Responsive Practice with Adults with Intellectual Disability

A PDF version of this document can be found here [link].

1. Introduction

Disclaimer: The material provided in this guideline is not legal advice and should not be treated as such. The information is intended as a guide only and should not be relied upon as the definitive authority on the law regarding communication with, or representation of, people with intellectual disability. No liability is accepted for any adverse consequences of reliance upon it. Further disclaimer information is provided here [link].

1.1 This guideline has been developed to assist legal and justice professionals, including police, lawyers, and judges, to work effectively with adults with an intellectual disability who are involved in the legal system.

1.2 In New Zealand, the term "intellectual disability" is commonly used in the contexts of diagnosis and funding allocation, however the term "intellectual disability" is increasingly being used interchangeably with "learning disability". "Learning disability is the term preferred by people with such disabilities themselves. 1

1.3 People with an intellectual disability have the right to be active participants in legal issues and processes as expressed by articles 12 and 13 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) (for more detailed information refer to the UNCRPD guideline). However, they are often denied this right due to an inability on the part of legal professionals to identify their disability, and/or to recognise and appropriately respond to their communication needs. They can also be disadvantaged by negative assumptions about their competence.

1.4 While people with an intellectual disability should not automatically be assumed to be vulnerable, the factors outlined above can combine to create significant vulnerability when they are engaged in the legal system.

1.5 This guideline includes general information about intellectual disability, and more specific instruction relating to case and client management when working with people with an intellectual disability.

2. What is Intellectual Disability?

2.1 Intellectual disability can be described as a life-long cognitive impairment, which could be genetic in origin, or the result of a brain injury experienced before, during, soon after birth, or during childhood. 2

2.2 Although people with an intellectual disability may take relatively longer to understand new information or learn new skills, they continue to learn new concepts and skills throughout their lives.

2.3 Some people will need intermittent and/or low levels of assistance relating to specific aspects of daily life (for example budget advice or help to develop literacy skills). Other people may require higher levels of support from disability services across all areas of life (for example 24-hour support within residential services).

3. How is a formal diagnosis of intellectual disability made?

3.1 An intellectual disability involves both impaired intellectual functioning and impaired adaptive functioning known to have occurred before the age of 18. 3 All of these factors are relevant in determining whether the impairment is present and its degree.

3.2 Impaired intellectual functioning includes difficulty in reasoning, problem solving, planning, judgment and abstract thinking. Intellectual functioning is often measured using IQ testing. Current best practice recognises that IQ testing alone is insufficient in diagnosing intellectual disability, 4 however in general terms an IQ score of less than 70 meets the diagnostic criteria for intellectual (intellectual) disability. This impairment has been described as a spectrum of degrees.

(a) borderline (IQ ranging between 70-75)

(b) mild (IQ ranging between 50-70)

(c) moderate (IQ ranging between 35-50)

(d) severe (IQ ranging from 20-35)

(e) profound (IQ below 20) 5

3.3 Adaptive functioning refers to a person’s ability to understand and demonstrate conceptual skills (for example, language and literacy); social skills (for example, communication and interpersonal skills); and practical skills (for example, independent activities of daily living across multiple environments).

3.4 Although the diagnostic criteria for intellectual disability requires that it was present before the age of 18, it is not uncommon for an assessment and confirmation of an intellectual disability to occur when the person is older than 18. 6

3.5 Importantly, intellectual disability often occurs in combination with other neurodevelopmental disabilities such as Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder, and mental distress related to depression and anxiety. 7 These conditions also need to be taken into account when working with the person. [Refer to relevant guidelines for additional information and strategies].

4. Identifying intellectual disability

4.1 In a legal context, it is important to identify a possible intellectual disability as quickly as possible so that formal assessments can be carried out and appropriate support and accommodations put in place. 8

4.2 As noted above, some people may not have been identified as having an intellectual disability prior to their appearance in court. 9 When a person’s adaptive functioning is similar to her or his peers, intellectual disability may not be obvious (e.g., when a person has a mild intellectual disability). Further, the person’s presentation, the particular legal context, and/or the level of knowledge held by police and lawyers can make intellectual disability difficult to identify.

4.3 Intellectual disability occurs in various forms and degrees of impairment. Therefore, it is impossible to rely on a single factor or indicator. That means that in a practical sense, people with an intellectual disability will possess individual strengths and skills but the nature of their impairment means that they are also likely to experience a combination of the following traits or characteristics including:

(a) Difficulty understanding straightforward questions;

(b) Being slow to answer, or experiencing confusion when responding to questions;

(c) Speech difficulties or reliance on alternative means of communication;

(d) Limited expressive language, language comprehension and/or lower than expected reading ability;

(e) Difficulty remembering personal details or events;

(f) Impaired reasoning;

(g) Difficulty expressing feelings;

(h) Difficulty with planning and problem solving;

(i) Poor concentration;

(j) Poor interpersonal skills, for example difficulty maintaining eye contact or initiating conversation, or unanticipated responses to certain social situations;

(k) Difficulty understanding time;

(l) Difficulty understanding their legal rights and/or legal processes;

(m) A desire to please when responding to questions;

(n) A tendency to be suggestible, or to acquiesce (agree to scenarios or questions posed to them);

(o) Fear of authority;

(p) A tendency to disguise their disability and associated difficulties.

