This week, Melissa (Assistant Lead Practitioner) and Rachel (Team Leader) attended the Inclusive EmployersInclusioneers Conference 2023, held at Chelsea FC’s Stamford Bridge.
The event was held to share best practice and bright ideas on topics including recruitment and positive action, hybrid working, racial equity, inclusion & diversity strategy, and staff networks. A keynote speech was delivered by LGBTQ+ voice, Nathaniel J Hall, an HIV activist, producer, writer and star of unmissable drama, It’s A Sin.
Rachel was especially inspired by calls to “Make inclusion an everyday reality” within organisations. She explained, “We had a really enjoyable day listening to the fantastic speakers at the Inclusive Employers Inclusioneers Conference 2023 – from learning top tips for inclusive recruitment and flexible working to hearing about personal experiences in relation to racial equity and being a member of the LGBTQ+ community. Everyone’s ideas and stories were so inspirational, insightful, and we have definitely come away with more tools in our inclusion kitbag that we are looking forward to sharing with our colleagues”.
Inclusion isn’t just important for our service users (who often require adaptations and adjustments to ensure they have equal access to justice). It’s also important for us as an organisation. We work with an incredibly diverse range of court users, and we strongly believe that this diversity should be reflected within Communicourt itself, to allow us to provide an ever-better informed and attuned service to people with communication needs.
Communicourt is always working to improve inclusion and diversity within the organisation, implementing recruitment policies to diversify our workforce, nurturing staff groups (including a Neurodiversity Network and team of Diversity Ambassadors), and amplifying diverse voices within the company, via internal platforms.
The Inclusioneers event has offered lots of food for thought and fuel for future developments, and we look forward to putting this learning into practice.
My name is Anna and I’ve been an intermediary at Communicourt for two and a half years now (wow time flies!). I studied Psychology at university and, once I had finished my course I became an analyst – which I found very boring as I had to look at excel spreadsheets for hours on end! But it was in this job that I first heard about the role of an intermediary from one of my colleagues. I started to research the role and it really appealed to me. I’ve always been interested in court. My Granddad became a magistrate when he retired, and growing up, I always loved hearing his stories from the courtroom. However, I was never drawn to a career in law. So, when I heard about the role of an intermediary, I was very excited at the prospect.
My job as an intermediary is to assist individuals with communication difficulties going through court proceedings. This is usually in either the criminal or family court. In this blog post, I will take you through a recent week in my intermediary life! However, it’s important to remember that no two weeks are the same for an intermediary. Each new week brings new cases, new people and fresh chances to have a positive impact on an individual’s access to justice.
Monday
My week started with a remote family court case. Working from my home, I emailed the solicitor to try and arrange pre-hearing discussions so I could talk with the service user to introduce myself, build rapport and explore how we could communicate during the hearing.
Unfortunately, I did not get a response. Despite making lots of different phone calls, by 9:30 (when the court hearing was due to start) I still had not had any contact from the solicitor, nor received a link for the court hearing itself.
After continuously trying to make contact, I was finally sent the link to the hearing – well after court had already started! I joined mid-way through the hearing and made a note of what was said. After the hearing, I tried to arrange a post-hearing conference to explore the service user’s understanding of the hearing and to provide support with any areas of difficulty. Unfortunately, this was also not possible. I then updated the case notes so the next intermediary who works with this service user can check their understanding of the case.
This was a frustrating start to the week, as usually remote hearings are much more straightforward than this. In the majority of cases, contact numbers are available and it is straightforward to set up a pre- and post- hearing discussion. It is also very rare that an intermediary is only provided access to the hearing part-way through. Typically, at the outset of remote hearings, ground rules are discussed with the intermediary, so everyone is appraised of any needs the service user may have and knows how remote intermediary assistance will be managed.
Equally, by the time most remote hearings start, I’ve usually had a chance to speak with the service user. At this stage, I typically explore the best options for providing remote assistance (either through an open phone line during the hearing, by using a CVP intermediary room or by text messaging during the hearing – all dependant on the technology available to the service user, and their level of literacy). In most cases, by the time hearings commence, myself and the service user will have exchanged numbers and set up a method of communication, to ensure they have access to simplification, recaps and other assistance. Today, things didn’t go so smoothly, but it can only get better from here!
Tuesday
Tuesday was supposed to be a day to catch up on admin work but, at approximately 10:30am, I received a call from the Communicourt bookings team asking me to cover a last-minute family court hearing. To make matters more interesting, the person I would be assisting needed some further assessment to gain a full understanding of their communication abilities.
By 11am I was on a Zoom call with the service user, conducting some further assessment tasks which looked at some areas of communication that had not been previously assessed. After this, I gave their barrister a quick call to update him on the new findings, before entering the remote family court case.
The court hearing was about ensuring the individual would be able to participate in the upcoming in-person hearing effectively. I addressed the judge and gave some recommendations to the court about what would help this person participate to the best of their ability. The judge agreed to all of my recommendations which included:
Advocates for all parties to send their proposed questions to the intermediary in advance of the service user’s evidence (to allow the intermediary to check the questions are worded and structured in a way that will be best understood by the service user – allowing them to give their best evidence).
Permission for the service user to remain in their usual seat in the body of the court during their evidence (due to high levels of anxiety).
Only one advocate to ask questions on behalf of all parties (to help minimise the impact of anxiety upon their ability to process questions and formulate responses).
Frequent breaks (with recommended timings).
Permission for the service user to make use of an attention aid (tangle toy) at court.
Wednesday
On Wednesday I had a break from the family court and instead attended a conference with a young person facing criminal proceedings. They were someone I have assisted before, so I already knew a bit about their communication profile, but I reminded myself of their communication needs by reviewing their intermediary report and cognitive report in advance. I also reminded myself of the case by reading the intermediary case notes.
It was then time to attend the conference, after a short walk over to the solicitor’s office, I helped the service user to understand the process of a trial by creating a simple court diagram showing who will be sat where and by explaining the job of each person in the room. I also used a visual aid to help the service user decide whether he will be plead ‘guilty’ or ‘not guilty’ by using a flowchart to explain each option and the potential outcomes of both. Throughout our meeting, I intervened to check the service user’s understanding and simplified any low frequency language his barrister used, this helped the service user give clear instructions and follow what was being said.
Ficticious example only, does not include key information (e.g., impact on sentence)
Thursday
On Thursday I attended another conference, this time with someone who had a very important family court hearing coming up. Again, this was a service user I had previously worked with and so I already had an understanding of their communication abilities, but it is still important to frequently remind myself of the individual’s case and communication profile. I re-read the intermediary report and case notes in advance of the meeting.
During the meeting, I assisted the solicitor to ask questions in a way that made sense to the individual and allowed him to give clear responses.
For example, the solicitor asked, “So you don’t agree with what the local authority want?”. This is a statement-style question which invites agreement (making it harder for more suggestible people to contradict). It also included a negative (“don’t”), which can prompt unclear answers.
