What is trauma?

Rhianna explores how trauma can affect communication skills.

“The physical trauma – or more precisely the memory of the trauma – acts like a foreign body which long after its entry must continue to be regarded as an agent that is still at work”. – Freud and Breuer

Trauma is a subjective experience which overwhelms a person’s ability to cope. It may involve an individual feeling as though there is a direct threat to their life, sanity, or safety. In an effort to survive, preserve a coherent sense of self, and process the traumatic experience, the brain seeks out various coping mechanisms.

The brain can make mistakes – and these coping mechanisms may leave enduring consequences on an individual’s ability to integrate their emotional experiences and process information. The shadow left by a traumatic event may affect how an individual presents, behaves, communicates, and relates to others.

Research into the understanding of trauma is developing. Increasingly, professionals and practitioners across many fields are shifting towards a trauma-based perspective when dealing with those who live with Post Traumatic Stress Disorder (PTSD). However, this has not always been the case. PTSD has only existed as a diagnosis since 1980. Prior to this, veterans and victims of abuse who were suffering, with what we now call PTSD, would be routinely misdiagnosed with a plethora of conditions, including alcoholism, substance abuse, depression, mood disorder, schizophrenia, or neuroses.

Whilst people diagnosed with PTSD may experience any of the aforementioned conditions (plus many, many more), trauma lies at the heart of the issue. The roots of trauma run deeply, the consequences and effects branch wide.

Fight, Flight, Freeze, Collapse

Our nervous system is ancient. Like all species, humans have evolved self-protective mechanisms to help us survive imminent danger. This system evolved to mobilise us away from very real threats such as, a predator, a landslide, or a fire. The complexity of modernity means, however, that the dangers we face are not always as concrete as they were historically. We may misinterpret safe situations, seeing danger where none exists. Before our rational brain can process and de-escalate the situation, our central nervous system has already sprinted into action.

Trauma survivors are often hypervigilant to danger. They may be far more likely to misinterpret situations, to feel like danger is imminent and inescapable, when in fact they are perfectly safe. Individuals with PTSD are effectively on hyperalert. Their fight or flight response has been hijacked, meaning that this chain reaction can be quickly triggered.

Once this chain reaction has been set off, the body is running on pure instinct. This is an extremely physical response. The amygdala (the stress centre of the brain) fires stress hormones called cortisol and adrenaline through the body. The pupils dilate, and we experience the phenomenon of tunnel vision. Blood flows to the major muscle groups such as the thighs, and arms, preparing us to run from or fight off an attack. The breath and pulse quicken, our blood pressure increases, and we are elevated to a heightened state of tension. The intensity of this physical response can have serious consequences for our ability to communicate, and we may struggle to articulate our feelings, to decipher meaning and to express ourselves coherently.

Courtroom environments can be extremely overwhelming, in particular for people with PTSD. The atmosphere is heightened and stressful, the pressure on the individual is intense, and the consequences are often life changing. Breaks from the court environment can interrupt the mounting anxiety trauma survivors may be feeling. Intermediaries can monitor the emotional presentation of service users and alert the court if it deteriorates. Taking some time and space away from the court environment can reset an individual’s anxiety levels and allow them to de-escalate their panic response.

The intermediary can assist further with this by implementing grounding exercises. These exercises may include guided deep breathing with a particular focus on the outbreath, as this stimulates an individual’s parasympathetic nervous system and slows their heart rate. The intermediary may also guide the service user through exercises to assist them to reconnect with their senses, for example, by asking them to name 5 things they can see, 4 things they can hear, 3 things they can feel, 2 things they can smell and 1 thing they can taste.

Feeling a sense of presence and connection with the earth can bring us back to the current moment, and the intermediary could invite the service user to feel the full weight of their body against the floor or chair. The path of the vagus nerve carries messages of panic through the throat, chest, and abdomen. Grounding exercises can help to direct an individual’s focus away from this system. Focusing attention on the hands, which lie outside of the path of the vagus nerve, can create physical sensations which can counterbalance the feeling of being out of control. The intermediary could introduce the use of fidget objects or offer the service user some paper so that they can draw, write, or shred. The intermediary may guide the service user through some gentle movement, such as tapping on the pressure points, or simple stretches. These exercises can help create space and movement in the mind, body and voice, which acts as an antidote to the frozen, paralysing fear we experience when living in a traumatic moment.

Speaking out and sitting down

As part of our instinctive panic response, a key area of our brain which is used for communication – known as the Broca’s area – completely shuts down. The Broca’s area is a key speech centre, and if this part of the brain stops functioning, you are effectively unable to articulate your feelings. This poses enormous challenges to individuals who are required to give evidence in court.

With an impaired Broca’s area, individuals in court will struggle to alert professionals when miscommunications occur. They may have difficulty recognising and advocating for breaks when they are needed. They may struggle to decipher meaning when presented with information which uses low frequency vocabulary (for example, the word, ‘instigated’ may be harder to process and understand than the word, ‘started’). They may also struggle to comprehend complex sentence structures, such as tag questions, or questions which contain multiple parts. Of course, all of these issues are only magnified if the individual already experiences barriers to their communication in their daily life. Any pre-existing communication difficulties will be exacerbated, at a time when effective communication could not be of greater importance.

When asked to give evidence in court, individuals who have PTSD may become so overwhelmed that they can barely speak. Their nervous system may be hijacked into a state of panic, rendering them unable to clearly articulate what happened to them. Their evidence may be fragmented, chaotic, confusing, or incoherent. Alternatively, they may try and recount the events of what happened to them in a way that prevents them from becoming triggered. This may result in their responses appearing evasive, minimal, or unreliable.

An integral part of the intermediary role is assessing the communicative ability of the individual service user and intervening to ensure that the questions asked of them in evidence are appropriate for their communication profile. At the assessment stage, the specific difficulties each service user faces will have been identified, and recommendations for effective communication will be set out in the intermediary report. However, the service user’s ability to process and understand language may fluctuate, and this will need to be constantly monitored by the intermediary. If a service user enters fight or flight mode, they may become far less able to process question types which ordinarily may not pose any issues.

The intermediary can alert the court’s attention to complex question types and offer suggestions for simplifications. Ensuring that language is kept extremely simple and that questions are short and easy to understand, will assist the service user to provide their best possible evidence to the court. If the evidence given by the service user lacks sufficient detail, the intermediary can also recommend the use of simple, follow up questions, such as, “Where did you go next?”, or, “What happened after that?”. If the service user is unable to understand or process verbally presented information, the intermediary can intervene and offer visual explanations, using simple visual aids. These strategies are not only effective when a service user is giving evidence, as the intermediary can continue to use visual aids and give verbal simplifications throughout proceedings to support comprehension.

Our nervous system is a powerful thing, and the intensity and regularity of the fight or flight response can have lasting consequences for how trauma survivors understand, process, and retain information. Over a prolonged period of time, constantly elevated stress hormones can have serious impacts on the memory of traumatised individuals and their ability to maintain concentration and attention.

The court environment was not designed with PTSD survivors in mind. In court, there is often large volumes of complex verbally presented information, which contains unfamiliar or court-specific language, such as ‘indictment’, or ‘threshold’. This can be extremely fatiguing for individuals with trauma-related communication difficulties to process. In addition to this, the court environment has an intensity which requires focused attention, and due to time pressures, breaks are not always factored in.

This is where intermediaries can assist individuals with PTSD to access and participate fairly in the justice system. Having a timetable or checklist of what is coming up within the court day can manage expectations and assist the service user to maintain their attention. Another key strategy which intermediaries may implement to support the retention and concentration of individuals with PTSD is enabling regular breaks. The intermediary can closely monitor the presentation of the service user, and if it is clear that the fight or flight response has overwhelmed their ability to participate fairly, then the intermediary can advocate for breaks and alert the court when they will be necessary. In these breaks, salient points from proceedings can be repeated and recapped to assist retention. Time should also be carved out within the break for the service user to have a complete rest from processing, which will then enable them to concentrate more effectively when they return.

Flashbacks

A common experience of trauma survivors is that of visceral flashbacks. These flashbacks are intense physiological experiences and do not operate in the same way that typical memory does. When an individual with PTSD is presented with images, sounds or thoughts which relate to a traumatic event, the amygdala lights up in alarm. Physiologically, their body reacts as though the traumatic event is ongoing, as though the danger is immediate and inescapable, even if their brain is simultaneously aware that there is no tangible risk of harm.

When a flashback occurs, the left hemisphere of the brain deactivates. This can have disastrous consequences for an individual’s ability to communicate coherently. Without the left side of the brain functioning, the individual may find themselves unable to name and compare things and understand how one thing relates to another. They may be unable to organize and sequence events, and whist being consumed with overwhelming emotions, individuals may have extreme word-finding difficulties. This can leave them feeling incapable of communicating their subjective experiences to others.

The court environment is rife with stimuli that could trigger a flashback or adverse reaction. When attending court, individuals may be required to publicly relive traumatic events. Some may be faced with seeing the perpetrator of their trauma. Individuals may undergo cross examination which may feel invasive, personal, or triggering. The subjects that are discussed in proceedings are often highly sensitive, and even if not directly related to their trauma, could nonetheless stir up distressing memories and feelings. In addition to this, the unique formality of the court environment, the stakes and pressure of the situation, as well as the anticipation and anxiety surrounding court attendance, could all act as further catalysts.

