CVP Intermediary Rooms: The inside view

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.

A woman with her head in her hands looking at a laptop. She looks very stressed.
Photo by Elisa Ventur on Unsplash

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 Action social media image for Tourette's Awareness Month. It shows a head in profile with the brain filled with different coloured areas. Each area includes a feature of Tourette's Syndrome, including sensory needs, anxiety, insomnia and OCD.

Tourette’s at court: 5 tips to support your client’s participation

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 Action social media image for Tourette's Awareness Month. It shows a head in profile with the brain filled with different coloured areas. Each area includes a feature of Tourette's Syndrome, including sensory needs, anxiety, insomnia and OCD.

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 ticsVocal tics
Head jerkingRepeating words or phrases
Shrugging shouldersClearing throat
HittingSinging
Blinking excessivelyHumming
Clicking fingersGrunting

A common misconception is that everyone with Tourette’s shouts out obscenities! Coprolalia is 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:

  1. 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.

  2. 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.

  3. 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).

  4. 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.

  5. 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.

To learn more about Tourette’s and tic disorders, visit the Tourette’s Action website and get involved with the #ItsWhatMakesMeTic campaign on Instagram, TikTok, Twitter, LinkedIn and other channels.

Picture of Florence in black and white with a purple background. The text reads "Being a Me with Epilepsy".

Being a ‘me’ with epilepsy

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:

  • What things cause you to have a seizure?
  • What warning do you get?
  • How often do they happen?
  • What time of day do they happen?

(Epilepsy Action, 2023)[3]

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:

  • A single location (focal)
  • Both hemispheres (generalised)
  • An unknown location in the brain

(ILAE, 2017)[4

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)
  • Being vacant
  • Automatic body functions (such as swallowing).

(ILAE, 2017)[4]

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:

  • How long are your seizures?
  • What happens when you have a seizure?
  • Do you get a warning before you have a seizure?
  • How long does it take to recover?
  • Do you need any first aid after a seizure?
  • Do you need any help after a seizure?
  • Do you take any medication?

(Epilepsy Action 2023)[6]

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.


References

[1] https://www.epilepsy.org.uk/info/seizure-triggers/photosensitive-epilepsy

[2] https://www.epilepsy.org.uk/info/seizure-triggers

[3] https://www.epilepsy.org.uk/app/uploads/2023/03/B135.08_Work_and_Epilepsy.pdf  

[4] https://www.ilae.org/index.cfm?objectid=B2747210-1E7A-11E9-87F8204747814332

[5] https://epilepsysociety.org.uk/about-epilepsy/what-epilepsy/epilepsy-facts-and-myths

[6] https://www.epilepsy.org.uk/app/uploads/2023/03/B135.08_Work_and_Epilepsy.pdf

[7] https://www.ncbi.nlm.nih.gov/books/NBK430686/#:~:text=Medical%20complications%20include%20cardiac%20arrhythmia,with%20status%20epilepticus%5B19%5D.

[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.

[9] https://epilepsysociety.org.uk/learning-disabilities

[10] https://www.tandfonline.com/doi/full/10.1080/14737175.2020.1840979

[11]  Małgorzata Sadowska, Beata Sarecka-Hujar & Ilona Kopyta (2020) Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options, Neuropsychiatric Disease and Treatment, , 1505-1518, DOI: 10.2147/NDT.S235165  

[12] https://www.autism.org.uk/advice-and-guidance/professional-practice/epilepsy-autism

[13] https://www.youngepilepsy.org.uk/what-we-do/health-research/information-about-epilepsy#:~:text=Epilepsy%20facts%20and%20stats,-Approximately%20600%2C000%20people&text=Approximately%2060%25%20of%20people%20have,myoclonic%20seizures%20and%20other%20types.

[14] https://www.bbc.co.uk/news/uk-england-humber-64709971

Dementia Action Week text. It reads, "It's not called getting old, it's called getting ill".

Dementia Action Week 15-21st May

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 problems

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.

A woman's ear up close, she has dark hair and her face is cropped out

Deaf Awareness Week 1st–7th May

This week is Deaf Awareness Week and the theme for 2023 is “Access to Communication”. To mark the event, we’ve shared some information, tips and resources below, to help ensure access to communication in court for people with hearing loss.