I therefore asked the service user, “What do social services want?” and, “What do you want?”. This enabled me to check the service user understood what other parties in the case were asking for, and also enabled the service user to provide clear instructions.
We then spoke about what sort of recommendations could be made in court to aid the service user’s participation in the upcoming hearing. For example, asking the court to sit for shorter days, due to the service user’s difficulties with concentration, and asking for regular breaks, so the intermediary can check understanding and allow time for the service user to ask any questions.
Friday
Friday brings yet another new court case to my calendar. I assisted a young person who I have worked with numerous times before. Today was an in-person family court hearing, which involved taking an early morning train to court. Whilst on the train, I read through the report and case notes to remind myself of exactly what sort of support was required.
When I arrived in court, I met the service user and barrister, and we found a quiet space to have pre-hearing discussions. During this conversation, I assisted the service user’s understanding by explaining low frequency vocabulary (less commonly used words) and asking questions to check they had understood what was being said.
For example, when the barrister said, “The local authority’s position is ambiguous right now” I explained that meant, “The social workers are not being clear about what they want”.
At the end of the conference, in order to check the service user’s understanding, I asked specific questions such as, “What does *NAME* want to happen?” and, “Why are you having an assessment?”. These questions enabled me to check that the service user had gained a clear understanding of what had been discussed.
After a break, it was then time to enter the courtroom. I sat with the service user and whispered real time explanations to them throughout the proceedings. For example, when one of the barrister’s said *NAME’s* statement has been “filed and served”, I whispered to the service user, “The court have got a copy of *NAME’s* statement”. I also drew a simple line drawing of the courtroom to show who was sitting where and what their job was. This assisted the service user to understand who was speaking on behalf of who.
Ficticious example (does not include names)
At one juncture, they made an important comment to me, so I passed a note forward to the barrister. The barrister then addressed the judge on this point. After the hearing, we had a quick conversation with counsel to go over what was said in court. I checked the service user had understood everything by asking focussed questions and asking them to explain what had happened in court in their own words.
It was then time to go home. On my train home I completed some admin tasks and wrote up the case notes from the day.
Working as a Communicourt intermediary requires resilience and adaptability. It is an extremely rewarding role, where every day is interesting and new. The job is unpredictable and unforeseen circumstances arise all the time, but every day brings new stories, unexpected twists, new challenges and the chance to make a positive difference to people facing some of the most difficult moments of their lives.
If you would like to learn more about the intermediary role at different stages of family and criminal proceedings, visit The Access Brief. A growing library of free resources developed for legal professionals working with clients who have communication needs, including guides to working with clients who have a range of common conditions which impact communication.
As Frances Ryan for the Guardian writes, the crowd’s support for Lewis Capaldi during a performance affected by tics was “the sort of display of communal spirit that didn’t just feel like Glastonbury at its best, but humankind generally”.
Her article celebrates the response of festival-goers, who cheered on the singer and sang when he could not, as his vocal performance was increasingly impacted by Tourette’s (which includes involuntary movements and tics affecting his breathing).
However, Ryan’s article also highlights the rarity of visible disability – particularly on stages as prestigious and global as Glastonbury. On this unusual occasion, a person experiencing communication barriers was publicly celebrated and supported – not out of pity, but through acceptance. The crowd acknowledged Capaldi’s difficulties and worked collaboratively and responsively with him, to triumphantly finish the set. This wasn’t about bleeding hearts or saviour complexes. This was about wanting Capaldi there, wanting to be part of a moment with him, and working towards a successful communication exchange in an act of mass collaboration.
Here are the voices of some people with Tourette’s in response to the performance:
The disparity between this one, magic moment and society’s typical responses to disability (including wrong-footed, well-meaning ones) is stark. In Capaldi’s statement following the festival, he said he was “annoyed” with himself, perhaps a reflection of the shame some people with Tourette’s and many others are made to feel, when they are unable to mask their differences – an often exhausting task, upon which their equal treatment can feel dependent.
Making communication work
Capaldi’s performance highlighted that communication is a two-way (or in this case a 100,001 way) exchange, which both sides of the ‘conversation’ have a duty to make work. In many ways, the Glastonbury set illustrates best practice when working with a court user (or communicating with anyone, in any context) who has a communication difference or difficulty.
Communication is an exchange, which all participants have a duty to facilitate as effectively as possible. Part of successful exchanges involves understanding each participants’ communication strengths and needs and implementing adaptations to overcome any barriers. This doesn’t mean frustratedly ending an exchange because it isn’t working, or assuming that what somebody is trying to communicate isn’t of value.
Successful communication can look different for everyone, but collaborative, person-centred approaches are often the key. This is how the crowd approached their exchange with Capaldi. Listening to what he had to say about the difficulties he was experiencing, responding to his cues and providing the support required to facilitate a successful interaction.
Tourette’s & communication in legal proceedings
In a recent Communicourt blog for Tourette’s Action Week, we explored the condition (which affects an estimated 1% of people in the UK) and shared tips and strategies for legal professionals working with a client who has Tourette’s.
Many of these strategies focused on raising communication partners’ awareness and understanding (for example, addressing a jury to explain a defendant’s Tourette’s presentation and that this must not influence their verdict) and working collaboratively with the court user to implement effective communication strategies (for example, by asking what helps them).
Concepts like “understanding” and “awareness” may sound fluffy, but they can and should have concrete outcomes. For example, understanding that some people prefer to suppress tics (which can result in fatigue and impair attention) means that courts can take measures like implementing more frequent breaks, providing written summaries (in case evidence is missed through loss of attention) or working to ensure the individual feels more comfortable to tic freely during proceedings.
Meanwhile, being aware that anxiety and stress can exacerbate Tourette’s symptoms can prompt the court to explore special measures to help manage these feelings, like permitting remote attendance or the use of a screen during the court user’s evidence, which can assist the individual to give their best, clearest and most reliable evidence.
However, when we start to consider a list of possible ‘strategies’, it’s easy to lose sight of the person at the centre of these measures. Adaptations must be made on a person-by-person basis, and informed by the individual they are intended to assist.
For example, while some people may prefer for their tics to be ignored in conversation, others will feel more comfortable with an alternative approach. While some people will feel less anxious engaging in proceedings remotely, for others, video calls can be particularly anxiety inducing. Instead of following a ‘tick-list’ when communicating with a person who has a communication difference or difficulty, actively seeking and integrating individual communication preferences is essential.
These principles don’t just apply when communicating with a person who has Tourette’s Syndrome, or when cheering on your favourite musician on the Pyramid Stage. They should be at the heart of every interaction. When we take a flexible, responsive, informed and person-centred approach to communication, we help ensure everyone can be part of the conversation.
Learn more about court communication from experienced court intermediaries on The Access Brief. A growing library of free resources developed for legal professionals working with clients who have communication needs.
