Thu, 16 Apr 2026 02:19:43 -0700WeeblyTue, 14 Feb 2017 19:45:11 GMThttp://www.specialist-speech-therapy.co.uk/blog/childrens-speech-and-language-therapy-leadDue to increasing demands for our children's speech and language therapy services, we are delighted to announce that Louise Engers is now leading the children's services.
Louise Engers qualified as a Speech and Language Therapist in 2003 from Birmingham City University and gained her MSc in Learning Disability and Multi-sensory Impairment in 2009 from Manchester University.  She has worked in a variety of roles with both children and adults with learning disabilities.  Louise has a special interest in learning disability, autism, sensory integration and developmental communication disorders.  She is a current member of HCPC and RCSLT and holds an enhanced DBS certificate.
​You can contact Louise directly to discuss your needs on 07411 765114
]]>Thu, 25 Aug 2016 18:55:37 GMThttp://www.specialist-speech-therapy.co.uk/blog/speech-and-language-therapists-requiredSpecialist speech and language therapy is seeking speech and language therapists to work as associates with either adult and paediatric clients. 
You can work at evenings and weekends to suit your needs (or during the week) . 
Hours are highly likely to increase due to demand for services rising on a daily basis. 
Excellent rates of pay. 
​Supervision provided and your time is paid during supervision.
Contact me to find out more about the opportunities available. ]]>Wed, 29 Jun 2016 01:00:01 GMThttp://www.specialist-speech-therapy.co.uk/blog/what-can-an-intermediary-doBelow are the some of the ways I have worked with vulnerable defendants as an intermediary:

​Working with defendants pre trial

• ​used pictures/ maps generated by the defendant to establish their evidence.
• work to explain the different options re: plea
  
• familiarisation visit to explain court room and its layout and who sits where.
  
• visual timetable to explain trial process
  
• producing guidance in form of a detailed report
  
• attendance at the Ground Rules Hearing

​Working with defendants during the trial

• ​explain proceedings
• explaining difficult concepts
  
• use of a visual timetable
  
• use of a map to explain testimony of others
  
• finding relevant information in a bundle
  
• requesting breaks
  
• use of line drawing to map to the court room
  
• allowing defendant to leave the room and then explaining what they had missed
  
• using drawing
  
• writing down key words to support understanding
  
• writing down comments to enable them to discuss the evidence they have heard with counsel
  
• intervening as necessary
  

Post-verdict or plea

• ​exploration with the legal team re basis for plea
• attendance at sentencing hearing
  
• facilitating communication at probation meeting
  

]]>Fri, 24 Jun 2016 01:00:02 GMThttp://www.specialist-speech-therapy.co.uk/blog/areas-of-communication-assessed-by-an-intermediary-for-vulnerable-defendantsThese are some of the areas I assess when asked to produce an intermediary report for a vulnerable defendant:

​Attention and Concentration

• ​how long?
• How do you know you have lost their attention?
• How long do they need to recover?
  
• What is the best method of signalling a loss of attention and concentration?
  

​Expression

• ​abilities to describe people and places
• extent of their vocabulary
• word finding difficulties
  
• abilities to suppress colourful language a
  
• abilities to sequence a narrative
  
• use of AAC such as writing, drawing or a communication aid
  
• use of gesture, facial expression, body language
  
• can they take turns in conversation?
  
• Can they stay on topic?

​Understanding

• ​vocabulary
• length of sentence
  
• legal terminology
  
• speed of processing
  
• grammatical complexity
  
• tag questions
  
• written language
  
• symbols
  
• pictures/maps
  
• figurative language
  
• body language and intonation
  

Speech

• do they stammer?
• is their speech unclear?
  
• What strategies have they got?
  
• Can they correct themselves if their message is not clear?
  

Suggestibility an ability to challenge

• ​do they try to answer questions they can't know the answer to?
• are they able to say they don't know or don't understand
  
• Will they correct me if I am wrong?
  
• Do they agree with the load of the question?
  