Hearing loss is very common, particularly among older age groups. In the UK, it is estimated that 1 in 6 people have some form of hearing loss (that’s around 12 million people across the country). The Royal National Institute for Deaf People (RNID) estimates that “in the UK, more than 40% of people over 50 years old have hearing loss, rising to more than 70% of people over the age of 70”.

As hearing loss is so common, it’s essential that knowledge is shared to improve understanding of the condition and strategies communication partners can use to help others achieve Access to Communication.

Intermediaries and hearing loss

At Communicourt, we rarely work with profoundly d/Deaf court users who use sign language to communicate. These individuals may require a sign language interpreter and/or lip reader and, with this support in place, may not require an intermediary. When a d/Deaf court user also requires intermediary assistance, this is often provided by specialist d/Deaf intermediaries (like Chantelle De La Croix and Chris Bojas).

Communicourt intermediaries do, however, frequently work with service users who have different degrees of hearing loss.

Hearing loss is a term used when sound signals do not reach the brain. There are many different types of hearing loss and different degrees of severity:

  • Mild hearing loss – The individual may have difficulty hearing speech clearly in a busy environment. They may struggle to hear quiet speech, especially soft sounds like “s” and “f”
  • Moderate hearing loss – The individual may struggle to hear speech at a normal volume and may require amplification (using devices such as a hearing loop).
  • Severe hearing loss – The individual will not be able to hear normal speech and may only be able to hear loud sounds.
  • Profound hearing loss – The individual will not be able to hear any speech and may only hear some loud sounds.

Hearing loss at court

The courtroom can be an especially challenging hearing environment, even for people who do not have a hearing impairment. Rustling papers, multiple people talking at once, large rooms, technical difficulties playing video evidence, sitting in the dock behind a glass window – all of these factors and more can make it particularly difficult to hear clearly at court.

For court users with hearing loss, these factors can make hearing proceedings even harder, adversely impacting their ability to follow legal argument and evidence.

Hearing aids and hearing loops are two devices which can amplify sound in the courtroom. Hearing loops can be used separately from or in conjunction with hearing aids at court. The court user can be provided with a hearing loop headphone set or can wear a device around their neck which broadcasts sound from the courtroom hearing loop to their hearing aid (when these are set to the ‘T’ function).

However, it’s important to remember that court hearing loops can be affected by feedback and background noise, so may not ensure clear hearing at all times. You can read more about hearing loops in this Communicourt blog (which includes a judge’s experience of using a hearing loop).

Strategies to support hearing difficulties at court

The strategies required to support an individual with mild or moderate hearing loss will vary from person to person and may be affected by any other communication needs they have. The following general tips may be of assistance in the courtroom and in private legal meetings:

  • Learn more about the person’s hearing. Is their hearing different in different environments? How has their hearing loss previously impacted them in legal proceedings? What assists their hearing? Have they used a hearing loop before? What was their experience of this?
  • Adapt the communication environment. The court user is likely to hear speech sounds best in a quiet setting, without background noise. A busy courtroom with loud typing and paper shuffling may be particularly challenging. Adjustments (like seating them closer to the judge and barristers) or repetition of key points may be required.
  • Minimise background noise as much as possible. This might include turning off fans or buzzing equipment in the room, closing windows, or choosing a meeting room on the ‘quiet side’ of the building.
  • Face the individual and ensure you have their full attention before speaking, so that they can see your mouth clearly. Visual cues like lip-shape can help support communication.  
  • Make sure everyone can see each other, round tables are best for meetings. Make sure there is nothing on the table obstructing your view of each other. Ensure there is good lighting in the room so everyone can be seen clearly.
  • Speak clearly at normal speed, don’t slow down your speech as this distorts your lip patterns, making it harder to use visual cues to support hearing.
  • Ensure just one person speaks at a time. It can be much more challenging to hear clearly when multiple people are speaking.
  • Use writing (if your client has effective literacy), on paper, on a laptop screen or via text, to communicate information which the individual is struggling to hear.
  • Repeat yourself when necessary, be patient, don’t say “it doesn’t matter”.

If the court user is using a hearing loop in the courtroom:

  • Avoid hybrid hearings, if possible. These can cause feedback.
  • Use a flashcard or agreed signal to allow the individual to indicate when they are unable to hear. The clarity of the hearing loop may fluctuate.
  • Be alert to issues with interpreters and intermediaries. When wearing a hearing loop, the court user may not be able to hear their interpreter or intermediary clearly and alternative arrangements may need to be made. For example, permitting the court user to connect to the hearing remotely from a private room. This will allow the intermediary or interpreter to provide summaries or translations at a loud volume (without disturbing the court).