We were very proud to sponsor, judge and attend the Northern Law Awards last night, celebrating the expertise and dedication of legal teams in the North of England. The Communicourt team had a wonderful evening, meeting and applauding outstanding legal practitioners at the awards dinner in Newcastle.
Alongside other judges, we were tasked with the difficult job of selecting the winner of the “Family Law Team of the Year” Award. We met with delegates from the four finalists, Cygnet Family Law, Major Family Law, Sintons LLP and Tilly Bailey & Irvine LLP and were asked to select the team who best demonstrated legal expertise, appreciation by clients, client service excellence, project management skills and team working. It was an extremely difficult task, as all four finalists clearly embodied all of these qualities and achievements.
However, after careful consideration and deliberation, Communicourt’s managing director, William Scrimshire, was delighted to present Cygnet Family Law with the Family Law Team of the Year Award, at the awards ceremony held at the Hilton Newcastle Gateshead. We found the Cygnet team to be “an outstanding team providing outstanding expertise”, and were very pleased to be able to recognise their exceptional work. Congratulations to the whole team!
Our intermediaries work alongside outstanding family lawyers across the North of England (and beyond) every day, so it was a real pleasure to take part in recognising the skill, empathy and commitment of legal professionals who we know consistently go above and beyond for their clients, particularly those with communication difficulties and other vulnerabilities.
Were you paying attention?
Did you notice the fidget aids hidden in our Communicourt gift bags on your party’s table? These resources can assist many different people to regulate their emotions and attention more effectively. Anecdotally, intermediaries see this in the courtroom every day, and there is a growing body of research which points to their effectiveness:
Intermediaries often offer court users attention aids during hearings and meetings. They can be particularly helpful for people with ADHD, anxiety and PTSD, but many others also find them useful, including some autistic court users and neurotypical people. If you happen to be caught without a specific fidget aid, there are lots of alternatives that can be implemented which have a similar effect, such as encouraging a client to doodle, or providing a simple piece of Blu Tack or a hairband.
Thank you & congratulations
Our sincere thanks to the Northern Law Awards, it’s been a pleasure to sponsor the event and to celebrate many of the dedicated legal professionals our intermediaries work alongside. Finally, a huge congratulations to all of the finalists and winners, including newly crowned Family Law Team of the Year, Cygnet Health!
We’re delighted to announce that Communicourt has been chosen as a finalist in three categories at the SME National Business Awards 2023. From hundreds of applicants, we’ve been selected as finalists in the Positive Impact, Service Excellence and Employer of the Year categories.
“This is the first time we have ever been in the race for this kind of award. It was a pleasure to go through all the positive things Communicourt has done and achieved in the last 12 months with the rest of the team and we look forward with anticipation to the awards evening.“
William Scrimshire (Managing Director, Communicourt)
Each application to the SME National Business Awards is rigorously appraised and scored by four judges, selected from a panel of 30 leading businesspeople from a wide range of fields.
Positive Impact
This category is all about innovations and adaptations which allow businesses to thrive, to the wider benefit of society. The judges are looking for businesses which make real, positive change and take active steps to continue boosting their impact.
When applying for this category, we were especially pleased to have an opportunity to show off The Access Brief – a library of free resources we’ve developed to assist any and all legal professionals working with a client who has a communication difficulty – not only in cases where an intermediary is allocated.
Service Excellence
This category focusses on the quality of the service businesses deliver to clients and customers, from going the extra mile, to consistently ensuring an outstanding service and striving to continually improve on that offer. Communicourt was lucky enough to have a wealth of wonderful testimonials from service users, judges, barristers and solicitors to support the application to this category.
“I want to just take this opportunity to thank your intermediary for his time and patience with me last week and Monday of this week. I want to let you know how good he is at his job, I just could not have gone through that without him by my side.”
– Communicourt Service User
Employer of the Year
This award will be won by a business which invests in its team’s growth and wellbeing. Applicants were asked to tell the judges, “how you as an employer look after your employees so they take care of your business”. From Team Days and remote yoga classes, volunteering days, Diversity Ambassadors, a Neurodiversity Network and our active internal hubs, we had lots of great things to share, which help make Communicourt a community.
The winners of the 2023 SME National Business Awards will be announced on 1st December 2023. Very best of luck to all of our fellow finalists!
This year, Learning Disability Week is all about busting myths about living with a learning disability. Learning disabilities affect individuals in all sorts of ways and every person with a learning disability has their own unique strengths and challenges. However, learning disabilities are often surrounded by misconceptions that can lead to stereotypes and hinder support.
It is estimated that 4-6% of the entire population has a learning disability. The exact cause of learning disability is much debated. Sometimes it is because a person’s brain development is affected [NHS] either pre-birth, during birth or in their early childhood. There are also some health conditions that may pre-dispose someone to a learning disability, for example cerebral palsy and foetal alcohol syndrome.
Learning disabilities can vary in severity and they are typically categorised as severe, moderate, or mild, based on the impact they have on an individual’s daily life. The measurement and classification of learning disabilities involve a comprehensive evaluation by professionals such as a psychologist.
This Learning Disability Week, Mencap are campaigning to smash preconceptions and stereotypes about who people with learning disabilities are and what they can do. For many people, it’s all about access. With the right support and adaptations, people with learning disabilities can overcome societal barriers and achieve their goals, whatever they might be. Read on to discover the stories of individuals who demonstrate that a learning disability does not limit one’s potential.
But first, let’s tackle some other misconceptions about learning disabilities…
Myth 1 – Learning disabilities and learning difficulties are the same thing.
“Learning disability” and “Learning difficulty” are terms which are often used interchangeably, but there is a big difference between these two, distinct diagnoses.
Learning disability refers to overall reduced intellectual ability, which impacts learning across all areas of life, from experiences in education to daily living skills. For example, an individual with a learning disability may have struggled in school (without the correct support) and may find tasks like budgeting, planning and time management challenging. It’s important to note, whilst learning disabilities can make some aspects of everyday life more challenging, individuals with learning disabilities also possess unique strengths and talents, whether that is deep empathy, outstanding creativity and anything in between.
Learning difficulty, meanwhile, is an umbrella term which describes a range of specific difficulties that can impact learning, such as dyslexia, ADHD or dyscalculia. Unlike a learning disability, learning difficulties do not affect the overall intellectual ability of an individual. For example, a person with dyslexia may have above average intellectual abilities, but may find specific literacy skills challenging.
Myth 2 – Learning disabilities can be outgrown.
Learning disabilities are lifelong conditions which are usually present from birth. While individuals with learning disabilities may develop strategies to manage any challenges they face, the learning difficulties themselves will persist for the duration of life. This doesn’t mean that individuals with learning disabilities can’t achieve success. Instead, they may need to find ways to navigate skills they struggle with.