As intermediaries, we can implement various strategies to minimise the risk of an individual experiencing a flashback. If the service user is likely to be triggered by seeing a particular individual in a court setting, intermediaries can recommend the use of special measures, such as screens, to shield the service user from being visually confronted with the source of their trauma. If the court building itself could be a trigger, we could implement a familiarisation visit, to allow the service user to acclimatise to the environment in which the proceedings will be taking place. If this does not alleviate the service user’s anxiety, we could recommend that the service user attend remotely from another room in the court, or even a neutral building, such as a solicitor’s office.

Whilst attending court remotely certainly has its own complications, for some service users it can be a far less anxiety inducing experience and enable them to fully participate in their proceedings. Some individuals may find authority figures intimidating and could feel triggered by the hierarchical structure of the court environment. In some cases, a service user’s anxiety can be alleviated if certain court specific formalities and traditions are forgone. For example, it may be helpful to refer to traumatised individuals by their first name, or to allow them the opportunity to meet the advocates and judge prior to the court hearing. Some traumatised individuals may have a comforting object, or a person who provides emotional support who they may wish to accompany them to court. The presence of a reassuring object or individual in such an overwhelming environment may help to create a feeling of familiarity and safety.

Rapport and repair

Trauma is a rupture which can drastically alter how we view ourselves and interact with others. Those who have been traumatised may have great difficulty trusting new people. If their trauma was enabled by an abuse of power, they may find it particularly hard to engage with professionals and authority figures. It is for that reason that building a rapport is so fundamental to the intermediary role when working with trauma survivors. This rapport is the foundation on which all other assistance provided by intermediaries is layered. If the service user feels comfortable and relaxed working with the intermediary, they are more likely to express their lack of understanding or their need for a break. They may engage better with simplifications and explanations provided in court. In addition to this, there may be an increased likelihood of the intermediary being able to effectively assist with managing any emotional dysregulation.

Humans are innately social beings. When we feel under threat, we instinctually turn towards others to seek reassurance or call for help. If our distress is recognised and reassurance is given, this can go a long way to avoiding the stress response escalating to a fight, flight, freeze or collapse response. It may sound simple but acknowledging an individual’s emotions can be an extremely useful tool for de-escalation. Simple mirroring statements, such as, “I see you are very upset”, “I know what Mr X said made you very angry”, or “I understand that you feel very anxious about tomorrow”, carry a reassuring message: that the service user’s subjective experience is heard, understood, seen, and acknowledged. Having an intermediary in court can provide a soothing and steadying presence for those who suffer from PTSD. Whilst an intermediary is impartial, our purpose at court is specifically to assist the service user. For the service user, knowing that there is someone there who will be attentive to their communicative needs, and provide support when necessary, can be hugely beneficial in managing emotional dysregulation over the course of proceedings.

Trauma is complex and subjective. The ripples that it creates are far reaching and unique from individual to individual. With appropriate therapeutic intervention, traumatic experiences can be re-integrated and processed by the ever learning and adaptable brain. Left unresolved, however, trauma can permeate all aspects of how one interacts with the world. Individuals with PTSD who are required to attend court can feel as though they are being left exposed, vulnerable and at risk of re-traumatisation, if their experience is not adapted to meet their unique needs. Intermediary support can enable individuals who carry the complex scars of a traumatic past to participate fairly in a justice system which may often shine a light directly onto their wounds.

What we learned from Stress Awareness Month 2022

One of our Team Leaders, Rachel, reflects on what we have learned from sharing experiences and tips for managing stress.

The theme of this year’s Stress Awareness Month was ‘community’, which the Stress Management Society defines as more than just a group of people. It’s about having a sense of belonging and connection to others and feeling supported and accepted by them. This theme was chosen because a lack of support and lack of feeling of community can cause loneliness and isolation. This in turn lowers people’s wellbeing, impacts mental health, and can lead to mental illness. 

This month, some of our team members got together to reflect on stress awareness in more detail. We discussed what stress is, how it can affect the body, and aspects of the intermediary role that can contribute to feeling stressed. We shared our strategies and tips for dealing with stress and most importantly, how you create a keep a sense of community when you work on your own most days.

What we learned from Stress Awareness Month 2022

We approached the definition of stress using a visual aid, of course! The team found the bridge analogy to be handy when considering what stress is. When a bridge is carrying too much weight, it will eventually collapse. It is possible to see the warning signs before this happens, for example, the bridge would bow, buckle and creak, or you might see some cracks appear. When we apply this to ourselves, excessive demands and challenges placed on our bridges might create early warning signs. However, stress can creep up on some of us, resulting in an unexpected breakdown or health issues.

Image taken from Stress Management Society

When reflecting on how stress impacts us individually, one thing that stood out in our discussions was that no individual is affected in the same way – parts of our job that one person found stressful for example, didn’t impact on another so much.

We thought about how this can make it hard to give advice to someone who is experiencing stress, because what might work for us might not work for them. It also makes it hard to identify stress in others.

The Stress Management Society highlighted three categories of change that might occur in someone when they are feeling stressed:

  • Emotional, eg. moodiness, irritability, frustration, panic, anxiety, feeling overwhelmed etc
  • Physical, eg. chest pain, rapid heartbeat, aches and pains, frequent colds, skin complaints etc
  • Behavioural, eg. sleeping too little or too much, demotivated, isolating yourself etc

As a group, we decided how important it was to look out for these changes in ourselves and in others (friends, family and colleagues).

Community at Communicourt?

As intermediaries, we often spend a lot of time working alone. Even before the pandemic we were considered remote workers, travelling to courts and solicitors’ offices across the country without an office as a base. There are times when this can feel quite lonely, especially when you are on a particularly early or late train or are in a hotel away from home!

One of the main things we all took away from our group discussion is that we are never actually alone. We all share very similar experiences and stresses, and we all felt a level of comfort and connection in knowing that.

We reflected on whether we felt there was a sense of community in the workplace (despite us all living and working separately) and everybody agreed there was. We all believed that everybody does what they can to make others feel accepted, connected and like they belong, whether this was through informal Teams sessions, group chats, group challenges, team days, or just keeping in touch with our cohorts.

We also drew on the final aspect of the definition of community – feeling supported. We thought maintaining wellbeing lay more in the clear expectations we have of our roles and responsibilities. Having the opportunity to come together, if only virtually, for regular training and CPD sessions gives us an opportunity to share ideas and experiences. We have also been making a team effort to recognise and appreciate our colleagues more, and of course it is always lovely when we get appreciation from our service users.

Sharing some personal experiences of stress, and the strategies we used to overcome this, also gave us a feeling of being part of a community. We all left our group discussion knowing that it wasn’t ‘silly’ to feel stressed about something that could be perceived as being a small issue by others. We are feeling grateful for the opportunity to try a new strategy.

A big part of being an intermediary is about making recommendations for others, looking out for warning signs that might lead to emotional dysregulation, for example, and putting strategies in place to assist. Stress Awareness Month allowed us to focus on and consider ourselves, how stress may impact us and put some strategies in place for each other.

Our top tips for stress management:

  • Talking to each other or the wider team
  • Doing something creative in our spare time
  • Colouring
  • Exploring the different places we visit and stay in, e.g. taking a trip to an art gallery, museum or the zoo!
  • Going for a walk or having a change of scenery, especially when working at home or when in the middle of a long piece of written work
  • Laughing
  • Breathing exercises

Using receptive and expressive language

Effective communication requires a high level of language skills. When communicating with one another, people use a combination of both their receptive and expressive language. In this post, one of our intermediaries Miriam explores what these language skills are, and why many people don’t know the difference between the two.

Receptive language skills are important in communication as they allow you to have successful interactions with others. ‘Receptive’ refers to the understanding of language. These language skills are key to communication as they allow a reciprocal exchange to take place.

For example, if a person does not understand what is being said to them, they cannot give an appropriate response, which could lead to a breakdown in communication. Receptive language is more than just listening to someone. It can be described as the ‘input’ of the language. It is a person’s ability to comprehend spoken language that they hear or read.

If someone is asked to “pass me the salt”, this relies on their receptive language ability. Much of receptive language is inferring meaning from our experiences and environment. When children are developing, they are usually able to understand (receptively) more language than they can use (expressively). This is one reason why people’s receptive vocabularies are often larger than their expressive vocabularies.

Understanding is built on:

  • receptive vocabulary – understanding of words
  • receptive grammar – understanding meaning the grammatical structure of a sentence
  • non-verbal communication – this level includes understanding non-verbal communication and drawing inference from language. You can learn more about pragmatics in a recent Communicourt post on how difficulties with pragmatics can affect our service users. 

In this post, we’ll be focussing on the building blocks of receptive language, receptive vocabulary, and grammar, as well as taking a closer look at expressive language.

There are a number of people who struggle with their receptive language. This difficulty can be harder to spot, as it is often hidden and not as obvious as an expressive language difficulty. Many people learn to mask their receptive difficulties, often by ‘nodding along’ and agreeing, without indicating that they have not understood. These individuals may find it hard when:

  • following directions
  • understanding questions
  • understanding the meaning of words
  • making inferences
  • paying attention

Expressive language

On the other hand, expressive language is the ‘output’ of the language. This sort of language skill encapsulates a person’s ability to express their wants and needs through verbal or nonverbal communication. It is the ability to put thoughts into words and sentences in a way that makes grammatical sense and is understood by the listener.