Further reading (legal)

Useful services, charities and organisations

My Intermediary Week: Laura

Have you ever wondered what a ‘typical’ working week looks like for an intermediary? To give you a glimpse into the intermediary world, Laura has shared her experience of a final hearing at Newcastle Family Court, where she assisted a service user named Mandy*. 

*Names, locations, case details and other identifying information have been changed

A bit of background…  

I first met Mandy before her final hearing, in fact, I was the assessor who met with Mandy and recommended that she was assisted by an intermediary throughout her case. The assessment was carried out with the assistance of an interpreter, as English wasn’t Mandy’s first language.  

The assessment 

During her intermediary assessment, I noted Mandy had difficulty in a number of communication domains, which would likely affect her engagement and participation in court proceedings. For example, she had difficulties with concentration, she often digressed at length from the topic of conversation to discuss unrelated topics, and she did not always recognise when she needed a break. I also observed her to have literacy difficulties, limited understanding of court vocabulary and limited understanding of less commonly used words in general.  

The assessment took three hours. Working with an interpreter always requires more time, as more communication is required to share information. In addition, Mandy often moved away from the topic at hand, to discuss unrelated matters at length. She required support to refocus upon the current subject. These two factors meant that the assessment tasks were not all completed within our three-hour meeting. For this reason, I carried out the remaining assessment task at court (just prior to the Case Management Hearing).  

Preliminary hearings 

I assisted Mandy at a Case Management Hearing and then returned for the Issues Resolutions Hearing, where I was able to assist the court during a short Ground Rules Hearing. This step is to ensure that measures are put into place and agreed to ensure Mandy has a fair trial.  

Thanks to our regular encounters, Mandy became comfortable around me, and we were able to build a good rapport in advance of the Final Hearing. I was pleased I was assigned to assist her during her Final Hearing as I already knew her case and understood her communication needs well.  

The final hearing 

The final hearing started off as normal. I was required to attend court at 9am. Luckily, it was only a short train trip for me as I am already based in the local area. This was a case where the Local Authority was seeking a care order for the children (foster care)*. The guardian agreed with the Local Authority’s proposals. Mandy opposed the social worker’s plans and wanted her children back in her care. 

On the first day, we listened to the current social worker give evidence. On the second day, we heard from the social worker who completed Mandy’s parenting assessment.  

Whilst in court and conferences, I worked with Mandy to ensure she understood the evidence. She had difficulty understanding legal terminology, following lengthy legal discussions and understanding written information. I used strategies including visual aids, simplifying information, repeating key points and asking her to repeat what she understood in her own words (to check her understanding). These strategies were helpful in this case. After discussion with the court, I also asked the interpreter not to directly translate everything that was being said as this would overload and confuse Mandy. Instead, I provided simple explanations throughout, which were then interpreted to Mandy. 

Evidence from the professionals began to paint a picture which suggested that Mandy should have been provided with additional support to learn parenting skills (as recommended in the parenting assessment), which had not been provided. This appeared to be the theme of the case and it was becoming a concern for both Mandy’s barrister and the guardian. 

Unfortunately, the next day was adjourned due to one of the social workers having health issues*. I went back home on this day and used it as an admin day (which included updating case notes and replying to emails). I also worked on one of my targets. This target was on researching the effects of strokes upon communication, specifically dysarthria (slurred or unclear speech), and creating an information sheet that included some strategies intermediaries can use when working with individuals who are affected by this condition.  

A change in direction 

After listening to more witnesses from the Local Authority, the guardian asked the Local Authority to reconsider their position. This meant that, if the Local Authority took the guardian’s suggestion, they would have to do a new parenting assessment with Mandy, providing her with the right support and education as part of that process. Proceedings would be adjourned until this work had been undertaken. 

The next day, the Local Authority decided that Mandy should be re-assessed and they were no longer asking for a care order. Court was then adjourned to allow the Local Authority to make enquiries about how the assessment would be carried out.  

After the hearing 

That afternoon, I spent time with Mandy, her barrister, and the interpreter. Due to her learning difficulties and language barrier, I decided it would be a good idea to construct a visual aid to help her during contact sessions.  