To give an analogy, a person who is diabetic can still be an amazing athlete, but they need to figure out how to balance their medical condition with their training. In the same way, people who have a learning disability can achieve their goals but may require adaptations (like access to easy read documents) and different strategies (like identifying when and how best to seek support) to do so. Early identification and intervention is therefore essential to support individuals with learning disabilities to thrive.
Myth 3 – Having a learning disability means you can’t be successful.
Many individuals with a learning disability have achieved great success in various fields. It’s important to remember that having a learning disability may affect how an individual processes and understands information. But it does not mean they are incapable of learning or achieving their goals. People with learning disabilities have proved countless times that they can achieve remarkable success, challenging the misconception that they cannot be successful. Below are some examples of individuals with learning disabilities who have achieved significant accomplishments:
Alastair has Angelman syndrome, a rare genetic condition that affects the nervous system and causes severe physical and learning disabilities. Alastair is a creative artist, skateboarder and explorer. He has spread the message that being non-verbal doesn’t mean a person lacks understanding – the key is communicating in the right way.
Alastair Smith
John Cronin
John Cronin is the co-founder to a successful business, John’s Crazy Socks! He has Down Syndrome, and, along with his father, he turned his passion for colourful and creative socks into a successful business. Through his business, he advocates for the abilities and contributions of individuals with disabilities. John has shown that people with learning disabilities can excel in the workplace. His business challenges stereotypes and encourages others to pursue their goals.
Jessica Jane Applegate
Jessica Applegate is another remarkable individual with learning disabilities. She is a paralympic swimming champion who had competed at a global level. This requires immense physical and mental endurance, highlighting her determination, discipline and ability to overcome obstacles.
Jessica has shattered stereotypes and evidenced that individuals with learning disabilities can achieve whatever they set their mind to. She is an inspiration and role model showing the potential for people living with learning disabilities.
Ellie Goldstein
Ellie Goldstein is a British model with Down Syndrome. In recent years, Ellie has been busy breaking down barriers in the fashion industry. She has recently become the first model with Down Syndrome to feature on the cover of the British Vogue magazine. Her talent has caught the attention of other brands and designers. Ellie’s success has inspired and empowered many people with disabilities to pursue their dreams in the fashion industry. Her success highlights the beauty of diversity.
These individuals, among many others, have demonstrated that having a learning disability does not define a person’s potential for success. These remarkable individuals and their accomplishments serve as a testament to the importance of inclusive attitudes, equal opportunities, and supportive environments that enable individuals with learning disabilities to reach their full potential.
Individuals with learning disabilities can be supported to understand legal proceedings to ensure they can effectively participate in the legal system. At Communicourt, we support people with a range of communication difficulties to help them understand their trial or hearing. Here are some key strategies which may assist:
Highlight the topic and speak about one subject at a time. It may help to use a visual list of topics in conference (or an order of proceedings), crossing each off once complete.
Use simple language. Choose everyday words and use short, simple sentences.
Break complex information down and provide visual aids to enhance understanding.
Create a supportive environment. For example, allow an individual with learning disabilities extra time to comprehend proceedings, allow the presence of a trusted friend or family member to provide emotional support, or ensure written material is accessible in easy-read formats. You can download a free guide to creating easy read documents from the Communicourt Access Brief (see more below).
Implement reasonable adjustments. This might include advocates providing questions in advance of evidence to an intermediary to ensure the questions are framed in the best possible way.
Have a Ground Rules Hearing. At this hearing, everyone involved in the case can be alerted to the specific requirements of the individual, as well as strategies which can improve their understanding and participation. Search The Access Brief for a free guide to Ground Rules Hearings.
By implementing these strategies, many individuals with a learning disability can be better supported to understand and engage with legal proceeding.
Individuals with learning disabilities can excel in their chosen area, break barriers, and contribute meaningfully. They inspire others by challenging stereotypes, promoting inclusion, and showing the abilities of those with learning disabilities. This Learning Disability Week let’s dismantle misconceptions and myths by reminding ourselves of the strengths, talents, and resilience of individuals with learning disabilities. The journey of myth busting does not end here – let’s carry the spirit of learning disability week forward!
Imagine yourself in a police interview. The room is divided by a one-way mirror. One side is a space where the interview is conducted. On the other side, officers make observations and have discussions through a soundproof one-way mirror. The officers can see and hear both sides, but the individuals in the interview can only see and hear what is in their room. The room with the officers making observations is the closest representation of the intermediary room on CVP.
What is a CVP intermediary room?
The intermediary room, also known as the interpreter room, was an HMCTS development of the Cloud Video Platform (CVP) to improve multilingual services during remote hearings, particularly during the COVID-19 pandemic.
According to the CVP guidance, there are two ways to ‘interpret’ spoken language in a court hearing; consecutive interpretation and simultaneous interpretation.
The purpose of CVP is to mimic what occurs in a face-to-face hearing in a remote setting. The benefit of using the intermediary room, is that the court will always be able to see the court user and the intermediary or interpreter and vice versa. However, the court will not be able to hear the intermediary or interpreter giving real-time explanations or simplifications, meaning the hearing can continue without having to pause.
Prior to the pandemic, all hearings were fully attended in person and remote court hearings were a concept unknown to a lot of people. It was also unheard of for interpreters to assist remotely. There were some occasions where intermediaries could assist remotely, i.e., assisting with evidence via video-link from a witness suite, however, these occasions were extremely rare. Back then, intermediaries may have recommended that court users attend remotely, for example, to assist a court user with severe anxiety. However, judges were often reluctant to agree to this and the intermediary would have to thoroughly explain the need for this measure and the potential benefits to the court user’s participation.
The technology used to facilitate assisting remotely before the pandemic was not as advanced and accessible as it is now. Previously, a designated TV, laptop or computer in the witness suite was a common option. However, today, court attendees can usually join using any device, from anywhere in the world, provided they have the correct CVP link and PIN to access the meeting.
How are intermediary rooms set up?
The organiser, normally the court clerk, will set the link up. They will host two linked CVP ‘rooms’.
What happens if there is no intermediary room?
The intermediary room can only be facilitated on CVP. If the hearing is on Microsoft Teams, there is not an option for an intermediary room.
The intermediary can request the organiser (the clerk) to create an intermediary room when they join a hearing and find out that an intermediary room has not been created. The organiser will then create a second room and put the intermediary and the court user in that room.
Why are intermediary rooms used?
Commonly, the intermediary room is arranged by the court without any discussion with the intermediary. From my experience, the use of the intermediary room is often necessitated by having the assistance of an interpreter. However, another key reason why intermediary rooms were used was due to COVID-19 restrictions.
CVP is still used in court proceedings today, for example, when barristers request to attend remotely due to a conflicting matter, or when professional witnesses are required to give evidence. CVP can also be used when people in custody are required to attend court hearings or partake in intermediary assessments. However, it is becoming less common for intermediary rooms to be used to facilitate work with a court user.
