Summary of the impact

Over 60% of young people in the criminal justice system have speech, language and communication difficulties (SLCD), compared to 1% in the general population. SLCD is a contributing factor for reoffending, and researchers at the University of Surrey have developed best practice for mitigating SLCD, allowing successful reintegration of young offenders into society.

This work impacted policy at the national level, with specialist services now available throughout the UK. In addition, successful reintegration of young offenders impacts quality of life for the individuals and has a substantial economic impact at the institutional level.

Underpinning research

Within the general UK population, approximately 1% of people are estimated to have SLCD. However in Young Offender Institutions, this figure is considerably higher, at approximately 60%. SLCD is a major hurdle for the successful reintegration of young offenders into society, and hence understanding and effectively treating SLCD is central to young offenders' health and wellbeing, and their long-term futures.

In a HM Prison Inspectorate-supported study, the Surrey research team formed the first analysis of SLCD in young offenders. The 2004 publication of these results demonstrated that SLCD was common in young offenders, with approximately half of participants scoring significantly below acceptable limits in at least one test (1).

The results of this study were expanded through work funded by the Helen Hamlyn Foundation, a trust specifically targeted at benefiting people in the UK. The outcome of this study was the first systematic assessment of speech, language and communication difficulties in young offenders using a standardised assessment (2). The study established that at least 60% of young offenders presented with SLCD at a level sufficient to affect every day functioning, including their ability to benefit from interventions designed to prevent re-offending. Importantly, the study took place within a two year project that funded the first speech and language therapy (SLT) services within two Young Offender Institutions in England, in partnership with the prison service. This provided the first evidence that SLT could be effectively delivered within a custodial environment and could enhance the quality of the regime overall.

While the aforementioned studies clearly demonstrated the prevalence of SLCD in young offenders, and the benefit of SLT to these individuals, the data was limited to those individuals present within Young Offender Institutions. In 2011 Bryan published the first study of the effects of SLT intervention in young offenders within a community youth offending service setting (3). The study demonstrated that SLT could be effectively delivered within a community-based youth offending team, allowing early intervention and prevention of criminal escalation for individuals.

References to the research

Details of the impact

The underpinning research has a led to a number of changes in UK government policy on the treatment of young offenders, demonstrating an important policy impact. Many of these approaches are being incorporated into policy across the international arena, demonstrating the reach of this impact. The health and wellbeing impact of this research is also significant. The successful rehabilitation of young offenders and their reintegration into society is important not only for the individuals concerned, but for society as a whole. Prevention of re-offending also has a significant economic impact, leading to a reduction in the institution and courtroom costs required to deal with young offenders.

The research has underpinned the development of speech and language therapy services for vulnerable young people who are in contact with criminal justice services. The 2004 and 2007 studies provided the first hard evidence that at least 60% of young offenders present with communication difficulties. The prison inspectorate, Department for Education, Department of Health and the Youth Justice Board all requested details of the findings, and Bryan gave presentations to senior staff and a meetings with key officials. This dissemination of the research findings resulted in an impact at the level of policy on the management of young offenders (Ref 1), as well as an impact on practitioners through improved training of individual youth offending team members (Ref 2).

Bryan has continued to drive the development of policy and practice in this area through her inclusion on inspection teams by the past two HM Chief Inspectors of Prisons, leading to specific recommendations on communication difficulties in these inspection reports (Swinfen Hall and Warren Hill). These recommendations have influenced the development of new standards for inspection, including an emphasis on understanding SLCD in young offenders (Ref 3).

In parallel to the development of policy and practice in this area, the work of Bryan has been fundamental in the development of speech and language therapy services in 15 Young Offender Institutions in the UK. In addition, four Youth Offending Services have established services to aid young offenders with SLCD, with another 12 conducting scoping studies for such services. As such, the work of Bryan has led to significant changes in practice in a manner that has had a significant positive impact on the health and wellbeing of young offenders, both in the short and long term. The provision of SLT for young offenders is now beginning to have an economic impact due to the reduced re-offending rate as a result of such intervention: at present, each young offender costs the criminal justice system £8,000 per annum, with the top 10% costing £29,000 per annum, with nearly two thirds of young offenders known to re-offend (Ref 4).

As well as driving policy change within the prison and health professions, the work of Bryan has had a wider reach, impacting upon general service development and guidelines for young people. In consultation with service managers and commissioners this work has been used to drive NHS guidelines and practice in this area (Ref 5). In addition, the continued impact of this work on healthcare policy can be seen through the contribution of Bryan to the updating of the NICE guidance on conduct disorders in children and young people (Ref 6). Bryan was also invited to give evidence to the Bercow Review of speech and language therapy services for children, which was fundamental to policy and service development for young people with communication difficulties (Ref 7). One direct action from the Bercow Review was the creation of a Children's Commissioner in 2011, with the work of Bryan being seen to influence this field through meetings with the Commissioner during the launch of the Children's Communication Coalition (Ref 8). Bryan was called to give oral evidence to a parliamentary review chaired by Lord Ramsbotham in July 2012, building on the Better Communication Research Programme that stemmed from the Bercow Review and which produced an advisory report for both Houses of Parliament on Social Disadvantage and SLCD, making policy recommendations (Ref 9).

In summary, the work of Bryan has been fundamental in driving the development of SLT in the UK. Her work has demonstrable impacts on policy and practice within both the Prison Service and NHS. In addition, the reach of this impact continues to develop through the involvement of Bryan in policy development at the highest levels of Government.

Sources to corroborate the impact

Ref 1. HM Government : Healthy children, safer communities — a strategy to promote the health and well-being of children and young people in contact with the youth justice system (2009)
http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/dH_109771
Sentencing Advisory Panel: Advice to the Sentencing Guidelines Council Sentencing Principles- Youths (2009)
http://sentencingcouncil.judiciary.gov.uk/docs/web_overarching_principles_sentencing_youths.pdf
The Centre for Social Justice: No Excuses — A review of Educational Exclusion (2011)
http://www.centreforsocialjustice.org.uk/publications/no-excuses

Ref 2. Update to training of individual youth offending team members.
HM Inspectorate of Prisons

Ref 3. HM Government Report: Joint speech, language and occupational therapy service (2013)
http://www.justice.gov.uk/youth-justice/effective-practice-library/joint-speech,-language-and-occupational-health-service

Ref 4. National Audit Office: The cost of a cohort of young offenders to the criminal justice system
www.nao.org.uk/wp-content/uploads/2010/12/1011663_technical_paper.pdf

Ref 5. Policy Document on managing young offenders within the NHS (2009)
http://www.rcslt.org/speech_and_language_therapy/commissioning/resource_manual_for_commissioning_and_planning_services

Ref 6. NICE guidelines on Conduct disorders in children and young people (2013)
http://guidance.nice.org.uk/CG/Wave24/8

Ref 7. Bercow Review of speech and language therapy services for children (2008)
http://www.literacytrust.org.uk/policy/nlt_policy/821_the_bercow_review

Ref 8. Children's Communication Coalition (2010)
http://www.rcslt.org/about/young_offenders_and_criminal_justice/ccc_introduction

Ref 9. All Party Parliamentary Group on Speech and Language Difficulties (2013)
http://www.cypnow.co.uk/digital_assets/All_Party_Parliamentary_Group_on_Speech_and_Language_Difficulties_inquiry_report_copy.pdf