Again, there are a number of people who struggle with their expressive language. These individuals may find the following hard:

  • using words in sentences
  • grammar
  • sentence structure
  • telling their side of the story

Receptive language in court

The courtroom environment poses a number of barriers for those with receptive language difficulties. Trials and hearings require individuals to demonstrate excellent attention skills, while rapidly processing information, comprehending different types of questioning and being able to listen to more than one person at a time.

Receptive vocabulary

Courtrooms are full of specialised vocabulary which is unfamiliar to the average person. Crawford and Bull (2006) conducted a study which investigated the understanding and misunderstanding of legal words by older children (aged between 12 and 15 years). This study looked at the understanding of 37 words typically used in court demonstrated by a group of school-going teenagers. Findings suggested that all participants identified difficulty with understanding even with words like ‘jury’, ‘defendant’, and ‘cross-examination’.

In another study, researchers were startled to discover that, when it came to key legal words and concepts, 17-year-olds were likely to be confused and mistaken, and only slightly more likely to understand than 13-year-olds – even after the words and concepts had been explained, and even among those who had previous juvenile court experience (Lavigne and Ryboreck, 2011).

Many of the individuals we work with have a limited receptive vocabulary. If someone finds it difficult to understand the words being used in court this will negatively impact their understanding of evidence, legal discussion and legal advice provided in meetings with their legal team.

Individuals without language difficulties are often able to recognise when they have misunderstood or do not understand legal language and therefore may ask their counsel to explain this further. However, individuals with language difficulties may find it hard to do this, especially in a courtroom where there is increased formality.

It is crucial to note that it is not just court vocabulary that individuals may struggle with. Someone with a receptive language difficulty may not understand words which we think everybody understands. For example, a lawyer once asked his client to indicate when he did not know the meaning of something. The client nodded. However, when the intermediary checked the client’s understanding of the word ‘indicate’, the client explained that they did not understand what this meant.

Receptive language

Being able to rapidly process and accurately retain syntax (the grammar of speech) is essential to understanding legal proceedings. Many people with receptive language difficulties process syntax incorrectly, resulting in poor understanding or misunderstanding. They may have difficulty holding words in mind in order to process and ‘decode’ them. Another common difficulty, for example, is switching reversible position words. For instance, switching the position of the names in the following sentence, dramatically alters its meaning:  “Cressida was screaming at James” vs “James was screaming at Cressida”.

People with receptive language difficulties may also have an impaired auditory working memory capacity. Someone’s auditory working memory capacity is the amount of information they can ‘hold on to’ whilst working out the meaning of the sentence. If a person is given too much information at once, this capacity gets overloaded. An example of overload would be when given directions, or a long list of things to buy at the shops. If a person has a low auditory working memory capacity, they will have difficulties following proceedings especially if the information presented is complex and delivered at a fast pace.

Much of the syntax used in a court setting is complex and formal. Legal professionals may speak rapidly, using multiple clauses and complex sentence structures. This can make it very challenging for an individual with a receptive language difficulty to process and retain verbal information accurately. Many people with receptive language difficulties will struggle to process verbally presented information. This difficulty is exacerbated if they are unable to understand the words which are being used in court (a reduced receptive vocabulary). Individuals may find it hard to retain key bits of information from what they hear in court and therefore may find it difficult to give instructions to their counsel in conference. 

Receptive language difficulties affect individuals with a range of diagnoses including Developmental Language Disorder (DLD), Cognitive Communication Disorder (CCD – often following a brain injury), autism, aphasia (often following a stroke) and learning disabilities.

What is DLD?

DLD is a type of speech, language and communication need which affects the way children understand and use language. People with DLD may struggle to interpret sentence structure and therefore receive message of the sentence inaccurately. In some cases, processing words in the incorrect order could alter the meaning of the information. For example, “I had my dog walked” has a different meaning to, “I had walked my dog”. Therefore, in court, this will have an effect on a service user’s overall understanding of the language being presented to them.

Giving evidence

Strong receptive and expressive language skills are required at all stages of legal proceedings. A service user’s evidence, however, can be one of the most demanding aspects upon their receptive and expressive language. When somebody is giving evidence, it is crucial that they are able to understand the question that is being put to them in order for them to have a fair chance of putting their side of the story across. However, the types of questions which get asked in a courtroom setting are often complicated in structure and content and can lead to people with receptive difficulties becoming confused or answering without a full understanding of the question.

Some examples of question structures which someone with a receptive language difficulty may struggle with include:

  • Questions preceded by preamble

When a barrister asks a question, it often contains preamble and information which is redundant. If someone has difficulties with their auditory working memory, they are likely to struggle with questions which are unnecessarily long. For example, Questions that start with “I suggest to you that… I believe you told us that… Isn’t it a fact that…” are complex sentence structures and likely to be problematic.

  • Interrogative statements

A typical cross examination approach is to put a case using interrogative statements, for example, “You knew he would be at the pub that night?”. This question type expresses a question as a statement and invites agreement.

Some individuals with receptive language difficulties will not always recognise that a response is required from a statement. Some individuals are particularly suggestible and therefore may agree with a statement. For example, ‘It was raining’ would be better rephrased as, ‘Was it raining?’

  • Questions containing negatives

People with receptive language difficulties sometimes find questions containing negatives hard to process. These questions can end up being less reliable for getting accurate information. For example, “Didn’t he go with you?”, “I do not doubt that…” , can be rephrased as, “Did he go with you?.

  • Questions containing tags.

An example of a tag question is, ‘It’s raining, isn’t it?’. These questions are linguistically complex and can be very difficult for people with receptive language difficulties. This question could be rephrased as, ‘Is it raining?’.

  • Questions containing multiple parts.

Questions which are asked in court can often be very long. This poses a significant difficulty for those people with receptive language difficulties who have difficulties with their auditory working memory. For example, I worked with someone who was asked, “Did you go to the shops with Annie and then go to the cinema?”. The individual answered “No”. However, when this question was broken down to say, “Did you go the shops with Annie?”, he replied “Yes”. When he was then asked, “Did you then go to the cinema?”, he replied, “No”.

This person had been unable to hold all of the information in their head and therefore only answered one part of the question. They also required it to be broken down into separate questions before being able to answer this question correctly.

Expressive language in court

When someone goes to court, they are required to use their expressive language skills to give instructions to those representing them and to tell their side of the story when they are giving evidence. Within court proceedings, an individual is expected to be able to clearly communicate under significant pressure and answer questions in a way that also requires them to remember legal advice.

A study by Lavigne and Ryboreck (2011), conducted on criminal proceedings, found that language deficits limit a person’s ability to:

  • provide their lawyer with vital background information and factual information about the case.
  • convey important details.
  • construct a narrative.

These expressive language difficulties can interfere with a lawyer’s ability to understand their client’s defence and any potential mitigating factors they need to put forward on their behalf. An American Judge called Judge Jack Weinstein recently said: “effective assistance of counsel is impossible unless the client can provide his or her lawyer with intelligible and informed input”.

Individuals may not possess the necessary vocabulary needed to express themselves. Individuals may feel the pressure of being in a formal environment and feel the need to speak ‘proper’. For example, using words and syntactic constructions which they are much less familiar with. This could result in them using vocabulary which they do not fully understand the meaning of and therefore could have a detrimental effect on their evidence. A person I worked with was once asked to describe his state of mind at the time of the crime he was being accused of committing. He stated, “I felt on edge”. When cross examined further, he was unable to provide more of an insight into his thoughts and feelings at the time of the crime because he did not possess the expressive vocabulary to do so.

Some individuals may find it very difficult to stay focussed when they are asked questions. Sometimes their answers may become very tangential, verbose, and lengthy. They may have specific topics that they want to talk about and therefore may find it difficult to answer the specific question. Conversely, some individuals may struggle to give detailed responses and instead provide one-word answers to questions. In both of these instances, listeners may have difficulty gaining the relevant information needed.

Narrative discourse refers to the ability to structure information units so that the story is told to a listener in a logical way. Being able to give a narrative is of significant importance in a courtroom setting as it means a person is able to tell their side of the story. It is closely connected to many cognitive and linguistic skills (Paul et al., 1996) and therefore, narrative competence is strongly associated with language competence. Research has found that people with speech language and communication needs frequently lack the ability to provide narrative information in a logical and sequential manner (Humber & Snow, 2001) and in a way that meets the needs of the listener (Snow and Powell 2005).

Another challenge people with expressive vocabulary difficulties may experience is with word retrieval, also known as a ‘word finding’ difficulty. This difficulty occurs when a person knows and understands a particular word but has difficulty retrieving it and using it in their utterance. It is similar to when we feel that a word (for example someone’s name) is on the tip of our tongue. These difficulties can cause significant challenges for someone when they are giving instructions. Word finding difficulties can typically be found in individuals who have aphasia. This diagnosis results from damage or injury to the language parts of the brain (e.g., stroke). However, it is important to note that word finding difficulties are not restricted to just those who have had significant brain damage.

How can we help?

Receptive language

If somebody struggles to understand figurative language, they may have difficulties with a phrase like, ‘in a nutshell’. This breakdown in communication can be avoided by using clear  language and avoiding figurative language where possible.