The positives
The main (and most significant) positive is being able to provide live, real-time explanations without having to use a different device and without disrupting the flow of the hearing. It is also useful when there are natural pauses during court, as it means that the court user can ask questions and make comments in real-time. However, this system, whilst theoretically a good solution, is not without its flaws…
The downsides
Ironically, in my experience, communicating using the intermediary room is often difficult. It can be difficult to hear the court user speak and hear the court at the same time. There is no way to adjust the volume in the courtroom, or the separate room, which means that intermediaries can often feel that they are either not hearing the court user, or not hearing the court properly. Due to these difficulties, court users may be put in a position where they have to choose between listening to the hearing or engaging with the simplifications given by their intermediary.
Trying to communicate with the court user in this kind of setting can be overwhelming for them as there can be many communication ‘inputs’ to attend to, without always being able to visualise the faces of the participants.
If court users do not have access to a laptop, they may be required to join the hearing from their mobile phones or be dialled in. If they are joining the hearing from a mobile phone, they may not be able to see and visualise all of the participants as there is limited space on their mobile phone screen. If court users are dialled in, then they would not be able to see any faces at all, as being dialled in is essentially like being on a telephone call. The picture quality of the hearing is also often reduced, and the intermediary and court user appear smaller on the main hearing room screen (due to split screening), which makes it difficult for the people in the main hearing room to see the intermediary and court user in detail.
Technological difficulties can also be a big issue.
Oftentimes, the volume of the main hearing is too loud, meaning that it can be a struggle for the intermediary and court user to effectively communicate. It can be challenging to talk over the conflicting voices in court, which results in difficulty hearing one another. The sound feedback can also be quite bad, which makes communicating harder. So, it can be difficult for intermediaries to provide real-time explanations, as they can only realistically communicate in brief moments, when there is a natural pause in the main hearing room.
All of the participants may not have good and stable Wi-Fi connections, especially if cameras are turned on. Turning the cameras off can improve the internet stability and sound, however, it means that the intermediary cannot see the court user. Therefore, it is harder to interact, and there is no way of ensuring that the court user can hear what is being said or monitor their participation. Turning cameras off would also mean that court users would have no visual reference to determine who is in the courtroom and who is speaking.
The intermediary room is often muted during the hearing, which makes it very difficult for the intermediary to communicate any difficulties or recommendations which arise to the court. Sometimes, it is not clear when the room is muted, and intermediaries can accidentally interrupt the hearing! There is the chat box function, which only the clerk or organiser has sight of, but it can take a while for them to notice any messages. In most cases, intermediaries have to get an email across via the barrister to the judge to make any recommendations or adjustments.
Overall, based on the feedback I received from other intermediaries at Communicourt, there tends to be more negatives than positives to the intermediary room. It should be borne in mind that the intermediary room was created to replicate something virtually that generally worked really well in person. This technology was developed during a time of crisis to improve access for court users who had no choice but to attend hearings remotely. Unfortunately, however, the technology currently available undermines what is theoretically a good idea.
In an ideal world, intermediaries would have:
Adjustable volume settings which the intermediary can operate in the intermediary room.
A selection of notifications that the intermediary can use to communicate with the main hearing room (for example, ‘pause’, ‘break’, ‘intervene’, ‘slow down’, etc).
Make the intermediary room chat box content visible to the main hearing room, to improve communication between the two rooms.
Until these changes are developed and implemented, there are a few tools and strategies intermediaries have at their disposal to help overcome the limitations of the intermediary room:
Confirm with the court first that they are allocated their own room before they start to speak (as they cannot usually see if they are in a separate room).
Make sure that both they and the court user have their cameras on, as the platform is most effectively used that way (they can see, hear, and monitor both attention and emotional regulation more effectively).
Recommend and use a “pause” and “break” sign which the intermediary can hold up. The “pause” sign is to request a short pause while the intermediary gives a simplification or checks understanding/wellbeing of the court user (during which, the main hearing room is quiet so the court user can hear the intermediary). The “break” sign is to request a complete break.
Ensure they have the email address of the clerk or barrister to pass on any messages, in case the clerk takes a while to notice their message in the chat box.
To learn more about the intermediary role, visit our library of free resources, created by intermediaries for legal professionals. The Access Brief is a growing bank of bite-sized guides covering everything from the intermediary role when court users also have an interpreter, to communication tips for clients who have a diagnosis of Traumatic Brain Injury.
Tourette’s affects 1% of the UK’s population, which doesn’t sound like a lot, until you realise that means there are approximately 690,000 people living with Tourette’s. That number only includes people who have been specifically diagnosed with Tourette’s and does not consider those who are undiagnosed or have other disorders with a similar presentation, for example Tic Disorder, autism and attention deficit hyperactivity disorder (ADHD).
In this blog, we’ll be sharing some more information about Tourette’s, tics and how legal professionals can help support the equal participation of a client who has Tourette’s or tics in the courtroom and conference room.
Tourette’s Awareness Month
15th May – 15th June are Tourette’s Awareness Month. This year, Tourette’s Action have chosen the theme #ItsWhatMakesMeTic to destigmatise the condition and to familiarise people with a range of tic presentations. The Tourette’s Action TikTok is full of videos from the organisation’s five ambassadors, who have been sharing their experiences, tics and coping strategies in real time, making the channel a fantastic educational resource for anyone who wants to learn more about Tourette’s.
What is Tourette’s syndrome and how might it affect a client during legal proceedings?
Tourette’s syndrome is a neurological condition that causes you to make involuntary movements and sounds called tics. Tics are fast, repetitive muscle movements that cause sudden body jerks or sounds.
Tics can often be made worse when the individual is going through a period of stress and anxiety, which is highly likely when going through court proceedings.
Below are some common examples of motor and vocial tics:
Motor tics
Vocal tics
Head jerking
Repeating words or phrases
Shrugging shoulders
Clearing throat
Hitting
Singing
Blinking excessively
Humming
Clicking fingers
Grunting
A common misconception is that everyone with Tourette’s shouts out obscenities! Coprolaliais the medical term described as: “The involuntary outburst of obscene words or socially inappropriate and derogatory remarks”. This is actually rather rare and only affects 1 in every 10 people with Tourette syndrome.
Since the COVID 19 pandemic, there has been a significant increase in the number of people (predominantly teenage girls) displaying ‘Tourette’ type behaviour and so the number of people presenting with similar symptoms is at a record high. With Tourette’s becoming increasingly prevalent, it is important for professionals in the legal system to know how to communicate with someone who has Tourette’s, and equally, how to assist those affected to communicate effectively with others.
Tips to assist a client with Tourette’s in legal proceedings
Below are some top tips for assisting a client who presents with Tourette’s or Tourette type behaviour during a legal conference or in a court environment:
Have an open conversation with your client about their Tourette’s
Don’t shy away from it or ignore it. Ask your client if they feel comfortable giving you information about their diagnosis (be mindful that they might not!). This can be an opportunity to find out if certain situations make them ‘tic’ more or if they have any strategies which they find useful in calming their symptoms.
