Communication difficulties are sometimes referred to as speech, language and communication needs or communication disabilities. Communication difficulties can be primary, such as specific language impairments or a stammer, or secondary, for example, as a feature of conditions such as learning disability, autism, hearing impairment and certain mental health conditions.

People with communication difficulties might find it hard to:

• express themselves through speaking, writing or non-verbal communication
• understand the spoken or written word
• understand body language, facial expressions and other ordinary social cues
• listen to what is being said directly to them or around them
• remember the information they receive
• express their feelings and emotions in an appropriate way
• relate to others in socially acceptable ways
• think clearly.

Some people with psychosis have particular communication difficulties. This is often because of ‘disordered thinking’. People with disordered thinking find it hard to keep a logical order to their ideas. Their thoughts and speech may be jumbled and disconnected. The person may appear to talk nonsense, make up words or replace words with sounds or rhymes.

Some medications for psychosis can cause problems with communication. Antipsychotics can cause persistent abnormal movement of the jaw, lips and tongue and can cause slurred speech.

Research shows that 60% of children who offend have communication difficulties. Around half of this group has poor or very poor communication skills (Bryan, Freer ad Furlong, 2007). Research involving adult prisoners with learning disabilities and difficulties showed that around two-thirds experienced problems with verbal comprehension skills, including understanding certain words and in expressing themselves (Talbot, 2008).

Further information on communication, including when an assessment might be necessary, can be found in Section 9e: Communication in court.