It is really important to be aware of the vocabulary used within a courtroom setting. Providing simplified explanations of unfamiliar legal or court-specific vocabulary and using simple and everyday words eg, ‘live’ instead of ‘reside’ will help to ensure someone is able to effectively engage in their proceedings. Visual aids can be used alongside these explanations to support someone’s understanding.

For those who struggle with retention and memory, keep your sentences short and imagine you are speaking in bullet points. Breaking down larger volumes of verbally presented information into smaller ‘chunks’ may help assist someone with receptive language difficulties as it reduces the volume of information that they need to process and retain at any one time. Conferences at the start of the day, as well as during proceedings, are a very good way of ensuring that a person is able to understand what is going on. They can also be used to recap key information heard in court.

It is crucial to monitor a person’s understanding of questions throughout proceedings, to ensure that they are following discussions and able to engage effectively within their trial/hearing. To help someone to process each part of what you are saying, speak slowly and allow the individual plenty of time so they are not rushed.

Expressive language

If a person says something unclear, clarify this information by repeating back your understanding of what they said to avoid misunderstandings. 

If a person presents with word finding difficulties, allow them extra time to form their responses, without interruption and encourage them to take their time. The intermediary can create a visual aid which may assist with these difficulties. For example, I once worked with a service user who had significant word finding difficulties. During a conference beforehand, we created a simple spider diagram (See below). The service user was able to take into court with her and use during conferences. This spider diagram had a space in the middle to represent the target word and lots of different questions round the side which would help prompt her to retrieve the word that she was trying to say.

Visual aids can also be used to help support someone’s ability to form a clear narrative. For example, writing down the current topic of discussion may help an individual to stay and topic and avoid becoming tangential. I once worked with an individual who found it very difficult to stay focussed. A helpful strategy I used with her was to use a clear visual prompt (eg, holding up a hand) and to remind her of the topic under discussion.

When individuals have difficulties adding details to their answers, it can sometimes be helpful to use simple WH prompt question (Where, What, Why) to support them in telling their side of the story.

I often ask people to clarify the meaning of a word that they have used if it appears inappropriate or out of context, to ensure that they understand what it means.

Keeping a clear chronology when asking questions as this will help assist people to provide an account in a logical and coherent way.

Putting the pieces together

Difficulties with language (receptive and expressive) eg, vocab and syntax, are only one piece of the puzzle and many other factors such as pragmatics, social communication, speech, and attention all come into play.

Receptive and expressive language are different. Competence in one should not be assumed because someone has competence in another. People with many different difficulties can have either expressive or receptive language. One particular way that people with these difficulties can be assisted, is through the appointment of an intermediary for their court proceedings, who can explore the specific difficulties they have and make recommendations to assist both the individual and the court to communicate with each other.  

References

Crawford E, & Bull R. 2006. Teenagers’ difficulties with key words regarding the criminal court process, Psychology, Crime & Law, 12:6, 653-667, DOI: 10.1080/10236190500489970

LaVigne M, & Van Rybroek GJ. 2011. Breakdown in the language zone: The prevalence of language impairments among juvenile and adult offenders and why it matters. UC Davis Journal of Juvenile Law & Policy 15(1):37–124. [Google Scholar]

Paul R, Hernandez R, Taylor L, Johnson Narrative development in late talkers: Early school age. Journal of Speech and Hearing Research. 1996;39:1295–1303. [PubMed] [Google Scholar]

Humber E & Snow P.C. 2001. The oral language skills of young offenders: A pilot investigation, Psychiatry, Psychology and Law, 8:1, 1-11, DOI: 10.1080/13218710109524999

Snow, P. C., & Powell, M. B. (2005). What’s the story? An exploration of narrative language abilities in male juvenile offenders. Psychology, Crime & Law, 11(3), 239–253. https://doi.org/10.1080/1068316042000209323

The changing role of an intermediary: criminal court vs family court

Intermediaries have to adapt their practice to accommodate the environment they are working in. Holly talks about the changing role of an intermediary.

The legal landscape has changed considerably over the past ten years, and the role of the intermediary has evolved since Communicourt was founded in 2011. Criminal courts are increasingly electing to assign intermediaries to support service users only during their oral evidence, while family courts make ever-greater use of intermediaries throughout proceedings.

In 2016, 81% of Communicourt referrals were related to criminal cases, and just 19% related to family proceedings. In August 2021, family proceedings accounted for 54% of our referrals, with 43% coming from criminal cases and 2% from other types of proceedings (e.g. medical tribunals and deportation hearings).

In every setting, the skills and strategies which intermediaries employ to improve communication and understanding are largely universal. Yet, in criminal and family courts, our practice must adapt to accommodate the very different legal arenas.

The early stages

In many criminal cases, a Ground Rules Hearing on the first day of a trial is the first time an intermediary will be assigned. In contrast, family cases more often have intermediaries allocated for a number of Case Management and Issues Resolutions Hearings prior to a Fact Find or Final Hearing.

Criminal court

Following assessment, our first interaction with a defendant and their case is at a Ground Rules Hearing. In Youth and Magistrates courts, a Ground Rules Hearing is typically rolled into the first day of trial and it is usually the case that the intermediary will be granted to assist during proceedings (often because the defendant is a child, or because the trial is due to take place over the course of that one day, for which the intermediary has already been booked).

In criminal proceedings, an intermediary is often granted on the first day of trial or booked to assist from the first day of a defendant’s evidence. With such limited time, the intermediary assigned will need to rapidly build rapport with the defendant and establish effective communication strategies, drawing on the contents of the intermediary report. At this stage there may be a number of barriers to contend with, including time constraints, limited access to the cells (depending on the court), limited conference rooms and higher levels of emotional dysregulation in the defendant (who may be facing their first day of trial).

In exceptional circumstances, an intermediary may be approved to attend conferences with the defendant prior to trial. These rare pre-trial conferences are often invaluable in terms of assisting communication. Here, intermediaries can start to build a working relationship with the defendant (away from the immediate stresses of a courtroom), assess their communication skills in an organic environment (rather than a supportive assessment environment), dynamically assess their response to intermediary strategies and collect crucial information to inform intermediary practice during the trial itself.

Family court

While the first hearing we attend in a criminal case is often the first day of trial, the first post-assessment appointment we attend in a family case is less predictable.

Often, we first meet respondents or intervenors at a Case Management Hearing (CMH) or Issues Resolution Hearing (IRH). In other cases, our first interaction with a respondent may be at a conference at a solicitor’s office.

Conferences may have been arranged to assist a service user to give instructions, to prepare a statement or to read through documents ahead of proceedings.

These preliminary hearings and conferences allow us to gain a better sense of the service user’s communication skills and difficulties, prior to a Fact Find or Final Hearing. This is in marked contrast to criminal proceedings, in which intermediaries typically must ‘hit the ground running‘, absorbing key case information, rapidly building rapport and swiftly identifying communication needs and effective strategies (albeit with the assistance of the intermediary report).

We take detailed case notes, adding to the understanding of the person’s communication needs and honing the strategies implemented for them. Meeting people in early conferences and hearings often allows intermediaries to build more effective rapport and trust, prior to any more significant hearings in the case. While the intermediary who attends conferences may not be the intermediary assigned to hearings, a wealth of helpful information can be gathered and shared during handovers, to maximise effective working with the individual. Although even short CMHs can be emotionally difficult for someone, at this stage in proceedings people are often more relaxed, allowing communication strategies to be explored more freely and helping the individual become more comfortable with receiving intermediary assistance.

COVID-19 has had a more marked effect on our early interactions with service users in family cases, than service users in criminal proceedings. In the majority of cases, early CMHs and IRHs are now held remotely. This impacts how intermediaries meet service users for the first time and affects our practice in the remote courtroom. The remote setting poses a particular barrier to rapport building, while also requiring the intermediary to liaise with the service user to establish a method of communication during the hearing (and any pre- or post-hearing conferences with counsel).

The Ground Rules Hearing

The experience of delivering a Ground Rules Hearing in family court is typically quite different to a Ground Rules Hearing in a criminal trial. While an intermediary may be questioned very closely regarding the necessity for intermediary allocation in a criminal trial, this is rarely the case in family proceedings. Similarly, questions regarding the intermediary’s qualifications and the necessity of specific measures are less common. While advocates and judges may still query the need for ‘meatier’ measures such as questions in advance at a family Ground Rules Hearing, the process generally feels more collaborative than adversarial.

Criminal

In Crown Court trials, the Ground Rules Hearing may take place at a separate hearing, prior to the trial. These hearings often include an application for the defendant to be assisted by an intermediary during the proceedings, whether that’s for the duration of trial or during their evidence. At this juncture, the intermediary is typically asked questions about the findings and recommendations of the report, to assist the judge in making a decision regarding intermediary provision.

If an intermediary is approved by the judge, they will often be required to outline the full recommendations of the report and request the adaptations to proceedings which were suggested by the assessor.

In Youth and Magistrate trials, the Ground Rules Hearing is more likely to be rolled into the first day of proceedings.

Family

Ground Rules Hearings in family proceedings are often less formal and more flexible than those held as part of criminal proceedings. As intermediaries often attend hearings prior to a Final Hearing of Fact Find, Ground Rules may be ‘sprinkled’ throughout early hearings, with intermediaries raising suggested recommendations as required. Some Ground Rules may need to be agreed early in proceedings (e.g. the frequency of breaks), while others may not become pressing until a Final Hearing (those regarding question style during a respondent’s evidence, for example).