Ensure your client feels comfortable asking for breaks
Tell your client, from the outset, that they can take a break whenever they feel they need one. Knowing they can remove themselves from the situation, in the event their tics become overwhelming, will likely be a comfort to a client with Tourette’s/tic disorder. People with tic disorders also tend to try and suppress their tics. This can be incredibly fatiguing so be mindful your client may require breaks more frequently.
Request a Ground Rules Hearing
This will ensure everyone is aware of the individual’s diagnosis and measures to assist (if your client feels comfortable sharing this information). During the Ground Rules Hearing that everyone within the courtroom has been made aware of the diagnosis (and discuss how the condition will be explained to the jury during a criminal trial), so that people know what to expect and that any motor or vocal tics are not intentional. Suppressing tics can be incredibly fatiguing, so it can be helpful to ensure your client knows everyone is aware, so they don’t have to stifle them. Highlight the particular stress involved in giving evidence and whether your client might have more tics at this stage. This will also be an opportunity to outline strategies that may assist your client. For example:
Asking hearing participants not to respond to any vocal or motor tics.
Allowing emergency breaks (your client could be given permission to hold up a break card, for example). This could be used if your client is experiencing an overwhelming amount of tics and needs to immediately remove themselves from the courtroom. It could be your client is experiencing a tic attack. If this is something your client reports to be an aspect of their condition, it should be raised at the ground rules hearing and discussions should take place regarding what to do in the event of a tic attack taking place.
Scheduling regular breaks in order for your client to have time to recover physically from the fatigue involved in both ticking and suppressing tics. These breaks should be in addition to those usual breaks implemented for recapping and checking your client’s retention of information (if required).
Recommend remote participation
Anxiety is strongly linked to an increase in a person’s tics and therefore remote participation may alleviate some (not all) of this anxiety, enabling the person to participate more effectively. Participating remotely may be particularly helpful during your client’s evidence, as this is commonly the most anxiety-inducing part of the court process. Ultimately, a conversation should be had, to establish the personal preference of your client and what they believe will help them minimize stress and anxiety.
Be patient
Tics may interrupt a person’s speech but be patient, don’t finish their sentences or predict what they are going to say. Give your client time to express their thoughts.
It’s National Epilepsy Week. This year’s theme is “Epilepsy Matters”, which encourages people with epilepsy to share their experiences and the things which matter to them about epilepsy. To mark the occassion, Communicourt intermediary Florence has shared her own experiences of epilepsy, alongside helpful learning and tips for court professionals who may be working with a client who has the condition. At the end of the post, you’ll also find information about how to help someone who is experiencing a tonic-clonic seizure.
Being a “me” with epilepsy
by Florence Roberts-Bowman, Communicourt intermediary
When I was about 8, I woke up in a wheelchair in hospital. I was a bit confused, as the last thing I really knew, I’d been watching Saturday morning programs on our big [cathode ray] tv. I don’t remember being particularly scared, just embarrassed to be wearing my pyjamas in public.
I don’t know to what degree a diagnosis of epilepsy impacted my little 8-year-old self. I knew that we got a new TV. I knew that I often had to close my eyes during films and theatre trips when everything got a bit strobe-y (which is always, annoyingly, during the best bits!). I didn’t have any responsibility for researching or managing my condition because my parents did all of that. And, thankfully, it wasn’t something that was intrinsically worrying for me. I used to enjoy an appointment at Walton Neuro, as it meant time off school, and invariably ended in a trip to the café. Over time, I’ve managed to glean dribs and drabs of information from specialists, understanding that there was a genetic aspect, a mutation. I have a letter somewhere about exactly what frequencies will set me of.
I will admit I’m not the ultimate authority on epilepsy. Firstly, I tend not to be awake or able to look in a mirror during a seizure, so I have no idea what they look like. Secondly, whenever I do engage in literature about epilepsy I get hit with words like ‘death’, ‘mortality’ etc., and that’s not particularly palatable. And I suppose, finally, thinking about what having epilepsy actually means sometimes makes me want to run back to that café and have a coffee and a brownie.
With that said, I thought I’d take some time to engage and explore what epilepsy means to me and other people with the condition, particularly those who we encounter in a court context.
Triggers
As I’ve grown up, I’ve learnt a lot more about what epilepsy is, and I’ve often found that, actually, it is quite difficult to find commonality between experiences. It surprised me to learn that only 3 in 100 people have photosensitive epilepsy (triggered by flashing lights or contrasting patterns – Epilepsy Action, 2022)[1]. Other seizure triggers might include:
Tiredness
Stress
Alcohol and drugs
Menstrual periods
Missing meals
Increased temperature due to illness(Epilepsy Action, 2020)[2].
This is why it is important not to assume that someone with epilepsy will be triggered by flashing lights, and instead seek to understand their individual experiences, where necessary. In a court environment, stress and tiredness are particularly important considerations. It’s essential for court professionals to be cognisant of someone’s presentation and to minimise possible triggers.
Important questions to ask to gain this information could be:
A starting point when working with someone with epilepsy is to check in with them at the beginning of and throughout the day, in order to monitor whether they have slept or are particularly anxious or stressed. Some questions like ‘did you sleep well?’ or ‘what did you have for breakfast?’ are very innocuous but can offer helpful insight. If long days in court, early rises, or travel are an issue, then shorter court days could be arranged.
When working with someone with epilepsy, it is also important to have a mechanism for breaks to be taken flexibly or on a more urgent basis. This may be to clear the court if someone is having a seizure or if the person is experiencing a sign that a seizure is approaching (for example someone may experience visual hallucinations before certain seizure types). As these warning signs (or certain seizure types) may not always be immediately obvious, it can be helpful to have someone close at hand to monitor presentation or provide the court user with a mechanism to request a break themselves (e.g., holding up a card or using a signal).
Having said that, I recently asked a janitor a Leeds Crown Court to turn off the flickering light in the toilets, so sometimes there is a straightforward answer!
Seizure types
When I had my first seizure it was the notorious ‘thrashing around on the floor’ type. The name for this is tonic-clonic or, alternatively, ‘grand mal’. I prefer the name grand mal because that would mean ‘big bad’ and that seems a fair description. It was only later that I was recognised as experiencing absence seizures (petit mal), which is where I forget where I am for a brief minute and flicker my eyes.
The impact that these seizures have on my life is markedly different to a tonic-clonic seizure. I will usually have a couple of absence seizures in the morning, generally at the weekend. Occasionally someone will point these out to me, but it doesn’t affect my activities. It’s more of a concern for me that people think I’m being rude and rolling my eyes. In contrast, if I had a tonic-clonic seizure, I would need some time to go and sleep it off. It would be a lot more concerning. If someone called an ambulance because I had an absence seizure, I would be quite annoyed because it was a waste of time. On the other hand, if I had a tonic-clonic seizure, it could be an appropriate step.