4.4 If intellectual disability is suspected, the following questions may assist in establishing whether a more comprehensive assessment might be appropriate. 10

(a) Are some things harder for you than for other people? [If yes] What’s harder for you?

(b) How easy is it for you to read?

(c) What kinds of things do you like to read?

(d) Do you fill out forms yourself? Do you sometimes get other people to help you?

(e) How was school for you?

(f) What school did you go to?

(g) Did you get extra help at school?

(h) What do you do for work?

(i) What do you do for fun?

(j) Where do you live? Who do you live with?

(k) Do you get help from someone to look after your home? Does someone help you with things like cooking, cleaning and shopping?

(l) Are you on a benefit? Can you tell me what the benefit is called?

5. Intellectual disability in the legal context

5.1 International research suggests that people with an intellectual disability are over represented in the criminal justice system, both as victims and as offenders, 11 and that they experience disadvantage in the legal system at all stages. 12

5.2 Due to the nature of their impairment, people with an intellectual disability can experience reduced memory retention, which may affect their ability to recall an event. Others may have limited understanding of their legal rights and court processes. Some people may experience difficulty with language comprehension or expression, be more suggestible to misleading information, or easily confused in the witness box. 13 All these issues can be addressed through responsive practice. 14

5.3 People with an intellectual disability have identified four key elements integral to quality legal representation: communication; a good relationship; trust; and openness. They expressed that lawyers who showed care and concern for their clients were more effective in meeting their legal needs. 15

6. The Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 (IDCCR Act)

Important: The IDCCR Act only applies when people with an intellectual disability have been charged with or convicted of an imprisonable offence. The IDCCR Act is designed for narrow criminal circumstances, not for civil matters. 16

6.1 The Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 (IDCCR Act) was specifically designed to provide a disposition pathway for defendants who have been formally diagnosed with an intellectual disability. The Act provides for specialist disability services for individuals with an intellectual disability who have been charged with, or convicted of, an offence that would ordinarily result in a person being sentenced to prison. If the person qualifies, she or he may be directed to specialist disability services for compulsory care and rehabilitation. Section 7(1) explains the meaning of intellectual disability for purposes of the IDCCR Act 17 and s 7(2) provides for how this must be assessed. 18

6.2 Please note, these guidelines have an emphasis on effective communication with potentially vulnerable people and are not intended to comprehensively cover the criteria or procedures for: the IDCCR Act 2003; mental defences to crime (such as the insanity defence); and fitness to stand trial. For further detail regarding the interface of the IDCCR Act 2003, MH(CAT) Act 1992 and CP(MIP) Act 2003, see standard texts on criminal law or specialist texts. 19 For a brief overview of the pathway to the IDCCR Act click here.

7. Case and client management with people with intellectual disability

7.1 Participation in legal proceedings can be difficult and stressful for everyone but can be particularly challenging for people with an intellectual disability. However, despite assumptions to the contrary, research has shown that people with intellectual disability are able to give credible evidence when they are given adequate support. 20

7.2 This section of the guideline covers practical suggestions for police, lawyers and judges working with people with intellectual disabilities in the context of criminal or other proceedings.

7.3 It is important to understand that different people will need different kinds of assistance at different stages in the legal process. Some people will require a lot of support to participate meaningfully, while others will only need small accommodations or adjustments to legal processes and/or practice.

8. Interviewing when a person has an intellectual disability

8.1 Preparation for interviewing a person with an intellectual disability is important. This increases the person's ability to more fully participate in the proceedings and to give the most complete and accurate evidence that they can. Good practice may mean having to alter or revise customary interviewing practices.

8.2 Where communication and/or comprehension is an issue, you can obtain a specialist Communication Assistant (“CA”) to assist in client interviews, witness interviews and suspect interviews. CAs are funded by the Ministry for Courts and/or Legal Aid (to find out more visit the Communication Assistance Guideline).

Get advice beforehand

8.3 If you are already aware there may be an issue, it is important to find out about the person’s communication abilities and needs before the interview. Most importantly, ask people what kinds of support would assist them during the interview.

8.4 Other potential sources of support and advice include:

(a) Whānau/family: Speak to the person’s whānau/family (with client permission) to ensure appropriate supports are available, and to discover how to increase the person’s ability to participate.

(b) Other support people: Support workers, advocates or other disability professionals may have more recent or relevant understandings of the person than their whānau/family.

(c) Communication Assistance: While some people with intellectual disability will be skilled communicators, in other cases it will be important to have a specialist Communication Assessment Report before the interview. [See the Communication Assistance Guideline].

(d) Court Liaison Nurses (in the context of criminal proceedings). CLNs help with assessment in the court setting. They facilitate referral to appropriate services and give the Court advice on the person's needs.