I created a document with pictures of healthy food, a parent hugging their child, game boards etc. The purpose of this was to give a printed version to Mandy to look at before contact sessions, to remind her of what to do and what to bring. Through working with the interpreter, we were able to come up with simple words we could put below each picture in Mandy’s first language, so Mandy had some extra context. Mandy was really happy with this resource and was able to clearly explain what to do at contact, when her understanding was checked.  

On the final day, we came back to court for a short hearing which confirmed the local authority plans for Mandy’s re-assessment.  

Final thoughts 

As an intermediary, there’s no such thing as ‘typical’ day or week.  Sometimes we may work with service users we have previously assisted and other times we meet new ones. Everyone we work with has differing communication strengths and needs. As intermediaries, it’s important to recognise this and think of ways to improve their participation and communication.   

In my case, I enjoyed working with Mandy at different stages – from the assessment stage to the Issues Resolution Hearings, down to the Final Hearing. I managed to build a good rapport with her, which helped her to become more comfortable around me, engage well with my strategies and allowed me to recognise how to better assist her.  

I was also able to implement effective strategies to work with the interpreter, without overloading Mandy. Approaches like discussing the boundaries of our overlapping roles (at the outset of proceedings) and the importance of verbatim translation of intermediary simplifications, helped to ensure Mandy’s needs were being met throughout.  

A yellow rosette prize on a blue background

We’re proud sponsors of the Northern Law Awards 2023

We’re delighted to announce that we are one of the main sponsors of the Northern Law Awards 2023. We’ve also chosen to sponsor the “Family Law Team of the Year” category, which celebrates the incredible work of family law teams across the North of England.  

Text logo for "Northern Law Awards 2023" in green and grey font.

Our intermediaries work with family solicitors who represent people with communication difficulties every day. So, we see first-hand the long hours, the commitment, the empathy and the tireless advocacy of family law practitioners, even (and sometimes especially) when faced with extremely challenging cases.  

We know that so many family law professionals go far further than the extra mile for their clients, and we see the positive impact of their hard work. For these reasons, we’re really excited to be sponsoring this category which recognises outstanding family law teams in the North of England. 

Nominees in the category were required to demonstrate some of the following qualities or achievements: 

  • Legal expertise 
  • Appreciation by clients 
  • Client service excellence 
  • Project management skills 
  • Team working

The finalists for Family Law Team of the Year have now been announced as:  

We’re looking forward to celebrating the nominees and winners at the Northern Law Awards Dinner on Thursday 22nd June 2023 at the Hilton Newcastle. More information about the event can be found here.  

Autism Acceptance Week: Celebrating strength, breaking barriers

Autism Acceptance Week provides an opportunity to celebrate the unique strengths and abilities of autistic individuals whilst also considering the barriers autistic people may face – and the importance of addressing these barriers to promote equality.

Autism is a lifelong form of neurodiversity that can affect how people communicate and relate to the world around them. There are currently around 700,000 autistic people in the UK. Whilst some autistic people may share some common characteristics, autism is an incredibly varied form of neurodiversity. This means that every autistic individual has a unique mixture of strengths, skills and differences.

“When you’ve met one person with autism, you’ve met one person with autism”

– Dr Stephen Shore

Neurodiversity is the idea that there is a natural variation in human neurocognitive functioning and that this diversity should be recognised, accommodated and celebrated, rather than stereotyped or stigmatised.

Many autistic people face misconceptions about their abilities and differences. Many also face barriers to participation in important areas of life, from the workplace and healthcare settings to educational spaces, legal proceedings and social groups. It is important for these barriers to be removed and for neurotypical people to understand autism and the possible adjustments that may assist neurodiverse people to ensure there is equal access in these spheres.

Celebrating autistic strengths

Two male forearms holding hand weights, the arms look strong and are flexing.
Photo by Ambitious Creative – Rick Barrett on Unsplash

Just like neurotypical people, autistic people have all sorts of diverse strengths and special skills. However, there are some strengths which are more commonly reported by autistic people.

One of the most oft-reported strengths is the ability to focus intensely on a particular topic or interest. Many autistic individuals have a special interest that they are deeply passionate about, which can lead to exceptional knowledge and/or skill. This intense focus and attention to detail can be a valuable asset. Additionally, many individuals with autism have very strong memory skills.

Some autistic individuals are very honest, direct and straightforward. While this can sometimes be misperceived as insensitive, it can also be refreshing in a world where people often hide their true thoughts and feelings. This directness can be a strength in court hearings and trials, especially during evidence giving.