There are lots of different seizure types and it is important to appreciate factors like:
Different seizure presentations
Their varied impacts on the individual
The kind of assistance the person would require during and after the seizure.
Seizure types are classified according to where they arise from in the brain. They can start from:
The presentation of that seizure will then relate to its origin. For example, the seizures I experience both have a generalised onset.
Another important area of variation is the individual’s level of awareness during seizures. For example, in a tonic-clonic seizure someone will lose consciousness, but in a focal aware seizure an individual would not lose awareness. It is important to appreciate that, for someone who experiences seizures in only part of their brain, the symptoms can be very different.
For example, in the case of a focal seizure, someone may experience:
Sensory symptoms (like unusual smells or tastes, a tingling)
Emotional symptoms like a feeling of dread or déjà vu
Involuntary motor movements (like lip smacking, wandering around)
These visual resources, created by the Epilepsy Society may be helpful in understanding seizure classifications:
Whilst I think it is important to appreciate the differences between seizures, I am by no means saying that you need to know your ‘tonic’ from your ‘hyperkinetic’. That would be a difficult task as there are 40 seizure types[5]! Most individuals with epilepsy (or someone close to them) will know what symptoms they experience, what triggers them, how often they have them, and what, if any, help they need. I particularly appreciate resources such as the first aid information on the Epilepsy Action website which highlight that what you should do in the case of a seizure is likely to vary a lot.
Important questions to ask someone about their seizures could be:
IMPORTANT: Whilst the first aid required for people experiencing seizures may vary, it is important that if someone experiences a seizure that is over five minutes long, an ambulance should be called. The name for this is Status Epilepticus[7], which carries a risk of mortality and can lead to medical and neurological complications.
Perception and comorbidities
In court, I once worked with a service user who had epilepsy. She had an epilepsy alert bracelet that would often go off and sent an alert to her phone to let her know that she had a seizure. Often, she did not notice herself that she had them, but it didn’t phase her, it wasn’t dramatic, and we didn’t have to adjourn when the alert sounded.
This presentation and impact differs from the wider perception of epilepsy, as many may misperceive seizures as dramatic and debilitating. Alongside misperceptions about the symptoms of epilepsy, there are also seem to be many stereotypes about the lives people with epilepsy lead. In literature around epilepsy, descriptors such as ‘socially isolated’ often crop up. As with so many of the things I have discussed here, I think this is, at best, a generalisation – something that a brief caveat could dispel…
For some people with epilepsy, certain activities are restricted, but I don’t think there is anything inherent in people with epilepsy that means they would have difficulty interacting or forming relationships. I particularly wouldn’t want a panicked parent reading that on Google while waiting in A&E after their child has had their first fit. I’d choose to believe that, where people with epilepsy are socially isolated, this is because of the barriers in society rather than there being an aspect of epileptic people that means they are ostracised. However, I know this is perhaps my own cross to bear. At least society has stopped believing that people with epilepsy are possessed by evil spirits (Kaculini et al. 2021)[8]!
Of course, I know that these misconceptions about epilepsy arise because some people lead very different lives to me. People with epilepsy experience higher rates of certain comorbidities. For example, around 1 in 5 people with epilepsy have a learning disability (Epilepsy Society, 2019)[9]. Additionally, the cause of some epilepsies may affect the individual in its own right (for example in the case on head injury or stroke)[10]. Epilepsy often co-occurs with Cerebral Palsy, with studies giving incidence figures of Epilepsy in Cerebral Palsy as between 15 to 60% and higher (Sadowska et al. 2020) [11] . Further, the relationship between Epilepsy and different conditions can be complex. The risk for autistic children having epilepsy without a learning disability is 8% and the risk of epilepsy for autistic people who have a severe learning disability is 20% (National Autistic Society 2017)[12]. Thus, for these groups, epilepsy may be just one factor that makes up their presentation or need.
Whilst I was researching this blog, I read that in the UK 70% of people with epilepsy could be seizure free and only 52% are actually seizure free[13]. That’s quite a stark thing to read, but it does make me wonder whether that is because there are people who don’t have the ability to advocate for themselves like I do. Other people that may not have had the same impetus to control their seizures as I did, such as living independently, or going to university.
Now
I’m never quite sure how epileptic I am. I don’t have tonic-clonic seizures anymore because of my medication, so, theoretically, I could never tell anyone and be ‘normal’. I don’t tend to believe that epilepsy impacts my life, but, at the same time, I’ve never had a burning urge to be an HGV driver or a DJ in Ibiza. I am lucky to have found a job where it is the norm to travel on public transport and I do not need to drive. Things like that make me feel that I’m making choices and my path in life hasn’t been determined because of my epilepsy. But that might not always be the same and, at some point, I’ll have to change my medication and I may feel a lot less ‘normal’ again.
For about 10 years of my life, I’ve been taking Sodium Valporate (Epilim). This successfully controls my seizures, and felt a bit like a magic pill when other medications weren’t 100% effective. However, Sodium Valporate has become a lot more (in)famous recently for causing birth defects[14], which means that I’m continually telling health professionals that I won’t be becoming pregnant, and being offered other, less preferable, medications. Thinking about changing my medication is a big, ominous unknown. It’s hard to think about giving up my ‘normal’.
I described this predicament to an advocate and service user once, as the service user had children who were epileptic. The advocate took a breath and then responded, “You could get a dog”. I laughed and responded that you can’t get dogs for epilepsy like you do guide dogs. She replied, “You could get a dog instead”.
I’m a little more reticent now about talking to service users with epilepsy about my epilepsy. I used to think that it’s useful to share experiences as a way to relate and form rapport. Now I think that there are so many differences in what that actually means, that it’s not fair to compare. I think you have to give people space to feel what they want about it because, even if nothing disastrous is happening at the moment with your health condition, it’s still always there in the background. And I start and end every day by taking my pills.
For National Epilepsy Week, the charity Epilepsy Action is encouraging people to watch and share the video below, which explains how to help someone who is having a tonic-clonic siezure. You can learn more about epilepsy, donate and get involved in National Epilepsy Week by following and exploring organisations like Epilepsy Action, Epilepsy Society and Young Epilepsy.
[8] Kaculini CM, Tate-Looney AJ, Seifi A. The History of Epilepsy: From Ancient Mystery to Modern Misconception. Cureus. 2021 Mar 17;13(3):e13953. doi: 10.7759/cureus.13953. PMID: 33880289; PMCID: PMC8051941.
Dementia Action Week is all about supporting people with dementia and raising awareness of this common degenerative condition. There are currently around 900,000 people affected by dementia in the UK. This year, the theme of Dementia Action Week is Diagnosis. The Alzheimer’s Society has chosen this focus to highlight a recent decline in dementia diagnosis rates, demonstrate the benefits of receiving a diagnosis and tackle misconceptions about memory loss being a normal part of aging.