Build rapport

8.6 Building rapport can put people at ease and make them feel less anxious about giving evidence in formal situations. 21 Try to develop rapport by asking people non-threatening questions unrelated to the legal proceedings, for example about their hobbies, work and social life. 22 Keep in mind that the voice tone and demeanour of the interviewer is also crucial to developing rapport.

Timing and breaks

8.7 Some people with an intellectual disability find it easier to concentrate at certain times of the day: ask the person and those who know them well about when they think the most effective time to conduct an interview would be.

8.8 It is also common for people with an intellectual disability to only be able to concentrate for short periods of time, and to tire easily if they are forced to concentrate for long periods. Several short interviews, or building in regular breaks throughout a longer interview, may be necessary when working with people with intellectual disability. 23 Some people may require a brief break after each question.

8.9 It is important not to rely on the person to tell you when they need a break as they may be too embarrassed to do so. Instead, make a point of asking whether they require a break at regular intervals, or make it your practice to insert regular breaks into the interview.

8.10 Do not delay if the person does ask for a break: a person with an intellectual disability may only ask when he or she is already overwhelmed. Continuing with an interview when the person has specifically asked for a break may result in them being less effective in communicating their evidence.

Plan for extra time

8.11 Communicating with someone who has an intellectual disability requires more time than you may typically allow. In order to ensure active participation, proceed at a slow pace; incorporate frequent breaks; and explain legal matters and processes as you go.

Plain language explanations

8.12 People with an intellectual disability often require more explanations of concepts and legal processes (e.g., the roles of lawyer, judge and witness). Explain in straightforward, plain language, even if they have been involved in the legal system before. For more advice see Section 13 below.

Give reminders

8.13 Repeat and remind the person about the information they have been given as they may find it hard to retain complex information, or to process large amounts of information at once. Be aware that people may need regular reminders about previously discussed concepts or information.

Check comprehension regularly

8.14 Ask the person to explain what is happening or what you have just said in their own words on a regular basis throughout any interview or discussion. 24 Their saying that they understand, nodding, or saying “yes” may not mean they actually do. At the end of the interview ask them if they can provide a brief summary of what they have understood.

Written material

8.15 Many people with intellectual disabilities have difficulty reading and writing so do not rely on written material as a means of communication. Provide any written information in plain language or with images and always explain it verbally as well.

Visual aids

8.16 It may be helpful to use visual aids for explanation (such as photos, pictures of room layouts, time-lines or body diagrams) and visual aids for communication (answer cards or stress “traffic light cards”) (see s. 9.12 below).

Complete questioning with closure

8.17 In the final stage of an interview it is best practice to summarise what has been said and to make it clear to the interviewee that if anything in the summary is wrong then it is ok to correct it. This is also a good opportunity to make the person feel as comfortable and relaxed as possible, especially if they have described upsetting events. 25

9. Pre-trial directions

9.1 Effective participation in court for a person with an intellectual disability depends on good pre-trial planning, including obtaining the right trial accommodations and good preparation for questioning.

9.2 A range of measures may be needed, along with additional strategies if the person also has another condition, such as autism or a sensory impairment. These measures apply to adults as well as children.

9.3 For defendants and civil parties, seek accommodations for pre-trial appearances as well as for trial or substantive hearings. See Pre-trial Case Management Guideline for detailed advice as to the mechanics of applications.

Timing applications

Early applications preferred

9.4 Early pre-trial applications for special directions are important:

(a) Some measures, such as expert evidence and a Communication Assessment Report, take time to organise;

(b) Defendants or parties with an intellectual disability will need accommodations during the pre-trial stage as well as during trial/substantive hearing appearances.

Directions for witnesses

9.5 The following pre-trial directions may assist a person with an intellectual disability who is involved in the legal system. If a CA is appointed, his or her report recommendations should guide the court as to pre-trial directions specific to the person’s needs.

9.6 See Pre-trial Case Management Guide for more specific information.

Alternate modes of testifying:

9.7 To reduce distractions, stress and memory deterioration, it may be appropriate to apply for:

(a) CCTV or screens;

(b) EVIs as evidence in chief;

(c) Remote participation;

(d) Pre-recorded cross-examination.

Communication Assistance:

9.8 Because people with an intellectual disability may have specific difficulties with communication, applying for a CA can be important to assist defendants to understand legal advice, give instructions and participate in court appearances, and to facilitate witnesses to give evidence as fully and accurately as possible. Refer to the Communication Assistance Guideline.

Language directions

9.9 If the person has communication or language difficulties, the Court can be asked for pre-trial directions restricting the language and questions that can be used in examination in chief and cross-examination. See “Language Directions” in the Pre-Trial Case Management Guideline.

9.10 Where a CA has been appointed, his or her report will guide the language directions.

9.11 Otherwise, see “Questioning a Witness with an intellectual Disability” below for a range of accommodations, which may be useful for witnesses and defendants with an intellectual disability while they give their evidence.

Visual aids:

9.12 It may be easier for a person with an intellectual disability to understand information presented visually rather than verbally and to communicate through visual media. 26 Permission could be sought for a range of visual aids including:

(a) Aids to explaining or understanding questions. Options include: