Rory Cahill investigates work being done to assist young men in prison with communication and language problems, and discovers the benefits could be massive

Jim was 18 when he committed a horrific sex attack on a much older woman that means he may never be released from Scotland’s justice system. He ambushed her and then raped her repeatedly at knifepoint. She thought she would be killed once he had finished with her. His crime was widely publicised at the time and met with universal revulsion from the public. Who could do such a thing and why?

Then you meet Jim on the protection wing of Polmont Young Offenders Institution, surely one of the most dispiriting and chilling spaces in the entire country. He comes shambling into the room, sits down and literally curls in on himself, face buried in the crook of his arm in an attempt to avoid eye contact. He does not look frightening, he looks pathetic.

Communicating with Jim – or more accurately, attempting to communicate – is painful, not just because you know what he has done in the past, but also because his basic language skills are so woefully deficient. You have to speak very slowly and enunciate words clearly. Often he will ask you to repeat what you have just said. It takes him a long time to comprehend questions and formulate a response and you will be lucky if you get a reply of more than four or five words. It is like talking with someone who is set on slow motion. It quickly becomes frustrating, not just for you, but clearly, Jim as well.

Jim suffered a severe head injury when he was in his early teens and that trauma, along with subsequent surgery, has impaired his ability to not only speak, but also his memory and ability to learn. But it didn’t affect his sense of right or wrong. It’s not an excuse for what he did. It doesn’t diminish his responsibility for his actions.

But that doesn’t mean we should ignore Jim’s communication disorders. To be able to qualify for consideration for release once the initial part of his sentence is served, Jim will need to complete a series of complex and emotionally gruelling programmes, aimed at helping him understand his offending behaviour in the hope he can curb it.

But how will a young man who can barely form a sentence, explain the emotions, or experiences, that helped place him in a state of mind where he could ambush a woman and then rape her a number of times?

But how will a young man who can barely form a sentence, explain the emotions, or experiences, that helped place him in a state of mind where he could ambush a woman and then rape her a number of times?

It costs about £40,000 a year to keep Jim in prison. If he doesn’t get the help he needs, and he stays in prison for the rest of his life, which is a distinct possibility, taxpayers will pay well over £2 million, in current terms, to clothe, house and feed him for the rest of his life.

Jan Green, the speech and language therapist (SLT) at Polmont, says that Jim has serious communication difficulties and without sustained work on these problems, has very little chance of ever becoming eligible for release. It costs on average £33,000 a year to fund an SLT like Green. But Green says, with visible frustration, that she simply cannot help Jim at the moment because there is only enough funding to employ her for two days a week. So Jim is on the waiting list. When he turns 21, he’ll be transferred into the adult system, where there is no provision at all for speech and language therapy.

According to the Scottish Prison Service, 26 per cent of young men coming into Polmont have ‘clinically significant communication impairments’. The impairments or disorders run a wide gamut from oral and facial physical development disorders
that can physically affect the ability to speak, specific speech and language delays or disorders, autistic spectrum disorders including Asperger’s syndrome, learning delays and disorders as well as dyslexia and various diagnosed or undiagnosed
mental illnesses.

Then there are also large numbers of young men who have suffered head injuries like Jim, often sustained during fights – young men who commit violence are also the group in society most likely to have violence inflicted upon them – or whose mother’s drug use and drinking significantly damaged their development in the womb. Some started drinking and taking drugs at such an early age that their childhood brain development was retarded.

Having a severe communication problem is a vicious circle, says Green, who says her work is not about teaching “kids not to talk like neds”.

“People do think it is elocution, but it is not. Speech and language therapy is about trying to facilitate and help people communicate in the way they would be able to if they didn’t have a communication disorder. It’s trying to help them communicate at the same level as their peers. It’s not pronunciation, it’s not elocution, it’s nothing like that,” she says.

If you can’t communicate effectively, Green says, you are not going to engage well with school and often, sadly but inevitably
given the almost complete dearth of dedicated SLTs in our school system, school is not going to engage well with you. From there, the markers on the road to prison pass by with dismaying predictability: exclusion from school, drink and drug use, Children’s Hearings, increasing trouble with the police and then Polmont. In Polmont, you can’t really engage with the many programmes on offer to help you gain an education and find a job on release. So after Polmont, more often than not, the young offenders pass through the revolving doors of a Scottish criminal justice system that locks up more of its citizens than nearly any other country in western Europe, most of them men with low educational attainment who have been in prison before.

There is clear evidence, both observational and empirical, that one way of breaking this unhappy cycle is by tackling the communication difficulties of young offenders.

Derek McGill, the governor at Polmont, is under no doubt as to the effectiveness of speech and language therapy.

“It is not recognised as traditional work but the benefits for me are that it can lead to a better performing prison, helps me with KPIs [key performance indicators] in terms of violence and helps protect staff because if people can express themselves, they are less likely to resort to previous tactics which is just to flare up and throw punches. It’s much better for staff, it’s much better for the prison and much better or other prisoners.

“This is something we should be pushing and you need to get that message over to people and now the benefits have been recognised, we need to build on the benefits we have got,” he says.