In some cases, Ground Rules may already have been lifted from the intermediary report, agreed by advocates and written into the order. In other cases, an intermediary may provide a list of suggested Ground Rules for advocates to review and discuss in hearings, as necessary. On the first day of a Fact Find or Final Hearing, an intermediary may still be asked to deliver a more conventional Ground Rules Hearing. In fact, this is often a helpful step, particularly given the likelihood of changes in advocates and judge, as a hearing progresses. A dedicated Ground Rules Hearing at the start of a longer hearing ensures all parties are on the same page about measures and strategies to assist a respondent.

In the courtroom

During trials and hearings, our role becomes almost wholly focussed on the service user. For this reason, there are fewer differences between the intermediary role in criminal and family courts at this stage. This stage in proceedings is the intermediary’s ‘bread and butter’; where we use strategies from visual aids and live simplification, to comprehension checking and anxiety rating scales, in order to assist people with a very wide range of communication difficulties.

During a person’s evidence too, our roles differ little in family and criminal courts (despite the more formal atmosphere of a criminal courtroom). Here we must intervene when questions are likely to be confusing or overly complex for someone, monitor their attention, monitor their emotional management and make recommendations to the court (where appropriate) to assist them to give their best evidence.

If you’d like to learn more about the strategies an intermediary uses during proceedings with a service user, these recent posts offer some excellent insights:

Perhaps the biggest difference between criminal and family proceedings at this stage, however, is closely connected to COVID-19 and the increase in remote Fact Finds and Final Hearings.

While criminal trials are almost exclusively conducted in person, family hearings are now often held remotely or in a hybrid manner. COVID-19 forced the courts to become more agile regarding technology, which means that the majority of Case Management Hearings and Issues Resolution Hearings are now held remotely. Although courts are now increasingly encouraged to return to in person Fact Finds and Final Hearings, the recent learning curve around remote hearings allows courts to be more flexible regarding the format of hearings.

For some service users, in person hearings are essential to improving participation. In person, a service user can access live simplification (among other strategies) from an intermediary and direct communication with their legal team, sitting with them in the courtroom and conferences. In this setting, judges and advocates are better placed to monitor a service user’s presentation, while intermediaries can more easily intervene and communicate with other court professionals.

For people with mental health difficulties and difficulties surrounding emotional management, however, attending a physical courtroom can result in elevated anxiety, which often has a detrimental impact upon communication skills. In the latter scenario, the option of remote attendance can in fact benefit participation. Permitting service users to attend court remotely from a neutral location (such as a solicitor’s office) with the on-site assistance of an intermediary, allows them to receive direct intermediary support without the increased anxiety of court attendance.

In rare cases, intermediaries must work remotely from service users throughout a Fact Find or Final Hearing. This is perhaps the most challenging arrangement in terms of implementing intermediary strategies. Ideally, intermediaries will have a direct line of communication with the service user via a separate CVP interpreter room (which comes with its own limitations), an open phone line or a messaging app. Some of these methods are more useful than others, but all limit an intermediary’s ability to monitor a respondent’s attention, emotional regulation and understanding. In this environment, other key intermediary strategies including whispered simplifications, simple notes and visual aids during proceedings is often not possible. More frequent breaks and conferences are, therefore, essential.

Conclusion

The biggest differences between the intermediary roles in family and criminal proceedings relate to the practical considerations of each setting, the conventions of these different legal landscapes and their differing rules. The increased formality and (often) greater rigidity of a criminal courtroom often means intermediaries have less flexibility in terms of the strategies they can implement. In family settings, greater contact with the service user over a number of hearings often allows intermediaries to hone communication strategies to a greater extent.

The move to virtual hearings in the wake of COVID-19, however, has made a difference to how intermediaries operate in family and criminal settings, with remote working still prevalent in the early stages of family cases.

Overall, once the differing conventions and atmosphere of family and criminal courts are accounted for, an intermediary’s role and strategies remain the same – focussing wholly on measures which improve a person’s understanding of their hearing or trial, and assisting them to give their best evidence.

Logo for HM Courts and Tribunals Service

Communicourt selected as Managed and Approved supplier for new HMCTS Appointed Intermediary Service framework

Communicourt has been selected as a Managed and Approved Service Provider for the new HMCTS Appointed Intermediary Service framework.

The new service framework will standardise support for vulnerable court and tribunal users, by providing clear guidance, standard booking processes and will set prices to ensure fairness and quality of service. The service will start in April 2022.

Julie Parkin, Senior Head of Intelligent Client Capability at HMCTS said,

“HMCTS’ Appointed Intermediary Service will provide users who have specialist communication needs the professional support to participate in proceedings. These contracts ensure there is a consistent service and access to justice for all.”

Legal representatives and HMCTS staff will be able to select an intermediary from an approved list of suppliers.

There are two types of suppliers – Managed and Approved Service Providers (MASP) are larger providers who manage the service on behalf of HMCTS nationally; and Approved service providers (ASP) who are usually small companies or self-employed individuals.

William Scrimshire, Managing Director at Communicourt said,

“We are delighted to be selected as a Managed and Approved Service Provider for the HMCTS Appointed Intermediary Services. We have always strongly supported more regulation in this area and welcome the opportunity to be part of this new scheme. We are committed to delivering a high-quality and consistent service.”

Further guidance and information about the Appointed Intermediary Service will be available on GOV.UK in April 2022. Find out more

Communicourt signs Mental Health at Work Commitment

Communicourt has signed up to the Mental Health at Work Commitment, curated by Mind and supported by The Royal Foundation and Heads Together.

In the UK last year, 41% of employees experienced poor mental health where work was a contributing factor (BITC and Bupa, 2020).

The Commitment demonstrates mental health and wellbeing is a priority for Communicourt. We have already introduced a number of employee benefits including a free, confidential counselling service and GP access.

Operations Manager Heather Jackson is also the Wellbeing Ambassador for Communicourt. She said: “The events of last two years have taken their toll on everyone. I am really excited to take up the role of Wellbeing Ambassador for the organisation, and we are training some of our staff to become mental health first aiders.”

“The Mental Health at Work initiative is so important and we didn’t hesitate to sign up. We challenge mental health stigma through the services we provide, and we want to make sure we are doing all we can for our colleagues as well. We are encouraging open conversations, encouraging and responding to feedback, and working hard to make sure we get our working conditions and work/life balance right for our colleagues.”

You can find out more about the Mental Health at Work Commitment here.

The stigma of a stammer

Miriam tells us about her experience of developing a psychogenic stammer.

I woke up one Friday morning and quickly looked at my clock, realising I was running late. As I jumped up quickly, I felt a really intense pain pierce through my shoulder. I was quite taken aback and fell straight back down onto the bed.

As I rang my company to tell them I wouldn’t be able to work, I was incredibly confused to realise that I couldn’t get my words out. I assumed this was because of the pain I was in (caused by my shoulder). I thought to myself ‘I’ll just have a rest and hopefully the medication from the GP will sort out my pain’. However, as the day progressed, I realised perhaps the shoulder pain and speech difficulties were unrelated. My stammer got worse and at points I wasn’t able to get any words out at all.

After following the advice of 111, I ended up in A and E being checked over by a neurologist. We had a bit of a laugh about how ironic it was that I was a Speech and Language Therapist and that I was in hospital because of a stammer. As I had anticipated, the doctor ruled out my stammer being caused by a stroke and told me that his suspicion was that I was experiencing a psychogenic stammer. A psychogenic stammer typically results from emotional trauma or even emotional stress. The doctor told me not to worry and that it would probably go away in the next couple of days.

Feeling relieved, I walked out of A and E, flagged down my friends and proceeded to explain what the doctor had said with significant difficulty (because of the stammer). My friends were understandably confused by what was going on and how dramatically my speech had changed. They were perplexed at how suddenly it had come on. I assured them it was nothing to worry about.

The next month saw me signed off work by the GP. I kept thinking how ironic it was that my job is to help people with their communication in court and here I was unable to work and struggling to express myself without stammering. I quite hilariously and incredibly fortunately ended up having Speech and Language Therapy from my old lecturer from university. And this whole slightly bizarre, terrifying, and confusing ordeal was all put down to stress. And therein lies the mystery that is psychogenic stammers and how they come about.

What is a stammer?

The first question friends asked me was, “What is the difference between a stammer and a stutter?”.

Stammering and stuttering both mean the same thing, with stammering being the preferred term in the UK and stuttering being more commonly used in America. Stammering is a neuro-developmental issue that typically first emerges between 2 and a half to 3 years of age. Within the UK adult population, the ratio of men-women that stammer is around 4:5, affecting approximately 1% of adults.

There are two types of stammers: developmental stammers, or the type I was experiencing, acquired stammers.

The most common stammers are developmental which occur in early childhood. However, stammers can also develop later in life when someone has never stammered before as a child.

Causes of a stammer

Developmental stammering can be genetic or due to subtle differences in the brain structure or the way the brain processes speech signals.

It can also be caused by speech motor skills problems, where someone with a stammer tends to be slightly slower at making the movements involved in speaking, for example, getting the voice started in the larynx or moving from one speech sound to another.

Acquired stammering can be caused by a head injury, stroke, or a progressive neurological issues. It can also be caused by drugs, medicines or because of extreme distress or psychological trauma.

Situational or environmental factors can also impact stammering. For example, people may stammer more in situations where there is more time pressure or when talking to large groups of people.

