Working With Intellectually Disabled Sexual Offenders

Mick Pykett

Dr Fiona Williams

Intellectual disability

IQ 70 and below ( as measured by a standardised IQ assessment)

Deficits in adaptive functioning

Evident before 18 years of age(DSM-IV-TR, 2000)

Communication and social skills ( Interacting and communicating with others)

Independent living skills ( Shopping, self care, budgeting, dressing and grooming)

Personal care skills ( Eating, hygiene, health and safety, dressing and grooming)

Employment/work skills (Self direction, use of own time, leisure time, following directions, completing tasks and getting to places on time)

Practical academics ( Reading, computation and telling time)

Impaired adaptive functioning

Language

Mental retardation –USA Mental handicap - Ireland Learning Disability - UK Intellectual Disability –UK 2000 onwards Specifc Learning Disability – Average IQ,

Dyslexia, dyscalculia

Common problems for ID offenders in prison Prisoners are not routinely assessed for ID or

other learning difficulties so the problem is unknown

Staff are not trained to spot or work with these difficulties

ID prisoners tend to get into trouble for not following orders – they may forget them, not understand them in the first place due to pace of conversation, take them literally or have problems initiating a behaviour

Difficulties with reading and writing and with adaptive functioning means they have trouble with choosing activities, canteen orders and food

May have difficulties putting in applications to healthcare or psychology or reading prison rules and notices. May be seen as lazy or trouble makers

Tend to ‘mask’ their behaviours e.g they give an an answer which may be incorrect – seen as rude or cheeky

May not respond to offending behaviour treatment – seen as resistant, not motivated and risky

Fear of failure Sensitivity to disability Not confident to ask for help Frustration/give up easily Desire to please Masking

Psychological impact

IQ assessment

Weschler Adult Intelligence Scale IV (WAIS IV)

Working memory Verbal Comprehension Perceptual reasoning Processing speed

Verbal expression

Receptive language problems – Difficulty understanding long or complex words, decoding sentences and understanding the meaning of language

Expressive language problems- Don’t know the right words to convey meaning, limited range of vocabulary, use words, sayings and clichés incorrectly.

Processing speed

May take longer for the brain to find meaning to what is being said

Responses are slowed because the brain is trying to decode

May lose track of things because they are trying to decode the last sentence

Very difficult to multi-task

Memory

Harder to find and recall memories Difficult to hold information in working memory

in order to use it Takes longer to record new memories e.g.

learn May forget a question asked of them and try to

mask this by answering unusually. E.g. closed answer to an open question, or provide an response that doesn’t match the question

Perceptual reasoning

Using your imagination to think things through in pictures, such as map reading, puzzles, abstract concepts

Hard to adapt to new novel situations as it is harder to anticipate what might happen

Difficult to categorise concepts – might struggle with the difference between thoughts and feelings

Difficulty with time sequencing and understanding time related concepts and words

Adapted Treatment ApproachesSelf managementIQ 60 – 80Motorway vs scenic path

ID individuals can learnIts our job to identify the best method to facilitate learningYou have to changePersonalised learning

Introducing VAK

Visual Auditory Kinaesthetic

Principles for Working with ID

Move away from exclusive use of the auditory/verbal style

Reduce need for abstract thinking and hypothetical situations

Reduce load on memory

Visual

Use pictures, drawings, symbols, posters, photos Ask them to bring in materials e.g. pictures,

books, writing Keep the visual stimuli simple and clear – i.e. Use

simple words Use timelines to mark out where things happened Visual imagery

Visual

Try to accompany all your questions with a visual aid

Draw situations you want to discuss Ask them to draw – to answer any

questions, show you what they mean Consider use of visually based

exercises

Auditory One question at a time Short sentences Use simple language - avoid words with 3 syllables

or more No clichés or dry humour Use metaphors to help them describe – ‘if your

feeling was a colour, cartoon character etc…’ Relate size of feelings to size of objects e.g. as big as

an elephant Adapt to their language needs – someone with good

receptive language may need to be asked questions verbally but answer through showing (visually or kinaesthetically) and vice versa

Auditory

Encourage group discussions Use of music if appropriate Use sound of voice to alter tone and pace of the session

– slow pace of speech Open questions Repetition of information to aid recall Frequent praise Pair auditory stimuli with visual and kinaesthetic

Kinaesthetic Exercises which help them get into a ‘state’ to

work with you – icebreakers, brain breaks during the interview

Explore things in role-plays – ‘show me’ what you would do/did do

You show them – demonstrate points or questions by role play or holding positions

Have them direct you – ‘tell me what I should do’

Put them in roles to achieve learning e.g. perspective taking

Kinaesthetic

Using hand gestures to accompany visual and auditory material

Use movement when appropriate Brain breaks Give each person in the group a specific role to

keep their attention Games that aid memory and recall

General tips

Be aware of suggestibility – try to avoid leading questions

Avoid hypothetical situations Check out learning by asking them to

tell you want they understand Use common anchors to help them

describe times e.g. meal times, birth days etc

.

Process

Is as important as

Content