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]]>Wed, 22 Jun 2016 17:30:01 GMThttp://www.specialist-speech-therapy.co.uk/blog/how-does-an-intermediary-assess-a-vulnerable-defendantIntermediaries methods of assessing a vulnerable defendant's ability to participate within the trial vary.  Some will rely heavily on formal language assessment whereas others will use more observation and conversation. 
Through conversation with the defendant I am able to establish their abilities without a formal, structured approach and in real time.  For a number of people being asked to point to a picture from a choice of four doe not reveal their ability to process language in the real world.  For example they are not also trying to interpret body language, facial expression and tone of voice at the same time as trying to interpret the spoken message and compete with other distractions.  Conversation also allows rapport to be built.  This is of vital importance given the length of time you may be working with them in close proximity.
​Some people need the formal assessment as a means of warming them up to be able to engage in the conversation element as they find talking to strangers difficult, for example.  It is also possible to use it less formally than the instructions may suggest to enable you to gain the target information about the person's communication.
​There is no one size fits all and each defendant needs a tailored approach to meet their personality and communication needs. 
Some of the defendants I have assessed, I did not feel would benefit from the services of an intermediary either because they have adequate language skills or because their communication needs are such that facilitation would not be sufficient to enable the to actively communicate.  Some defendants require the services of an intermediary throughout the trial process whereas some may only need support when giving evidence (for example due to a speech difficulty).


]]>Wed, 22 Jun 2016 00:00:01 GMThttp://www.specialist-speech-therapy.co.uk/blog/speech-and-language-therapy-medico-legal-reportThis is the second article in the series.
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​The results of the formal assessment needs to be calculated and standard scores (where available) worked out.  The results of these assessments are always considered in the wider context of function in the real world. 
​The report itself takes  a number of hours to complete.  Relevant research papers need to be considered and referred to and an evidence based rationale for the treatment I recommend needs to be argued.  the information gained from the bundle, liaison with others and the assessment itself all form part of the clinical picture.
​If their are two speech and language therapists (one for the defence and one for the claimant) a copy of each report may be served and a joint discussion arranged.  The purpose of this discussion is to see what are the areas of common ground and can we agree on the best therapy approach to be taken in terms of frequency, duration etc.  It is hoped that by producing a joint statement on which we are both agreed that we can remove the need to attend court to give our evidence.
​The length of time litigation takes is long.  It is important to be able to commit to being called upon to produce progress reports, attend meetings with counsel, attend court, prepare joint statements, consider other expert's evidence etc. etc, It can be many years between the first assessment and the case coming to court or being agreed (and in some cases in my being paid)
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]]>Sat, 18 Jun 2016 00:00:01 GMThttp://www.specialist-speech-therapy.co.uk/blog/intermediaries-and-vulnerable-defendants​Intermediaries and vulnerable defendants
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 Who do intermediaries work with?
​Intermediaries work with defendants aged 10 plus within the criminal justice system.
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A defendant can be deemed vulnerable due to their age or because of incapacity such as a learning disability, communication difficulty or mental health needs.
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In 2007 Bryant found that the incidence of communication problems was higher in offenders than in the general population.  A research study at Polmont Young Offenders Institute found that 70% had significant communication problems (Polmont, 2007)

​With some defendants, their communication difficulties are very apparent. There may be reports such as school reports, psychology  reports etc. But with some defendants their needs are hidden.  Their language and communication skills may not have been assessed for a variety of reasons such as lack of engagement within the education system.  These defendants may find it difficult to attend and concentrate or to retain information.  They are often adept at hiding a lack understanding and may rarely indicate that they have not understood as well as showing a tendency to agree with what is said.

​If any of these difficulties apply to a defendant you are representing it is advised to seek an assessment by an intermediary who can advise on the best ways of communicating with the client and if an intermediary would be of benefit to them (and you).  Contact us today to make a request for an assessment.]]>Wed, 15 Jun 2016 15:56:03 GMThttp://www.specialist-speech-therapy.co.uk/blog/registered-intermediary-training-part-oneI have had the privilege of being selected to train as a Registered Intermediary
Registered Intermediaries play an important role in allowing vulnerable witnesses with communication needs equal access to justice. Some vulnerable witnesses and victims need assistance with communication and understanding in order to achieve their best evidence – Registered Intermediaries assist them in communicating during an investigation and at trial. Registered Intermediaries will help to make the justice process accessible to some of the most vulnerable people in our society. In some cases a Registered Intermediary will be the difference between a witness being able to testify or not.

Defining common terminology relating to the Witness Intermediary Scheme (WIS)   

• Special Measures - The Youth Justice and Criminal Evidence Act 1999 (‘the YJCE Act’) created the provision for a range of ‘Special Measures’ for cases involving vulnerable and intimidated witnesses to give their best evidence in court, one of which is the intermediary special measure.  
   