Autistic people often value consistency and routine and therefore they may be extremely reliable. This can mean that autistic people with these strengths often follow through with their promises, show up on time and complete tasks thoroughly whilst meeting deadlines. Autistic people often thrive on predictability which can be a driving force in being honest and reliable. While reliability is a significant strength, it is important to recognise that not all individuals with autism possess this strength to the same degree and each individual with autism (or without autism) is unique.

Strength-based approaches to autism are increasing in research and practice. Such approaches are thought to improve well-being and mental health in autism. Additionally, a 2023 study by Taylor et al. found that autistic and non-autistic people reported similar strengths but autistic participants reported less external awareness and utilisation of their strengths compared to non-autistic people. The paper highlights the importance of autistic people understanding their own strengths and having the opportunity to utilise these abilities. The top ten strengths reported by autistic participants in the study were:

  • Pattern recognition
  • Using technology
  • Logical thinking
  • Intelligence
  • Attention to detail
  • Academic ability
  • Problem solving
  • Adherence to routines
  • Understanding systems
  • Repetitive work

Breaking down barriers

Photograph of a street obstructed by lots of road work signs and barriers.
Photo by Kevin Kandlbinder on Unsplash

There are also some barriers autistic individuals may face, often related to communication. They may require adjustments and adaptations to process and understand language (including non-literal language), express themselves, understand non-verbal communication and engage in neurotypical social routines. Further, some autistic people may have differences around receptive language, meaning they may not always comprehend what is being said to them. Some autistic individuals may have a delay in their ability to understand language and they might find it hard to process multiple sources of information at the same time, making it difficult for them to understand conversations in a noisy or stressful environment. It is important adaptations and adjustments are considered to ensure that effective communication takes place.

33% of the general population experience sensory challenges and this can also be a significant aspect of autism. It is important to note that everyone has different sensory preferences, some autistic people may have heightened or reduced sensitivity to certain stimuli such as light, sound, touch or smell. For example, someone with a heightened sensitivity to sound might find it difficult to concentrate or communicate in an environment where there are lots of different noises. What may trigger sensory overload for one person, may not be bothersome for another, also sensory preferences may change.

It is important to understand someone’s sensory preferences and then adapt environments to accommodate these sensitivities by taking measures such as, reducing noise levels, adjusting lighting, providing sensory stimulation (e.g., fidget objects) to help create a sensory-friendly environment for autistic people. To find out more about different sensitivities check out the Autism Speaks website.

Autism at court

Photograph of the front of the Royal Courts of Justice in London at sunset.
Photo by Mahosadha Ong on Unsplash

At Communicourt, we often work with autistic individuals in the court system. We see first-hand the difficulties faced by autistic people who are navigating the often overwhelming and confusing legal landscape. Court hearings and trials can be especially stressful with complex legal procedures, shifting timescales, unfamiliar processes and an environment that may prove challenging for some autistic people. These factors can lead to overwhelm, misunderstanding and miscommunication, which can have serious consequences.

In addition, the court environment can heighten some common autistic characteristics. Meltdowns or shutdowns may result from highly stimulating environments (such as a court environment) or situations which result in high anxiety levels.

When an autistic person is having a meltdown, they often feel extremely anxious and distressed, which may be misinterpreted as frustration, non-compliance, or anger. It is important to understand when a meltdown is happening and to support an autistic person through this process. Meltdowns can be very emotionally draining and physically tiring and, therefore, someone who has experienced this may need to take a break before they can continue processing information.

Shutdowns can also occur in overwhelming situations. During a shutdown, a person may partially or completely withdraw. If an autistic person is experiencing a shutdown, they will likely be unable to take in any more information and they may not respond to communication anymore. A break may be necessary, so the individual has time to withdraw and recover.

We work to ensure that autistic people have their needs accommodated and voices heard. Our goal is to ensure all of our service users receive bespoke support to enable effective participation in legal proceedings. It is important to focus on the individual and their unique experiences, strengths, differences, preferences and boundaries. This might include recommending alternative forms of communication or suggesting adaptations that can help autistic people feel more comfortable and confident in the courtroom. For example, considering the sights, sounds and environment. Visual aids such as pictures, timelines or written words may also help some autistic people understand verbal information and communicate more effectively.

