How communication and swallowing difficulties affect claimants

The Benefits of Instructing Speech and Language Therapy (SLT) Experts in these cases - By Speech and Language Therapist BSc (Hons) and expert witness Sadia Hussain

Speech and Language Therapy (SLT) experts can provide quantum, liability and advisory reports for claimants who experience communication and/or swallowing difficulties. SLTs are typically instructed on cases where a claimant experiences such difficulties arising from birth defects or neurological injuries, which can hinder their daily function, safety, quality of life, employment, social relationships and mental health.

Communication difficulties

Communication difficulties can range from mild to severe and can manifest in the following ways:

• Speech deficits: changes to the strength and movement of facial muscles can affect articulation and intelligibility.
• Voice disorders: damage to vocal cords can hinder the ability to produce efficient voice to speak. 
• Comprehension difficulties: reduced ability to understand spoken and written language.
• Expression difficulties: reduced efficiency of spoken and written language.
• Reading and writing impairments: changes in the ability to read and formulate writing or typing.
• Cognitive-linguistic disorders: impairment to cognitive skills can affect communication processing.
• Social communication difficulties: Changes in conversational skills can affect social relationships.
• Higher level language impairment: subtle changes in language can affect a claimant’s ability to reason and perform structured tasks.

There is a growing inclination for SLT experts to be instructed in cases where a claimant’s vocation/employment, mental capacity and use of technology has been compromised by communication deficits.

In addition, advisory SLT reports can increase the quality and reliability of all expert evidence. In cases where the claimant has communication difficulties, as a result of their injury or has pre-existing communication difficulties, the process of gathering expert evidence can be compromised. In such cases, a SLT assessment should be sought early in the litigation process to identify the claimant’s communication abilities and to ensure appropriate modifications are put in place, to facilitate interactions between claimants, the legal team and all experts. For example, if a claimant has difficulty understanding spoken information, then the experts assessing the claimant should be made aware that they will need to break down information into appropriate chunks and use key written words. Or, in cases where the claimant has slow and unintelligible speech they might benefit from using a communication device to express their opinions. This will improve the quality and reliability of the evidence, assessments and reports provided by experts instructed on the case.

Case Study: (Quantum) A claimant with subtle communication changes after a brain injury experiences disruption at work

A claimant diagnosed with a brain injury, who was physically mobile, was able to unintentionally mask subtle communication changes. These later became pronounced when she returned to work and was unable to perform her work duties. She struggled to process complex information and do administrative tasks, which were important duties in her role as a manager. A SLT expert was instructed to assess the claimant’s level of communication difficulties and whether she was able to continue in her current employment. The report found she presented with understated cognitive communication difficulties, which prevented her from continuing in her work role without support. It was recommended that she required adjustments at work, including part-time hours, support from a personal assistant and technical equipment to support her computing skills.

Swallowing difficulties

Swallowing difficulties can affect a claimant’s ability to eat and drink safely. The swallowing process comprises muscles and nerves associated with the face, oral cavity, respiratory system and larynx. The risks associated with swallowing disorders include:

• Choking
• Aspiration
• Malnutrition
• Dehydration
• Pneumonia

These risk factors can be harmful to the claimant’s overall health and in some cases can prove fatal.

Case Study: (Liability) Death caused by unreasonable care provided to a care home resident with swallowing difficulties 

The family of a deceased lady brought forward a claim against the care home, when the carers had incorrectly fed a resident with swallowing difficulties. They gave her a meal which contained hard lumps instead of soft textured food and as result she choked and died. SLT expert evidence was requested to examine whether there were failings with the care provided by the defendants, which then caused the deceased to choke and die.

Somek & Associates regularly provide training sessions, clinical / educational updates to fee earners in their offices or via webinar. We would be happy to provide such sessions regarding speech and language therapy updates, case studies and /or ‘the unique role of the SLT expert in the litigation setting’. This would be provided by one of our experienced SLT experts.  

If you have any queries regarding the above or would like to speak to Sadia Hussain, please contact admin@somek.com

If you are interested and would like to discuss your specific case needs in more detail, please email admin@somek.com F.A.O. Yvonne Lane, Client Relationship Manager.