kim turner, hmp & yoi feltham [email protected] … turner, hmp & yoi feltham...
TRANSCRIPT
Level of Need YOI Brinsford and Werrington - 55% of males (15-17yrs) in
a YOI scored poor or below on Test of Adolescent and Adult Language compared to 9% of controls Bryan (2007)
YOI Huntercombe- males (17-20yrs) had an average age equivalent of 12;04 on language assessment and 11;01 on vocabulary Pryor (1998)
Leeds YOT – 78% of males required input, 12% of females
Bradford Youth Offending Team – 74% performed below average but only 5.2% had previous contact with SLT
SLCN and Offending Receptive and expressive language functioning children at
kindergarten predicted later conduct problems (Hooper, Roberts, Zeisel, & Poe, 2003).
Linz, Hooper, Hynd, Isaac, & Gibson (1990) found that receptive language problems were predictive of disinhibited behaviour in adolescents with conduct disorder.
Ripley & Yuill (2005) cited multiple studies that demonstrated that excluded boys had undetected language impairments and performed significantly below their peers, with higher levels of behavioural problems in those with both receptive and expressive language impairments.
In a psychiatric clinic sample of 7-14year olds, two thirds of those diagnosed with conduct disorder also had a language impairment (Cohen et al,1998).
Current Access to Services YOI
17 in the UK
1 with full time provision
2 with part time provision
1 with possible
YOTs
32 in London
5 with current part time provision
Case Studies
Youth Offending Institute
Callum, 19yrs, social communication difficulties
Youth Offending Team
Andy, 17yrs, expressive language and social skills
ESBD School
Ben, 13yrs, SLI
Callum - Background Referred by Offender Manager in 2nd week of
admission
Possible in response to phone calls from mother
Difficulties in interaction skills
Also concerns from Unit staff
Difficult, rude, isolative
Additional referral made to CMHT
Information gathering Nocturnal enuresis to age 10
Statemented age 12 – given 1:1 support in classroom
Expelled from school x2
Seen by Educational psychologist
WAIS Non verbal IQ – 80, Verbal IQ – 108
High levels of cannabis usage
Escalating use of violence and aggression
Family history of mental illness
Assessment Seen immediately following altercation with Prison
officer, highly aroused
Angry and hostile after being called ‘rude’
Unaware how behaviour may have been interpreted as such
Language assessment
Expressive language – above average
Receptive language – within normal limits
Verbal memory – mild impairment
Assessment Results Clear social communication difficulties
Reduced meta awareness
Unable to read people
Unable to read situations
Queries over Aspergers, OCD, anxiety disorder
Joint assessment completed with CMHT
Other possible diagnoses discounted
Interventions Kelly hierarchy used Self and others awareness
Non verbal communication
Real life communication breakdowns What happened?
Who was involved?
What did you do? How did they react?
What did they do? How did you react?
What could be done differently next time?
Results E level prisoner
Reduction in concerns from staff
Reduction in anxiety for Callum
Acquitted before therapy complete
Meta awareness improved, recognising communication difficulties, requesting input
Onward path Does not attend Probation as acquitted
Does not fit CMHT referral criteria as no specific mental health issues
Does not fit Autism services as not a complete triad
Age 19 can not access paediatric SLT services, does not fulfil criteria for adult services
Asked local YOT SLT for involvement but SLT manager would not allow exception
Mother and prison staff fear that may re-offend in part due to communication difficulties
Andy - YOT Andy referred by YOT worker: “There’s something going Helen but I’m not sure what”
No history of behavioural difficulties or statement for educational need
Strategy at school was to keep his head down
Few friends
Assessment indicated poor expressive language, limited vocabulary and difficulties processing extended pieces of information
Poor awareness of difficulties
Outcomes Report influenced sentencing outcome - 18 month
DTO instead of 2+ years in custody
Diverted to a YOI with SLT access (which then closed), sent to therapeutic wing and had educational support
On release back to YOT is getting substantial support from SLT on assertiveness and social skills, work skills and language support
Providing the time - SEBD Nightingale is a school in Wandsworth for primary,
secondary and sixth form students who have social, emotional and behavioural disorders.
Traditionally only had ad hoc SLT input to the primary school.
Luckily the need was realised and a service was set up for the school - 3 days a week
Nightingale - Ben Had been known to SLT in the mainstream service since very
young
Engagement had been difficult due to his behaviours
Avoidant of work
Refusals
Lashing out
Poor peer relationships
Transferred to SEBD setting in year 4
I got to know him in year 7
Assessment… …difficult to pin down for substantial formal assessment…
In class - poor attention, avoidant of the pencil, often out the window
Staff were worn out by him, found him “immature” at times “sulky” others “clingy”, would kick, bite, scratch and spit when distressed
Trigger points appeared to be around “justice” and needing to explain his side but being unable to
Still very interested in others, lots of natural curiosity, great visuo-spatial processing, keen to try new tasks, small group of good friends
Tended to process the end of an utterance
Keen to engage with others despite significant difficulties with expressive language
Intervention… 3 sessions a week!
Initially focused on space building and relationship building over task completion Created a safe space behind my cupboard for thinking time
Spread out on the floor
Had an open door at breakfast and lunch time
Made use of the on-site farm and carpentry workshops
Set up projects that capitalised on his manual skills so language learning appeared incidental
Shared knowledge with key staff so that class tasks were differentiated but more importantly so that de-escalating was more effective.
Outcomes…? Using a pencil in class and sounding out letters in
front of others
Term and a half of good class attendance
Staff taking time to modify their language following incidents One question at a time
One focus to the question
Giving thinking time
The gaps are closing None of these young people would have accessed SLT without
the commissioning of specially tailored services
But gaps still exist …
The Bercow report indicated the need for each YOT to have access to an SLT and for each YOI to employ an SLT
Paediatric services need to find creative ways of delivering services to those hard to reach clients (SureStart)
SLTs need to educate other services on how to identify and refer those in need (The Box, The Communication Trust)
LinksThe Box e-learning, RCSLT
http://www.rcslt.org/thebox/open
The Box viral advert
http://www.youtube.com/watch?v=5XKtTK4i2hM
The Communication Trust website
http://www.thecommunicationtrust.org.uk/
Information on the Youth Justice System from the YJB
http://www.yjb.gov.uk/en-gb/yjs/