Happy Autism Acceptance Week!

During Autism Acceptance Week, it is essential to celebrate and raise awareness of autism. Let’s continue to break down barriers and create a more inclusive society for all. Autism affects each person differently; we should approach each autistic person with an open mind and recognise their unique strengths and challenges. Roy T. Bennett wrote in his book The Light in the Heart, “We are all different. Don’t judge, understand instead”.

If you are a legal professional looking to improve your practice when assisting autistic clients, download our free guide to autism at court from The Access Brief.

Image of a young boy looking sad in front of a blackboard featuring numbers

Dyscalculia: Why numbers matter in communication

3rd March 2023 is Dyscalculia Awareness Day. To mark the occassion, we’ve explored this specific learning difficulty, shared some personal experiences of dyscalculia and considered how dyscalculia can impact court users during legal proceedings. Legal professionals who would like learn more about assisting court users who have numeracy difficulties can download a free guide from The Access Brief.

What is dyscalculia?

Dyscalculia is a specific learning difficulty, which is lifelong. The DSM-5 defines it as:

 ‘Difficulties in production or comprehension of quantities, numerical symbols, or basic arithmetic operations that are not consistent with the person’s chronological age, educational opportunities, or intellectual abilities.’

The British Dyslexia Association states:

‘Dyscalculia is a specific and persistent difficulty in understanding numbers which can lead to a diverse range of difficulties with mathematics.’

In the past, dyscalculia was sometimes referred to as “number blindness”. In contemporary times, it’s often casually described as “like dyslexia for numbers”, but this can be misleading as they are separate conditions.

Just as dyslexia’s impact stretches beyond its effects upon reading, dyscalculia can affect people in ways that we may not immediately think of.

No two people with dyscalculia are the same, but areas of difficulty can include:

  • Counting, backwards and forwards
  • Connecting a number to the quantity it represents (e.g., the number “2” to two apples)
  • Using time concepts (e.g., planning travel times or considering how long a task will take).
  • Remembering numbers, such as times, dates, phone numbers, what area of the car park you are in, the number of your hotel room.
  • Doing mental arithmetic (people may prefer to work things out on paper or count on fingers).
  • Reading the time from analogue and/or digital clocks.
  • Recognising patterns and sequences.
  • Recalling mathematical processes, even after learning them several times.
  • Recalling mathematical facts e.g. times tables.
  • Handling money e.g. knowing the total cost of your shopping basket or working out change.
  • Distance and spatial issues, such as map reading, telling left from right, following directions.
  • Poor visual and spatial orientation.

Prevalence and co-morbidities

An estimated 3-6% of people have dyscalculia, with a much great number having maths learning difficulties to a lesser degree.

Like many learning difficulties, dyscalculia rarely occurs in isolation. 11% of people with ADHD have dyscalculia, and it often occurs alongside dyslexia or dyspraxia.

A visual depiction of statistics showing that 3-6% of people have dyscalculia and 11% of people with ADHD have dyscalculia

Similar difficulties can also onset later in life, due to conditions such as a brain injury or stroke. This is called acalculia.

Diagnosis

Dyscalculia appears under the “specific learning disorder” (SLD) section in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5). There’s no set test for dyscalculia. A psychologist may evaluate using academic history, personal accounts and numeracy assessments.

In the UK, there’s no standardised pathway for obtaining a diagnosis, particularly for adults. This means that many people with these difficulties will never be told they have dyscalculia, unless they pursue a diagnosis privately. Various ‘screeners’ are available, many for a fee, that can give an indication of whether dyscalculia is ‘likely’, though these tools cannot diagnose.

‘Maths Anxiety’

Often people don’t know that they have dyscalculia but are very aware of things that they find difficult, with no explanation for these difficulties. This can cause anxiety, which in turn can make people feel embarrassed and avoidant of certain tasks, or of asking for help.

People may feel embarrassed about using strategies such as counting on fingers or worry that they are holding others up when they need time to write things down or ask questions.

In education, it’s almost an accepted norm to say, ‘I hate maths’, but the dread of numeracy can creep into other subjects too, particularly as people get older and academic study becomes more nuanced. For example, what is physics, if not science maths? Chemistry is surely the maths that makes things go boom. Higher level education often relies on an ability to extract meaning from journal articles and research, where statistics, percentages, confidence intervals, standard deviations and ratios are commonplace.

