Evidence
Alert

Young offenders with undiagnosed language problems are twice as likely to reoffend within a year

Young people convicted of a criminal offence are much more likely to have another conviction within 12 months if they have an undiagnosed language problem.

People with developmental language disorder (DLD) have difficulty expressing themselves verbally or understanding what is said to them. The disorder often starts in early childhood but persists into adulthood and can cause many difficulties in life.

In a study of 145 young offenders recruited through the youth justice service, three in five were found to have DLD and none had been diagnosed before the study.

Poor language skills may make it hard for young offenders to take advantage of rehabilitation services designed to help them avoid reoffending. These services often involve talking through what happened, listening to victims and expressing regret.  If young people are unable to participate fully because of DLD, they may be more likely to reoffend.

The study suggests that bringing speech and language therapists into youth offending teams could help them to spot young people with DLD early. The therapists could suggest ways to tailor rehabilitation services to make them accessible to people with language difficulties.

What’s the issue?

Up to one in ten of the general population are estimated to have DLD, a little-known condition which causes problems with speech and language. Levels of DLD are six times higher in young people in prison for criminal offences.

One explanation for the high rates in prison could be that DLD increases the chances that young people who commit first crimes are unable to take effective part in rehabilitation services. That might make them more likely to reoffend and end up in prison.

Researchers wanted to know what proportion of first offenders had DLD, and whether they were more likely to reoffend than young offenders without DLD.

What’s new?

The researchers recruited 145 young offenders through youth justice services in England. Two-thirds were first-time offenders; the others had a previous offence but were still in an early encounter with the youth justice service.

Assessments of the young people’s language abilities, using two standard tests for expressing and understanding language, showed that three in five (60%) had DLD. None had previously been diagnosed, although two had seen a speech and language therapist in primary school.

The young people with DLD were 2.6 times more likely to reoffend in the year after their assessment:

  • 62% of people with DLD reoffended
  • 25% of people without DLD reoffended.

The researchers also measured the young people’s non-verbal IQ levels, age, previous offences, deprivation and other factors thought likely to affect their chances of reoffending. They found that DLD was a much stronger predictor of reoffending than these other factors.

Why is this important?

The research suggests that more than half of young offenders may not be able to make the best of the rehabilitation services offered to them. Identifying young people with DLD and developing services that they are able to access and engage with, might help reduce their very high rates of reoffending.

As a first step, a study in which speech and language therapists worked alongside youth workers in the youth justice service would be useful, to see whether their intervention could reduce reoffending.

What’s next?

Researcher Maxine Winstanley, a speech and language therapist, is applying for funding for a study in which she would work as part of a youth offending team. The aim would be to see if rates of reoffending among young people with DLD can be brought down.

Early identification of DLD when young people first enter the youth justice service could be extremely beneficial, she says, and she hopes these results will prompt closer collaboration between the youth justice service and speech and language therapy services. Ideally, every youth offending team would have an embedded speech and language therapist as an integral part of the team, along with a social worker and a police officer.

You may be interested to read

The full paper: Winstanley M, and others. Developmental language disorders and risk of recidivism among young offenders. J Child Psychology and Psychiatry. 2020. doi: 10.1111/jcpp.13299

The Raising Awareness of DLD (RADLD) organisation website explains more about the disorder

A paper about the prevalence of language disorders in youth criminal justice: Bryan K, and others. Language difficulties and criminal justice: the need for earlier identification. Intl J Lan & Comm Dis. 2015;50:763–775

An earlier study on the impact of language disorder: Norbury CF, and others. The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. J Child Psychology and Psychiatry. 2016;57:1247-1257

 

Funding: This research was supported by the NIHR Manchester Biomedical Research Centre and the Economic and Social Research Council.

Conflicts of Interest: The study authors declare no conflicts of interest.

Disclaimer: NIHR Alerts are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that views expressed in NIHR Alerts are those of the author(s) and reviewer(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Commentaries

Study author

As young people travel through the youth justice service, they are required to understand information given to them and many of the young people face challenges that are hidden or misinterpreted. There are many implications of unidentified DLD for young people in relation to their participation in youth justice processes.

Restorative justice policies are common with first time offenders. At the very heart of this is victim impact, and therefore the ability to communicate personal feelings as well as understand another person’s perspective and emotional state is crucial. Despite good evidence for restorative justice, my concern was for the young people who have DLD and the fact that it is a hidden disorder. Previous work with young offenders who are in youth offending institutions or on intensive orders consistently report disproportionate levels of DLD. It could be that their language skills are not good enough to access this rehabilitation, which relies on verbal mediation.

I wondered if young people were being pushed further into the youth justice system because of access issues to the rehabilitation that is on offer to them upon first entering the youth justice system. Are we getting it right at the first point of access?

I was expecting DLD to be a factor, but I was surprised by just how strongly it predicted reoffending. That is why this study is unique; we have not considered DLD as a predictor of reoffending before. The importance of early identification and treatment of DLD is important to help young people improve their life chances.

Maxine Winstanley, Clinical Lecturer in Speech and Language Therapy, School of Sport and Health Sciences, University of Central Lancashire

Lived experience

In 2011 I tried to stop someone committing a crime, but was then sued by the perpetrator. As an adult with DLD, I found the procedure that followed alienated me from society. I felt disbelief that I was being sued, I was seriously out of my depth during court procedures and deeply anxious.

Communication with my lawyer was problematic because I used simplified terms to explain the situation. This underplayed the seriousness of what had happened. The lawyer on the other hand used technical words like “interdict” which set me into a panic because I could not process his instructions. As a result of this mal-communication, the lawyer became muddled during the trial.

I knew that I would not cope with questions and answers in the court room, so by way of compensation I over-prepared my evidence. This annoyed the judge because he had too much to read in the allocated time. I doubt it was ever read. I had never been in a court of law before and was working from expectations, as opposed to explained instructions. When the sequence of events played out differently, I got frustrated and disruptive. Nothing made sense to me.

The perceived injustice of the whole fiasco destroyed my relationship with society. I can well imagine that a young offender with DLD, not able to fully engage in court procedure and understand the subtle nature of the judiciary, would feel further alienation from society.

Fiona Clubb, Castle Douglas

Advocacy group

When individuals with DLD receive the help and support they need, they make gains in their language skills and experience many successes. For many, however, their DLD is unrecognised and they may continue to struggle to understand language and to use language to express themselves. These ongoing struggles with language mean that they may not fully understand the rules, limits, and options described to them, and they may not have the words to explain their motives and intentions. These experiences can lead to negative consequences such as poor socioeconomic outcomes, anxiety disorders, and imprisonment.

This research, on the impact of unrecognised DLD, is particularly welcome. It’s focus on reoffending sheds light on the many barriers to accessing services experienced by those with DLD. The finding that those with unrecognised DLD are more likely to reoffend is compelling. Those with DLD might not be as equipped to fully take part in rehabilitation based on ‘talk therapy’ and restorative justice. As a result, their rehabilitation might not be as successful and this in turn might lead to higher rates of reoffending. The planned extension of this work to examine the impact of providing rehabilitation designed for those with DLD is a very important next step.

Lisa Archibald, International Committee, Raise Awareness of Developmental Language Disorder (RADLD)