• The Witness Intermediary Scheme (WIS) - The scheme set up by the Ministry of Justice’s Better Trials Unit to implement the intermediary special measure and through which Registered Intermediaries operate. Please note the lower case spelling of the word intermediary in the context of the YJCE Act legislation.  
   
• Registered Intermediary - A professional communications specialist who has been recruited, selected and accredited by the Ministry of Justice, and whose details are recorded on the Intermediary Register, the WIS’s national database. Such an individual will be known as a Registered Intermediary (RI). Please note the upper case spelling used for Registered Intermediary in the context of the WIS.  

• Non-registered intermediary - Any individual – professionally trained or otherwise – who (i) assists a vulnerable defendant as an intermediary in the giving of evidence or throughout a trial.  Please note that a prosecution or defence witness but is NOT recruited, selected and accredited by the Ministry of Justice as an RI operating within the WIS.

]]>Wed, 15 Jun 2016 15:51:33 GMThttp://www.specialist-speech-therapy.co.uk/blog/speech-and-language-therapy-medico-legal-assessmentThe role of an expert witness speech and language therapist is a challenging one.  I have been providing medico-legal reports (clinical negligence / personal injury / quantum) for over ten years.  No case is the same.  The importance of formal training in both producing high quality reports and in courtroom skills cannot be understated.
​Initial enquiries regarding instructions can vary from a quick "can you confirm your email" to a detailed letter outlining the case and skills and expectations of the expert.    I always ask myself I am the right person and do I have the necessary skills and experience to provide an expert opinion on this case?  Remember your professional credentials may be challenged in court so only take on cases you have the expertise to fulfil.
Sometimes a bundle of papers can arrive without warning.  The bundle can be as little as one or two pages to what seems like endless lever arch files.  I have become more adept at screening quickly to establish what is relevant to speech and language therapy so as not to spend hours reading unrelated materials.
​Some of the claimants have a treating speech and language therapist, some have had no speech and language therapy to date and some have not had any for  many years.  There may be a case manager involved.  I may speak to the treating therapist or case manager to gain further information, if agreed by the solicitor instructing me.
​The form the assessment takes is dependent upon the clients needs and any background information revealed from the bundle.  For example what their interests are, who they live with, football team, etc.  this information can be used to establish rapport at the outset of the medico-legal assessment.  It is also a means of observing their communication skills in amore functional context.
​Formal language assessment is an important part of the appraisal as this can give an indication of their functioning compared to people of the same age, education level and gender as well as measuring progress which is particularly important if producing a follow up report.  I will record the assessment, on occasion, particularly if someone has a complex speech and language presentation or if their speech needs more detailed analysis or transcription.
​Many of the people I see have swallowing difficulties (this can be in addition to their communication difficulties).  I will undertake a detailed assessment looking at

• ​oromotor skills (which muscles and nerves are affected)
• risk of aspiration (food or fluid going down past the level of the vocal cords)
• speed and efficiency of swallow
• impact of posture and positioning
• fatigue
• textures
• size of bolus
• method of presentation
• feeding vs self-feeding

Quality of life is also a fundamental measure.  How much do they go out? How reluctant are they to eat in public? Do they attend family events? What is their perception of the difficulties on their day to day life?
​I also think that when writing a speech and language therapy medico-legal report that is important to establish their wish for further therapy, either now or in the future.  What are their goals?  What do significant others e.g. partner/parents/employer want?
​Once formal and informal assessment, exploration of impairment, disability and quality of life issues have been explored and any other relevant factors considered the assessment with the person concludes.

​Contact me today to discuss your speech and language therapy medico-legal reporting needs.
]]>Sun, 12 Jan 2014 21:12:05 GMThttp://www.specialist-speech-therapy.co.uk/blog/welcome-to-specialist-speech-therapySpecialist Speech Therapy, as the name suggests, is a specialist speech and language therapy service providing responsive, high quality assessment and treatment to children and adults in Birmingham, Solihull and across the West Midlands.  
It is owned and managed by Elizabeth Ackroyd, a Consultant Speech and Language Therapist in adult acquired neurological conditions.  She has many years' experience in the assessment and treatment of adults with speech, language and swallowing difficulties as a result of stroke, traumatic brain injury, progressive neurological conditions etc.
There are a number of associates working with Elizabeth providing services to schools and individual children.  The demand for services is rapidly growing and we would be delighted to hear from any qualified speech and language therapists looking to work in private practice.]]>