Personal experience

Communicourt intermediary, Rory, has experienced persistent difficulties relating to numbers. He has kindly shared his personal experience of these difficulties:

“For me, I’ve taken the free screeners and been unsurprised by their indication that I may have dyscalculia. It sits alongside my being diagnosed with ADHD last year and would explain a lot of the difficult and anxiety-written experiences with maths and numbers that populated my education.

I have struggled with maths for as long as I can remember. Despite being labelled ‘gifted and talented’ in other subjects, I felt totally and stressfully behind in maths lessons. The phrases ‘You just think you can’t’ and ‘If you could just apply yourself’ came up a lot from well-meaning teachers and family members

Labels and diagnoses are not for everyone, but for me the explanation helps.

I am, regardless of a label, an adult who only knows the 5 times table (if given time to recite it whilst counting on my fingers).

I only know two phone numbers and two PIN numbers, and if I learn more, I think one may well fall out.

I wasn’t confident with telling the time on analogue or 24-hour clocks until I was in my teens.

I had 9 years of very patient maths tutoring and, every week, I turned up having forgotten all the processes I had learnt the previous week. (And the 450 weeks before that… Sorry, Mr K.)

I can listen to a personal finance podcast and understand the concept of a mortgage, or watch a (dozen) videos explaining what a standard deviation is, but once I try and apply that concept to actual numbers, it all crumbles away.

And very quickly, this becomes a list of things I’m not good at. And that then becomes a list of things I avoid doing in front of others, or at all. BUT, if I can admit that I find it difficult, I can spend my energy on working around that difficulty instead of beating myself up over it.

For example, If I’m given a code for a door at court or locker at a prison, the person who gives to me is going to have to wait while I dig out my trusty Post-Its or notes app and write it down. If I ask a service user for their date of birth, you can bet I’ll be heading straight for my trusty date calculator website to check if the age they gave was correct. I photograph the number on my hotel door before I leave. I’ve been blessed with ten fingers, and it would be rude not to use them for every counting opportunity that I can.

It’s not a flawless system. More than once I’ve diligently reviewed the number of the card I’m using for an online transaction and presently been contacted by the finance team to ask if I intended to buy my fancy pants on my company card (Sorry, Pam).

I still avoid certain tasks. I steer clear of credit cards, loans and investments because I haven’t got the foggiest idea how they work. If I can, I will pay something in a lump sum rather than instalments, to avoid any more numbers to keep track of. I have to trust that when my partner says, ‘This how much your share of the rent and bills comes to’, he’s telling the truth. (Hopefully he is and is not just saving for an early retirement at my expense. He is a spreadsheet man, and those things could say ‘Formula to steal all Rory’s money’ and I wouldn’t know…)”.

Dyscalculia in court proceedings

The intermediary role is generally associated with the understanding of words and language, and the understanding of numbers is not something that is typically considered when the court requests an intermediary assessment. However, time and number concepts are used in many areas of life and communication, and therefore difficulty with these concepts can impact court users’ participation in proceedings too.

For example:

  • Recalling and referring to dates is common in both written and oral evidence.
  • Detailed timelines and chronologies are often used in Crown court cases.
  • Navigating paperwork and court bundles e.g. ‘Page C653’ or ‘Paragraph 12.25’.
  • Expert reports often refer to percentages, percentiles, scores and ranges.
  • Number concepts occur in everyday speech e.g. “John missed a third of his classes” or “Mr Jones was late to 75% of the appointments”.
  • Difficulty with reading and estimating time can make planning journeys to court stressful, impacting service users’ punctuality and emotional state on arrival.
  • Knowing that being told to come back at “twenty to four” means they have to be back when their mobile phone shows 15:40.
  • Embarrassment or negative feelings about numeracy difficulties can lead to court users feeling anxious or trying to mask their difficulties. This can have a knock-on impact on attention, rapport-building and emotional regulation.

Communicourt intermediary assessments often look at a court user’s grasp of time and number concepts, and explore existing and potential strategies to assist each individual’s difficulties in the context of legal proceedings.

For more information on numeracy difficulties (and how legal professionals can assist court users with this area of difficulty) download our free guide on The Access Brief.

A speech bubble on a colourful background reading: "I've been feeling ... Can we talk?".

Open up on #TimetoTalk Day 2023

Today is Time to Talk Day, a day dedicated to breaking the silence around mental health. It’s a reminder that it’s important to check in on our mental health and the mental health of those around us. But let’s not limit these conversations to just one day a year. Let’s make it a daily practice to check in with ourselves and each other.