In an emerging field like this, the benefits may at first be hard to quantify, but there are already some encouraging statistics coming out. A study by the Learning and Skills Centre in England found that one group of young offenders who were treated for their communication problems more than halved the risk of re-offending, with the re-offending rate cut from the typical 44 per cent to 21 per cent. With research showing that 40 per cent of young offenders have difficulty in benefiting from verbally
mediated interventions like rehabilitation courses, anger management or sex offending programmes – the Jims of the world – it is obvious the direct benefits that SLTs can bring.

But where therapy can be most beneficial is in actually demonstrating to prison staff – and, people like Green hope, to teachers, social workers and others who may come into contact with the young men before they arrive at Polmont – that they are not being deliberately provocative, or ‘acting up’, but that their behaviour has an identifiable cause.

One prison officer on the Polmont protection wing says the offenders there can talk a whole lot of “mince”, or act in deeply provocative and unsettling ways, but once he knows they have actually been diagnosed with a disorder, he can formulate his response accordingly.

Given what we are learning about the importance of addressing communication disorders, what are we doing about it?

McGill, who has been governor of adult prisons, says it is vital we focus on assisting the young men in Polmont before they graduate – as so many do – to the adult system. But is that potentially too late in itself? Should we be intervening even earlier?

South of the border, action is being taken to address the issue of funding for SLTs, ironically, originally inspired by Scottish success. Lord David ‘Rambo’ Ramsbotham is a former Chief Inspector of Prisons for England and Wales. An ex-military man who served in Northern Ireland, Ramsbotham is by no means a bleeding heart liberal. But he is emphatic that speech and language therapy offers one of the best possible interventions currently available to prevent young offenders from becoming career criminals.

peaking to the House of Lords last year, Ramsbotham recalled the first time he realised the potential benefits of therapy
in the late 1990s:
“I went to the young offender establishment at Polmont. I was walking with the governor, who told me that, if by some mischance he had to get rid of all his staff, the last one out the gate would be his speech and language therapist

if by some mischance he had to get rid of all his staff, the last one out the gate would be his speech and language therapist

“I have to admit that in all the years I have been looking at prisons and the treatment of offenders, I have never found anything
so capable of doing so much for so many people at so little cost as the work that speech and language therapists carry
out.”

Ramsbotham now chairs an All-Party Group at Westminster that is working to get an SLT placed in every English and Welsh young offender’s institution. Conservative MP John Barcow lodged a Bill on May 1 this year – the Young Offenders (Provision of Speech and Therapy) – aimed at achieving this very end.

In Scotland, the SPS says there is no definitive plan to increase the funding for the one SLT – Green – working with Scottish young offenders. To put things in context, under the current arrangements, the Scottish system provides between 14-16 hours a week of speech and language therapy to be divided between every male young offender in the country.

“We recognise there is value in dealing with young offenders through a range of interventions. We shape the services we
provide to try and best meet the needs of the population, which can be quite different. We have no concrete proposals to
extend the provision, but this will be one of the issues that we look at. You cut your cloth to suit. But we do go for what works
and if this can provide demonstrable benefits, then it is something we will look at,” says an SPS spokesperson.

Detective Superintendent John Carnochan of the Violence Reduction Unit says that interventions like Speech and language therapy need to be made well before young men arrive in places like Polmont. Carnochan knows that the typical Scottish murderer is an 18-year-old man from an area of high deprivation and is not surprised by statistics that show that up to 55 per cent of four-year-old boys in areas of multiple deprivation have communication disorders of some kind.

“The frustrations felt by people who have an inability to communicate must be immense. This is vital stuff for the work we are doing, and these are things you can only learn in the earliest years, even earlier, things like non-verbal cues, understanding
how their behaviour can impact on other people.

“Without being able to do that, they find it hard to avoid risky situations which then means they are often both repeat victims and inflictors of violence,” he says.

Carnochan talks about the importance of parents in developing communication skills in the children, an issue of particular relevance, given that one in seven inmates at Polmont is already a father.

“We need to encourage things like parents reading to their children so they have a good grasp of language when they
reach school so they can make the most of school. That’s so important because it helps and builds socialisation.”

In Scotland, the opportunity to make these early interventions are severely limited. A survey by the Royal College of Speech and Language Therapists of Scottish SLTs working in schools found 100 per cent of respondents reported a demand for their services in the education authorities they covered and of those, 90 per cent said service provision needed to be significantly improved.

While there is undoubtedly a need o improve the way we deal with young people, most often boys, with communication difficulties before they arrive in a place like Polmont, we cannot forget that once there, they are still capable of amazing changes, given the right support.

Down on a mainstream wing, I meet Liam, who has completed a programme with Jan Green and now speaks brightly about a future that was non-existent before he got treatment for his communication problems. He speaks with a strong Edinburgh accent – enough to befuddle any American tourist who might ask him for directions – but is able to communicate his thoughts and opinions without more difficulty than any other teenager.

“I’ve got more confidence now. I used to get into arguments and fights because I couldn’t control myself in a conversation, and because I was paranoid about what people thought of how I spoke. I had a real attitude problem. I hated repeating myself when people would ask me to.

“But now, I’m going to work with my dad in his building business when I get out. I can communicate now. I’ve got people skills now. I don’t spend all my time trying to defend myself. When I meet new people, I’m confident. I’m looking forward to it.”

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