Some, but not all, adults who stammer experience elevated levels of anxiety in situations where they feel they will be judged by how fluently they can speak.

How stammering may present

People who stammer may:

  • Repeat how words e.g., ‘but, but, but I went…”
  • Repeat a single sound or syllable e.g., m-m-m-manage”.
  • Prolong or stretch sounds e.g., ‘ssssometimes’.
  • Look as though they are tensing up.
  • Try and physically push the word out by making other movements (tapping finger, stamping etc).

Impact of having a stammer in court

My world felt like it had changed dramatically over night. I am naturally a very fast talker, with lots of opinions and plenty to say and share. Suddenly I felt a huge amount of stress and frustration every time I wanted to say something. I noticed how I wouldn’t want to tell a joke with friends because it took too long to get to the punchline and I would have bored myself in the process.

I noticed how I would flip between being frustrated when people would finish my sentences, and being disheartened when they wouldn’t just understand what I was trying to say. But the biggest impact for me was not being able to go back to work.

As an intermediary, part of our role is to stand up in court and address the judge about the recommendations we are making to support someone to participate within their proceedings. Whilst I am naturally very chatty and confident in most areas of life, public speaking is something I hate. All eyes on you, silence in the room, the very overwhelming sense that you aren’t coming across as articulate as you sound in your head.

Whilst I had my time off work to recover, a fear loomed in my head: how on earth am I going to be able to get back to court and speak with a stammer? How am I going to be taken seriously when I can’t even get my words out?

For many of the people we support, their first time in a courtroom will be when they are attending their trial (in criminal cases) or proceedings (in family cases). They will understandably be feeling overwhelmed, entering an incredibly alien environment, with wigs and gowns, posh barristers, words that don’t make sense, not being able to speak out if they disagree with something someone is saying. And then the terrifying ordeal of giving evidence from the witness box; being cross examined for hours on end by lawyers who seem ten times more intelligent and skilled than your average person.

I was suddenly more aware than ever before that the stress of the courtroom will only magnify a person’s stammer and communication difficulties. I realised that the stress I felt even speaking to my friends, who know me well, are patient and were in no way judging me, was nothing in comparison to the stress of trying to give you side of the story in incredibly intimidating environment when the stakes are so high. And with stammers, it is a vicious cycle. The more stress you are experiencing, the worse your stammer seems to get: a frustration which is quite hard to articulate to someone who has not experienced it for themselves.

How intermediaries can help in court

As intermediaries, there are a number of strategies and recommendations that we can make to the court to ensure someone is able to give their best evidence.

Strategies to help with expressing themselves:

  • The most important recommendation we can make for someone with a stammer is to allow them plenty of time to speak and respond to the question. It is incredibly important not to rush them, or assume they have nothing to say if there is a prolonged pause.
  • The advocate asking the questions should remain calm and not react if a someone gets stuck on a word.
  • Alternative strategies could include providing a person with a notebook to write down the word with which they are struggling.
  • Intermediaries can intervene if they think the person has been cut off before they have been able to express themselves.
  • The intermediary can recommend that advocates pool their questions together, so as to avoid repetition of questions and minimise the time the person has to give evidence for.

Strategies to reduce stress:

  • One of the main things which can exacerbate a stammer is stress. Therefore, it is crucial to ensure the environment in which someone is giving their evidence is as comfortable as possible.
  • The intermediary can recommend the use of screens or the use of a video-link when a person gives their evidence.
  • Before giving evidence, the intermediary can ask the court to allow the person have a familiarisation visit to the witness box and a chance to answer neutral questions, so they get used to what it feels like to speak in court.
  • When someone is giving evidence, it will be of even greater importance for them to have regular breaks due to the increased cognitive demands.
  • Allowing them to have a family member/ friend in the courtroom while they give evidence may also help to reduce their stress.

The Michael Palin Centre (https://michaelpalincentreforstammering.org/) is an organisation which helps individuals who stammer from all around the world. A recent report from them stated seeing a significant increase in referrals to them over the past 18 months. They attribute the increase in referrals partly to the increased anxiety and the impact of talking on online platforms, which can put people who stammer on the spot. Between April 2020 and March 2021, the helpline received more than 2200 calls, more than double the amount in the previous year.

I was incredibly fortunate. The month off work combined with the Speech Therapy I received seemed to work. I have been back working for almost 3 months now, completely stammer free. My stammer disappeared one day, as quickly as it came on. But not everyone is as fortunate as I am and some people have to deal with challenges and stigma which comes with experiencing dysfluency difficulties long term.

Working with child witnesses, from assessment to evidence

Our intermediaries Jess, Sekai and Rachel talk about how we work with child witnesses

One of the most important ways evidence is presented at a trial or hearing is through a witness giving evidence. But how does the court ensure best evidence is given when a witness is a child under the age of 18?

This post aims to give you an insight into how intermediaries can implement measures and strategies to assist a young and vulnerable person to give evidence in court. We will discuss our role, as well as the relevant law and special measures that are available to a child witness and give a snapshot of our work with a child witness, from assessment to evidence.

Intermediary assessment of child witnesses

Firstly, how do we assess a child witness? The structure of an intermediary assessment is usually semi-formal, including tasks and set questions to gain a detailed understanding of that person’s communication profile.

In order to apply this to a child witness, all formality goes out the window. Building a rapport with a child may take much longer and is likely to be more difficult than an adult. Therefore, we must put in place strategies to promote rapport building from the very beginning, for example, wearing casual clothes and leaving ‘court attire’ at home.

We may play question games or use our surroundings to adapt the more formal assessment tasks to a child friendly format. Visual aids, colours and activities are all used to engage the child in the assessment and assess their communication skills without the formal environment.

One example could be using the simple game of ‘Simon Says’ to gain an insight into a child’s auditory working memory. Auditory working memory capacity relates to the number of key words we can hold in our minds at once, allowing us to accurately interpret and retain verbal information. The average adult is able to recall 6-8 key words. In children, auditory working memory capacity develops slowly, which can make it challenging for young people to ‘take in’ verbal information and fully understand long questions in a court setting.

Assisting a child witness in court

One of the most important stages in proceedings for an intermediary assisting a child witness at court is the Ground Rules Hearing. This is a short hearing which should involve the trial advocates and judge, as well as the intermediary.

At this juncture, the intermediary can answer any questions the court may have about the findings or recommendations of the intermediary report and discuss possible measures to assist the child witness. After discussion, the judge will then set the ground rules for the proceedings, stating what special measures may be used and what steps advocates must take when questioning the witness.

There are many strategies that we can implement to assist a child witness in court, which may be agreed at a Ground Rules Hearing for use during proceedings. This may include familiarisation visits to the court, ensuring the child witness has a comfortable environment in which to wait to be called to give their evidence, or assisting advocates in simplifying and rephrasing questions in advance of the child witness giving their evidence.

Child witnesses may also be permitted by the court to give their evidence via alternative means, including in a pre-recorded video session. This approach is explored in Rachel’s first-hand account of working with a child witness and the strategies she implemented to assist them to give their best evidence.

Assisting a child witness: Rachel’s experience

Part of being an intermediary means we get to assess and work with a wide range of people with a wide range of difficulties, and we get used to coming across lots of new situations and needs. When I was given the task of assessing a child witness in preparation for her evidence as part of a fact-finding hearing, I was nervous!

I wasn’t sure how Stacey* would react to being assessed and I wasn’t even sure I knew how to talk to or engage a young person. As always, I was supported by my colleagues and found ways to adapt my assessment so that Stacey was comfortable and happy to participate throughout.

The intermediary assessment

When I assessed Stacey, it was clear she had some communicative strengths, but because of her age and some anxieties around giving evidence in front of her parents at court, I recommended an intermediary to support her. The main recommendations in the report focussed on the wording of the questions she would be asked, making sure she had a familiarisation visit to the court and that she was allowed to give her evidence over a video link.

Preparations at court

Something else that is really important for young people is consistency. I was fortunate enough to be able to assess Stacey, accompany her to her familiarisation visit and then return to court a week later to assist with her evidence. This meant that by the time she came to give her evidence, she was comfortable with me, we had built a rapport and I had an even better understanding of her communication profile.

At the familiarisation visit, Stacey was taken to the vulnerable witness suite and shown all the facilities she had access to by the usher. It made me realise how even small things, like where Stacey would go to the toilet, could cause anxiety in a young person, and how important it was to take the time to go through these things beforehand.

When she was ready, Stacey was shown the video-link room where she would be giving her evidence from a week later. We spent as much time as she needed in here, deciding on seating arrangements and the positioning of the camera. She was shown exactly how she would see the court room, and how they would see her, so that when she gave evidence the next time she attended, nothing was a surprise to her.

Familiarisation

Stacey did not realise that everyone in court would be able to see her, so when it was explained in this way, with the visual context to help her, she was able to express that she did not want one of the parties to see her. I was able to take her thoughts on board and inform the court at the Ground Rules Hearing.

It was agreed that screens would be placed around the monitor in court so that Stacey could be heard but not seen by the relevant party in court. If we had not had the familiarisation visit and chance to talk Stacey through how a video-link worked, she may not have realised this until she came to give evidence and it could have increased her anxiety to levels that were detrimental to her communication.