Video from Alzheimer’s Society
What is dementia?
Dementia is an umbrella term for a range of progressive conditions that affect the brain. Each type of dementia stops a person’s brain cells (neurones) working properly in specific areas, affecting their ability to remember, think and speak.
There are over 200 different types of dementia. Alzheimer’s disease is the most common, followed by vascular dementia. Different types of dementia cause damage to different parts of the brain, and therefore have different symptoms. Each person is unique and will experience dementia in their own way. People often associate dementia with memory loss, but while this is the case for some, there are many other symptoms including:
• Problems with concentration.
• Difficulty following a ‘train of thought’.
• Difficulty following conversations.
• Problems with word finding.
• Difficulties making decisions and judgements.
• Difficulties with eating, drinking, and swallowing.
• Changes in personality or behaviour; becoming withdrawn.
• Difficulties with visual perception and spatial awareness.
• Literacy and numeracy difficulties.
• Problems with perception, orientation and movement
Dementia is progressive, as time goes on, communication will likely become more difficult for someone with dementia. Although dementia can take years to advance, symptoms can worsen at each stage. Receiving a diagnosis is often an important step towards managing symptoms and coping with dementia. The Alzheimer’s Society found that 90% of people reported that getting a diagnosis had been helpful, citing a number of reasons, including access to professional advice and support, the ability to plan for the future and avoiding reaching ‘crisis point’.
Dementia and legal proceedings
While some participants in legal proceedings who have dementia may be found to lack capacity (or may not be fit to plead), others will have capacity but may have cognitive or communication challenges which the court will need to accommodate to ensure fair participation.
In this blog, we’ll explore some of the common cognitive and communication difficulties which might impact an individual with dementia’s participation in legal proceedings. We’ll also unpack some strategies which can be used to assist.
Aphasia (using and understanding language)
People with the most common types of dementia, for example, Alzheimer’s disease and vascular dementia, usually have a mild form of aphasia (NHS). Aphasia is a communication disorder which impacts a person’s expressive and receptive communication.
Expressive aphasia affects someone’s ability to find the right words. Sometimes related words might be used instead, for example (‘vehicle’ instead of ‘helicopter’) or substitute descriptions (‘thing to put food on’ instead of ‘plate’) may be used. Other people may find it difficult to insert a replacement word. Expressive aphasia doesn’t mean that an individual doesn’t recognise a person, item or term, or doesn’t know what they are discussing, they are simply unable to access the correct name or ‘label’.
If the person with expressive aphasia struggles to find the words they want to use, or they use words which don’t make sense, acknowledge what they’ve said and encourage them to say more. It may also be helpful to encourage them to draw, write or gesture, to help them convey what they wish to communicate. Additionally, if they struggle to find the words they want to use, or use words which don’t make sense, it may be helpful to acknowledge what the person has said, then encourage them to explain further.
Receptive aphasia affects the person’s understanding, making it difficult for someone to process and understand the language they hear.
If someone with dementia finds it challenging to understand verbal information, it can help to use simple language and concrete examples. Avoid using complex language or abstract concepts. Instead use familiar ‘everyday’ words to help the person understand what you are saying. Speaking in short sentences and imagining giving information in ‘bullet points’ can also be helpful. Make sure you clearly indicate when you begin a new topic and allow extra time for the person to refocus when switching between subjects.
It may be useful to use non-verbal communication yourself when interacting with someone with dementia. For example, a great deal of information can be conveyed through body language, facial expressions and tone of voice. Visual prompts can also be helpful, for example a pictorial list of the stages in a trial.
Speech difficulties
People with dementia may experience changes in their tone of voice or pitch. They may speak more slowly or loudly than usual, or they may sound more monotone. This can make it difficult for others to understand their speech or to interpret their emotion. If someone with dementia is not able to express themselves clearly, they may lose confidence, and feel anxious or depressed. They may also get frustrated because they are not able to communicate in the way they used to.
If a person is finding communicating through speech challenging, there may be strategies which assist. Non-verbal communication, such as facial expressions, gestures, and body language, can play an essential role in communication. For some individuals, exploring other communication mediums (such as writing, texting or typing) may also be assistive.
Technology is also a great asset, with many apps available to help support communication. Some helpful apps include:
Memory loss can be a symptom of any type of dementia, it is often among the very first signs in Alzheimer’s disease, and this can impact communication in several ways. People with dementia may repeat themselves or forget what they were saying, losing their ‘train of thought’. They may also have difficulty remembering important information such as names, dates or events.
Memory loss can be a distressing part of dementia, both for the person with the condition and for the people close to them. Memory loss can occur due to damage to the brain, affecting areas involved in creating and retrieving memories.
In court, it is especially important that respondents or defendants (in particular) can follow the thrust of evidence and retain key details from hearings, in order to make informed decisions. It may be helpful to give the person with dementia written cues, such as a ‘court diary’ to assist with their retention of their hearing or trial. If reading is difficult for them, voice notes may be of assistance. Regular recaps of key points may aid the person with dementia to retain important details. Another helpful measure is taking regular breaks within the court day to check the individual’s retention and understanding of details, and to allow them to ask questions about anything they are unsure about.
Other cognitive difficulties
As dementia progresses, it can become challenging for people to maintain their focus on a conversation or activity for an extended period. They may become increasingly distracted or lose focus, leading to a disjointed or incomplete conversation, or causing them to miss important information. It’s also important to consider the impact of fatigue, which may be more severe.
Dementia affects the brain and has an impact on cognitive ability. Therefore, someone with dementia may not be able to think as quickly as they used to, may not understand complex ideas and may become easily confused. They may need additional processing time to figure out how to respond to a sentence or question. It can also be harder for people with dementia to hold multiple pieces of information in mind at once.
In court (if the individual has capacity), the individual’s cognitive functioning will need to be considered so that strategies can be put in place to ensure they can participate in their trial or hearing to the best of their ability. Strategies may include shorter court days, more frequent breaks, regular recapping of information and the other memory supportive strategies explored in the previous section. It may also be helpful to find out what time of day they are best able to attend to information (for example, when they feel most alert and least fatigued) and to schedule key events within the trial or hearing to accommodate these needs (for example, scheduling their evidence when they are most alert).
Dementia can have a significant impact on cognition and communication, including during legal proceedings. The difficulties associated with dementia can hinder an individual’s ability to understand and retain information, and express themselves effectively, potentially impacting their ability to participate in their trial or hearing. However, small adjustments can improve participation for people with dementia, depending on the nature and progress of their condition. It is crucial for court professionals to employ strategies that accommodate the unique needs of the individual.
If you want to read more, the Alzheimer’s Society has some additional tips on communication as well as lots of other useful information. The dementia support line on 0333 150 3456 is also there to help.
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