We’re taking this opportunity to remind everyone that it’s okay to not be okay and encourage you to reach out for support if you need it. Here are some general tips for maintaining good mental health.

  1. Take care of your physical health by eating well, getting enough sleep and exercising regularly.

  2. Connect with others, this could be through face-to-face conversations, phone calls or virtual chats.

  3. Practice mindfulness and relaxation techniques such as meditation or yoga. There are some great options online including Yoga with Adriene and the Calm app.

  4. Set realistic goals and work towards achieving them.

  5. Remember that it’s okay to ask for help.

Listening tips

Although it is Time to Talk Day, it’s also important to consider the people who listen and offer support.

At different times in life we may need to talk, at others, we may take on the role of listener and supporter. Both sides of this equation can be challenging and rewarding in different ways. Listening can feel draining or can impact your own wellbeing, but it can also help you feel connected and positive about your impact on others.

However, sometimes it can be hard to know how to reach out and talk to a someone who may be struggling with their mental health. Here are some tips to keep in mind:

  1. Be direct and honest. Let your friend know that you’re there for them and that you are worried about their well-being.

  2. Actively listen. Give your friend the space to share their thoughts and feelings, without judgement.

  3. Validate their feelings. Let them know that it’s okay to feel the way they do and remind them that they are not alone.

  4. Offer support. Let your friend know that there are people and resources available to help them (see resource list below).

  5. Encourage them to speak to a professional. Sometimes talking to a therapist or counsellor can be the best way to get them the help they need.

There are many charities out there who provide support and resources for people facing mental health issues. Some of these include:

  • Mind: Offers advice and support for better mental health.

  • Samaritans: Provides confidential emotional support to anyone in distress or finding it hard to cope. Samaritans are available to speak to 24 hours a day, all year long. Call them on 116 123 (free from any phone).

  • Rethink Mental Illness: Works to improve the lives of people affected by severe mental illness. Call them on 0808 801 0525 (between 9:30am and 4pm, Monday-Friday). If you want to webchat instead, visit this link between 10am and 1pm, Monday-Friday.


  • SANEline: If you are supporting someone with mental health problems or going through a mental health problem yourself, call SANEline on 0300 304 7000 (lines are open between 4:30pm and 10:30pm everyday).

  • Campaign against living miserably (CALM). Call the team on 0800 58 58 58 between 5pm and midnight, the lines are open every day. If you’d rather not speak on the phone, CALM have their own webchat service.

  • Your GP: Don’t forget, your mental health is just as important as your physical health.

If you, or someone you know is struggling with mental health, reach out to these charities, other support organisations or friends and family for help. Remember, talking about mental health is not a sign of weakness, it’s a sign of strength. It’s Time to Talk.

Time to Talk at court

Communicourt specialises in facilitating communication for individuals going through court proceedings. We see first-hand the very high levels of stress that court users can experience, and the toll legal proceedings can take on people’s mental health. In turn, this can negatively impact upon communication. 

From communicating with court users with mental health difficulties at some of the most difficult moments of their lives, our intermediaries are skilled in supporting people to talk at difficult moments.

Here are some lessons we’ve learned about really listening at court…

  1. Build rapport and create a safe and comfortable environment to enable effective communication.

  2. Allow time for clear communication and actively encourage court users to express themselves.

  3. Be aware of emotional dysregulation and provide support in a non-judgemental and empathetic way. Consider whether the individual needs a break and ask about strategies which can help them at difficult moments (whether that’s taking a walk, listening to music, doing a mindful activity or speaking to a supportive loved one).

  4. Ensure court users understand the legal proceedings and the court process.

  5. Empower court users to take control of their own mental wellbeing. Provide them with the resources (e.g., stress balls or fidget objects) they need to cope with the stress and uncertainty of a court case.

At Communicourt, we see first-hand how mental health difficulties can impact an individual’s ability to navigate the legal system. To find out more about the intermediary role, explore our website or visit The Access Brief (a free library of resources for legal professionals working with clients who have communication difficulties, including mental health difficulties).

On The Access Brief, you will find free downloadable guides on topics including supporting emotional regulation, assisting clients who have a range of diagnoses and what it’s like to work with an intermediary at all stages of family and criminal proceedings.