The role of an intermediary is to facilitate communication. Stacey was supported at the familiarisation visit by another adult – her support worker – who could ensure she was ok and support her emotionally, and I was there to ensure she understood how the process would work and that she was making fully informed decisions. As a team, this worked really well and we were both satisfied that Stacey was happy with the format and arrangement.

Another part of preparing a child witness to give evidence includes them watching their ABE interview. In Stacey’s case, we did this at the familiarisation visit. This presented a tricky part of the intermediary role, as while it was important to sure she was following her interview, it was essential to remain impartial and not to do anything that might seem like I was emphasising one part of her evidence over the other.

Instead, I monitored Stacey’s concentration and emotional management while she was watching the video of her interview and offered to pause it when it looked like she might need a break. Stacey accepted an offer of a break and went outside with her support worker for some fresh air. On her return, she was refreshed and able to complete the video.

Meeting the judge

The last part of the familiarisation visit involved Stacey meeting the judge. We went into a courtroom and the judge came to sit close to Stacey, rather than from her usual seating place at the bench. The judge used her first name and really put Stacey at ease, explaining the evidence process and why it was so important that the judge hears from her.

My job at this stage was the same as ever, just to facilitate communication and making sure Stacey had understood all the information the judge gave her.

When we finished with the judge, I asked Stacey what she thought. Before we went in, she said that she thought the judge was going to be strict and scary but meeting the judge the way we did made her see that the judge was kind and just wanted to find out what happened – another really important factor in reducing Stacey’s anxiety and giving her one less thing to worry about when she returned for her evidence the following week.

Giving evidence

When I next saw Stacey, it was for the day of her evidence. I had received questions in advance from the barristers that were planning on questioning Stacey, and the barristers all logged onto a remote meeting so that they could introduce themselves to her beforehand. We then moved into the video-link room, I made sure Stacey was comfortable and repeated who would be talking to her first once we joined the hearing.

During someone’s evidence, the intermediaries’ job is to monitor the questions that are being put to them and ensure they follow the recommendations outlined in the intermediary report. This was the same with Stacey. I had been provided with questions in advance which reduced the amount of times I had to intervene for Stacey. This was better for her as it meant she was in the ‘witness box’ for as little time as possible as there was less interruption to her questioning.

It is also the job of an intermediary to monitor concentration and ensure a person isn’t becoming fatigued. I did so for Stacey and suggested a break to the judge when I thought Stacey had been answering questions for a long time. Although Stacey declined the break because she wanted to get her evidence ‘over with’, the judge supported my recommendation and we took a short rest break. Stacey had her break away from the video-link room so that she could have a complete break from the process.

After her evidence, my role as an intermediary was complete, as I am not able to discuss her answers with her or tell her how I thought she did. We went back into the vulnerable witness suite waiting room where she was greeted by her support worker who offered Stacey the reassurance and emotional support that, as intermediaries, we are unable to give.

(*Names and key details have been changed).

The Law: rules & regulations surrounding child witnesses

Children can be witnesses in a criminal trial, but there are special procedures for child witnesses because of their age and vulnerability. The Criminal Practice Directions supplement the Criminal Procedure Rules by guiding judicial discretion, detailing a range of adjustments that should be considered in all criminal cases that involve children. 

The Criminal Practice Directions, on the other hand, are not secondary legislation. They:

  • Supplement the rules acting as a guide for the exercise of judicial discretion
  • Are binding in the criminal courts
  • Detail a range of adjustments (special measures and procedural modifications) that should be considered in all cases that involve a child witness

Applying the Criminal Practice Directions

Legal representatives must be familiar with the detailed provisions in the Criminal Practice Directions and ensure that they are complied with. These can be raised:

  • In the Crown Court, at the plea and trial preparation hearing, this hearing requires identification of any modifications sought or likely to be sought
  • In the youth court, at the first appearance
  • Where an application for special measures is granted or refused, the court must give its reasons

Special measures in court

Special measures are measures which have been put in place to help vulnerable witnesses, such as children, give their best possible evidence in court. They include:

  • Screens around the witness box – to prevent a child from having to see the defendant and the defendant from seeing the child.
  • Child witnesses can give evidence via a live TV link outside the courtroom – they will be able to see the courtroom and people in the courtroom and people in the courtroom, including the defendant, will be able to see them on a television screen.
  • Giving evidence in private – members of the public and the press can be excluded from the court in some cases.
  • Judges and barristers removing their wigs and gowns in the Crown Court to make the proceedings seem less intimidating.
  • A video recorded interview of the child witness before the trial to be admitted by the court as their evidence – a live video link or screen can be used when they are being cross-examined by the defence.
  • An intermediary to facilitate communication between the child witness and court. Intermediaries are also widely endorsed as measures which greatly improves the quality of evidence elicited from vulnerable witnesses, both because of their expertise in relation to the formation of advocates’ questions, and also because of their recommendations around the most effective combinations of special measures to invoke.

Current special measures limitations

The Victim’s Commissioner’s July 2020 Literature Review identified a number of current limitations affecting the implementation of special measures. For example, how well vulnerability and intimidation are being identified by the police, prosecutors and judges; whether the end-to-end process of preparing a vulnerable or intimidated witness for court and providing special measures is being delivered as it should be; to what extent child witnesses are part of the decision making on what special measures will work for them.

Other issues which the review identified that can undermine the effectiveness of special measures for child witnesses included: technology-related problems; poor planning of ABE interviews; and, problems with video transmission in courts. In regard to technology related problems, for example, the facilities for live link evidence leave a lot to be desired. The live link room is often very small and not child friendly; and with the current COVID-19 social distancing guidelines, if a child needs the support of both an intermediary and intermediary in the same room, it would be next to impossible to fit all three people in this space. 

Why request an intermediary assessment?

Kathryn, an intermediary, talks about assessments and how they can help people with communication difficulties

When we receive a referral to work with someone with communication difficulties, our first step is to carry out an assessment. There can be concerns about someone’s ability to take part in court proceedings for a number of reasons. They may have a diagnosed learning disability or learning difficulty, a mental health condition, or their age may be a factor.

The assessment establishes what additional support someone might need in order to participate in their hearing, including whether they will benefit from the presence of an intermediary at any or all stages of their hearing.

The purpose of an intermediary assessment is to identify communication difficulties, consider how these will impact a person’s participation in court proceedings and establish strategies that assist.

Following the assessment, we will carefully consider our findings and make recommendations regarding strategies and measures that will support the person’s participation in proceedings.

In many cases, due to the communication difficulties observed during the assessment, it is recommended that an intermediary is present throughout proceedings to assist with implementing the necessary measures. However, this is not always the case.

The assessing intermediary may determine that a person’s communication needs can be supported by the court, provided that the recommendations outlined in the report are consistently adhered to. On some occasions, the intermediary may find that someone’s communication needs are too great for an intermediary to be able to provide sufficient support.

We assess a person’s individual needs, and in 27% of the cases assessed by Communicourt, we  do not recommend an intermediary to be present at the trial/hearing.

The intermediary report provides specific recommendations and guidance for supporting communication at all stages of proceedings. This includes how best to communicate with the defendant or respondent during conferences, how they can be assisted to following proceedings whilst in court, and how they can be supported to give their best evidence.

What does an intermediary assess?

Everyone has a unique communication profile and will demonstrate a different combination of strengths and weaknesses.

An intermediary assessment aims to obtain a holistic view of someone’s receptive and expressive communication abilities; that is, their ability to understand and use language.

We will also discuss any medical diagnoses or conditions that are reported, in order to understand how these impact on communication.

We will explore a number of aspects of communication, these include but are not limited to:

  • Attention and concentration
  • Auditory working memory capacity
  • Expressive abilities
  • Literacy

Through exploring someone’s communication profile, we can identify communicative limitations, and advise the court how these will impact on a respondent or defendant’s ability to engage in different stages of proceedings.

The court environment is cognitively demanding and needs high levels of concentration. Defendants and respondents in criminal and family courts are typically required to:

  • Sustain their focus for long periods of time to follow what is being discussed in court.
  • Listen to technical legal arguments, submissions and directions, and expert evidence.
  • Remember key information over the course of their hearing which could last days, weeks or even months.
  • Respond to a range of long and complex questions and be able to indicate if they do not understand a question.
  • Provide their legal team, the judge and/or the jury with a clear and coherent account of their side of the story.

How does an intermediary assess communication?

Our assessments consist of a series of more structured tasks, as well as informal discussion and observation. From the beginning, we will be adapting to the individual’s needs and implementing strategies to support communication where necessary.

For example, during introductions, we will explain our role using simple language. Depending on the level of understanding that the person being assessed displays, we may then:

  • Use a visual aid, such as drawings or simple notes to supplement this explanation.
  • Repeat the explanation.
  • Break the information down into smaller ‘chunks’.
  • Provide a physical list or flowchart which outlines the assessment process.

Similarly, throughout the meeting we will be alert to any signs of attention difficulties. To support concentration, we may:

  • Implement breaks.
  • Offer a ‘fidget object’.
  • Minimize distractions within the environment.
  • Use clear ‘topic headers’ to direct the person’s attention.
  • Write down the tasks to be completed, so the person can visualize what is left to complete.

By observing difficulties and testing out different strategies, we can make informed recommendations about measures and adaptations that will support someone’s participation in proceedings.   

