to increase his understanding of the routine within the residential unit, and to develop more appropriate strategies for him to attract the attention of staff. Following SLT intervention, staff reported that L's behaviour had improved and he was coping well with the woodwork programme. Information from SLT was also used to plan appropriate service provision following L's release from prison.

  The third case is a young person with schooling problems pre-dating his offending problems. However, neither his school nor the college catering for excluded children had identified his language difficulties. N was 16 and a half years old and serving an 18 month Detention and Training Order as his second custodial sentence, and he was identified as a persistent offender in his local area. He lived with his family prior to custody and had a history of substance misuse.

  N had attended mainstream school but was excluded for the first time at age 11 years and following this his attendance was sporadic due to further exclusions. He eventually attended a course at a local college for excluded children, which he attended until age 16 years. N had never received a statement of special educational needs, despite difficulties with reading and writing, but was diagnosed with dyslexia while in prison. N was accessing education part time and had a part time job in the paints workshop. Induction staff reported that N was having difficulty engaging in conversation and in understanding what was said to him.

  N presented with a restricted vocabulary, equivalent to that expected of a child aged 10 years and word finding difficulties. N's speaking and listening skills were within the "low average" range. He also had noticeable difficulty understanding what was said to him particularly if two or three pieces of information were presented at the same time, and he showed some awareness of these difficulties. He had little confidence in communicating and low self-esteem, which was reflected in his limited eye contact and his tendency to give up when tasks became more difficult.

  The outcome of assessment was that N agreed to address his vocabulary, his ability to retrieve words, and his ability to express himself and talk about himself. Developing these skills would then help develop his confidence in communicating and promote his self-esteem. He received regular SLT input, which later fed into a pre-release preparation programme aimed at coping with interviews and coping with workplace communication.

  These three cases illustrate the complexity of the cases referred to SLT and the impact of speech, language and communication difficulties on many aspects of the young people's care, education and life experience. These cases were not unusual as the population screening described in the next section demonstrates.


 
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Prepared 19 July 2007