Structured assessment tasks help to provide greater insight into specific areas of communication, as well as how an individual copes when greater demands are placed on their processing abilities. For example, a person may be able to engage well during informal conversation, which may mask their underlying communication difficulties. These difficulties may become more apparent when they are required to listen to a short story and subsequently answer questions about it, or when asked to follow a series of instructions of varying lengths and speeds.

By using more structured assessment tasks, we can identify whether, for example, someone has a limited auditory working memory capacity, a reduced receptive vocabulary, or is unable to read with understanding.

The assessment environment is not reflective of the court environment; it is typically a quiet, one-to-one setting with the opportunity for a period of rapport building and regular periods of rest or informal conversation.

We have to consider how someone’s communication needs may differ in the court environment. We can ask questions about the person’s experiences at court so far, and how they feel about attending court in the future, so as to understand any difficulties or concerns from their perspective.

From assessment to court

The intermediary report will outline the assessment findings and any subsequent recommendations. This includes guidance on how language and questioning style can be adapted appropriately, and any other modifications to the court process that will support an individual’s needs.

These recommendations should then be discussed with an intermediary at the Ground Rules Hearing, to enable proceedings to run smoothly.

John and Susie’s experiences demonstrate how information gathered at the assessment stage can go on to ensure they are supported effectively at court:  

John

When John* attended his intermediary assessment, he reported that he takes daily medication that causes him to feel drowsy, particularly in the mornings. As a result, he had considerable difficulty attending to information during the assessment. However, he did not request breaks when he was struggling.

The intermediary recommended that the court consider sitting for shorter days, and incorporated regular breaks into the court day, in order to support John’s ability to concentrate during his hearing. The court accommodated this recommendation, starting late and finishing early each day, as well as taking regular breaks.

With this support, John was able to focus on and engage with the evidence being heard each day; this also helped to prevent him becoming too tired over the course of his hearing.

Susie

During her intermediary assessment, Susie* explained that she experiences sensory issues. In particular, she reported difficulty with concentrating and processing information when she is in a bright or visually stimulating environment.

The intermediary report recommended that Susie take part in a ‘familiarisation visit’ so that she could see the courtroom before her hearing and identify anything within the environment that may cause her to experience sensory overload. It was also recommended that Susie be permitted to wear sunglasses whilst in court to help reduce sensory overload from the lighting.  

The familiarisation visit gave Susie the opportunity to alert her legal team and intermediary to a light that she found overwhelming; as a result, the seating arrangements in court were reconsidered to ensure that Susie was not near to the light source. She was also permitted to wear sunglasses whilst in court. These adaptations helped to prevent Susie from experiencing sensory overload, enabling her to focus on proceedings more effectively.

*Names have been changed.

What inspired me to become an intermediary – Tracy’s story

I think it’s probably fair to say that I did not follow the most direct path to becoming an intermediary. 

It started off smoothly enough, leaving school at 18 and going on to study accountancy at university. How I ended up with a degree in social sciences is another story.  

While I was at university, I started to do some voluntary work and it slowly dawned on me that I would like a job that involved people rather than numbers. 

I was a member of a group that would collect patients from the local hospital for the ‘mentally handicapped’, as it was known at the time. We would take people out into the community to go to the pub or the cinema, and away on holiday. They absolutely loved it. 

It is shocking to think, and I don’t think the implications struck me as much at the time, for some of these people our outings were the only time they left the hospital. Some of the older patients had been born in the hospital to unmarried mothers and would probably not have met the criteria for an intellectual disability. This was the late 1980’s not the 1890’s! 

Changing my path 

After leaving university, I felt that I would like to become a social worker and decided to get some work experience before embarking on the professional qualification. I started work in a children’s home, which specialised in placements for children with challenging behaviours. Many of these children had been through numerous previous placements since they were removed from their families, and the resulting trauma should not be underestimated. In spite of the often extreme level of abuse that they had experienced within the family home, many still felt a strong attachment to their birth families.  

Sitting in family court now, in my role as an intermediary, I sometimes feel the trauma experienced by a child when they are removed from their families is minimised. Even when that move is clearly in the child’s best interests.  

So many of the people I have worked with in family court were themselves “looked after children”. Sometimes they haven’t had enough modelling of parenting skills themselves, it is therefore not surprising that they may not have the skills to be considered “good enough parents” to their own children. For all of us, the circumstances in which we grow up are “normal”. We have to be exposed to other ways of parenting in order to question how we should raise our own children, and many of the people I support in court have limited life experiences and knowledge of the world. 

After a couple of years, I was accepted onto a social work course, but before I could start, I found out that I was expecting my first child. I deferred my place for a year and then another year for baby number two and then again for number three! By this time, I wasn’t sure that I would be equipped to make the very difficult decisions that social workers are faced with making every day at work, so I had baby number four instead. 

I spent the next years at home with my children. I gained organisational skills that have served me well since I have begun working at Communicourt. All those years of dealing with the logistics of collecting four children from four different clubs or activities in different places, at more or less the same time. Some evenings, it felt akin to a military operation. It certainly makes getting to a court or an assessment on time in an unknown location seem relatively straightforward. 

Returning to adult social care

When my children were a little older, I returned to working with people with an intellectual disability as a support worker. I worked with people with varying levels of disability, some with a more moderate or profound learning disability who required round the clock support with all aspects of their daily lives. Others had a mild level of disability but with challenging behaviours or concomitant mental health conditions, such as schizophrenia or Autism Spectrum Condition (ASC). They required intense levels of supervision in order to safely engage with activities in the local community. 

It was particularly with these clients that I developed skills in modifying the way I speak to enable meaningful communication to take place. These skills have been so vital in my role as an intermediary, such as using simple language, keeping the pace slow, using visual aids and checking that they have understood by asking them to repeat what has been said in their own words.  

As a support worker, you are expected to teach clients new skills in order to maximise their independence. I became aware of just how much ‘overlearning’ is required before these skills become embedded. In family court, I often hear the charge levelled at the people we support that they have not made sufficient change, even when from their point of view, they have complied with everything they have been asked to do. They may lack the cognitive skills required to make and sustain the required changes – certainly, it would be very difficult for them to do this within the child’s timescales. At the same time, I recognise that the local authority try very hard to meet the needs of the parents and use modified parenting assessments, such as the PAMS assessment and adapted parenting programmes. 

Some of the parents I have worked with find it very difficult to talk about what is in the child’s best interests, and instead talk about what they would like to happen from their own perspective. A parent with a mild learning disability or low IQ is likely to lack the metacognitive skills to look at the situation objectively, and to put themselves in the child’s position. It is a highly emotive situation and would be difficult for any parent when faced with their child possibly becoming the subject of a placement order. This difficulty is compounded when the parent has only basic functional language skills and lacks the higher level metalinguistic skills required to provide explanations and express their thoughts articulately. 

The day our lives changed

I think my route to becoming an intermediary really began one morning, when as a family we experienced a massive shock. My healthy 13-year-old daughter had a major stroke one morning, completely out of the blue and with no warning signs. The next few months passed in a blur of hospitals, first in St Mary’s in London – the nearest paediatric intensive care bed they could find – and then at Birmingham Children’s Hospital for rehabilitation. 

When she first came out of a coma, the stroke had left her with severe right-sided weakness and the inability to walk, talk or swallow. She was tube fed for many months before pureed food could be introduced. 

My biggest concern soon became her inability to speak. I introduced an alphabet board, which she was able to use successfully. Luckily her language skills had been left intact. However, although we used this with her as a family in order to give her a voice, the nursing staff were very reluctant to use it, possibly due to lack of time – it was very time-consuming – and this led to even her basic physical needs frequently being overlooked. 

Once she was discharged from hospital, she was seen by a community multi-disciplinary team, including an excellent speech and language therapist. With her support, my daughter was gradually able to recover some of her speech (and her ability to eat a range of foods). 

Her speech is now intelligible to a familiar listener. However, she has dysarthria which affects some speech sounds and a neurogenic stammer, rendering her speech slow and effortful. Although her speech is not the only area to be affected long-term by the stroke – she has difficulties with short-term memory and executive dysfunction, as well as walking with a limp – it is her speech which has the single biggest negative impact on her life. As soon as she speaks, people make judgements about her, she is discriminated against in job interviews and people frequently put the phone down on her, when she attempts to make a phone call. 

Moving to speech and language therapy

I was inspired by my daughter’s experiences, and by the positive impact speech and language therapy had for her, to return to university to study for a degree in Speech and Language Therapy. 

On graduation, I found a post as a speech and language therapist in a special educational needs school, which was an excellent first role. It allowed me to put into practice what I had learned about assessing an individual’s communicative ability, identifying their difficulties and deciding on a course of therapy.  

I quickly realised that I was not going to effect massive change due to the pupils’ complex needs, and I changed my focus to looking at improving their functional language skills and pinpointing what would be most useful to them as they approached school-leaving age and the prospect of college or employment and independent living. 

Although I enjoyed this role, I began to miss working with adults and started to look for a new post. Communicourt piqued my interest, as it seemed that I could bring to the intermediary role the skills I had acquired throughout my working life, both as a speech and language therapist and as a support worker with adults with intellectual disabilities. 

I really love working as an intermediary. The work is varied and interesting, and whilst I am working with someone, I feel like I am making a positive difference for the short time I am involved in their lives, in helping them to understand the court proceedings and to tell their story in the best possible way. I appreciate the support I get from the organisation and from my colleagues. It’s a lovely environment to work in.