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The purpose of this paper is to outline and report on the initial development of a screening tool for offenders with suspected intellectual disability (ID) known as the rapid assessment of potential intellectual disability (RAPID).

This paper summarises the wider literature in relation to screening tools and methodology, indicating that quick and easy screening measures for this population are sparse. It outlines the processes involved in the early stages of developing an evidence-based screening tool for ID offenders, and an overall pathway approach to the identification, assessment and diagnosis of ID.

It is possible to develop a tool that can be used to identify potential ID with relative ease. The RAPID screening tool provided practitioners with a simple and easy measure to identify such individuals so that they may be referred for further specialist assessment. It has also demonstrated that it is an effective measure in identifying offenders with a possible ID.

Formal statistical validation of this tool will serve to establish and measure its overall effectiveness and utility, further encouraging the timely identification of ID offenders.

This paper responds to current extensive literature about the variability of screening measures, and provides an effective solution to the identification of vulnerable offenders. Those who may benefit from an assessment of ID, and thereafter reasonable adjustments and alternatives to custodial sentencing are considered.

At present, there are significant limitations to the criminal justice system’s (CJS) ability to respond appropriately to detainees or defendant with learning disabilities (LD). The development of Liaison and Diversion Services has provided the opportunity to more easily identify people with LD in the CJS through the use of screening assessments. Therefore, the purpose of this paper is to consider why there is a need for screening assessments and review the literature on existing measures, in order to consider the next steps to develop a more effective pathway from the CJS to LD services.

This paper takes the form of a literature review.

The review found that there is a significant body of research defending the need for LD screening in the CJS across the UK. The aim of a screening process would be to identify individuals who possibly have LD and ensure that the correct measures are in place to assess and manage these individuals, including appropriate diversion to specialist LD services. The learning disability screening questionnaire (LDSQ) is an instrument that could be utilised in these instances and could be carried out by Liaison and Diversion Services.

Neither of the tools reviewed in this paper have been vigorously field tested within forensic settings in the UK. It is recommended that there should be trials of the LDSQ as a screening tool within Liaison and Diversion Services with comparison against outcomes of full diagnostic assessments for LD.

Screening for LD is being discussed across the UK as part of Liaison and Diversion Services. This paper highlights the need for a reliable and valid screening tool and provides support for the use of the LDSQ.

The purpose of this paper is to report on a three‐year contract to provide learning disability in‐reach to young offenders serving a sentence of Imprisonment for Public Protection (IPP) at HMYOI Aylesbury.

A whole population sample (n=75) was obtained between December 2009 and July 2011, where all had received an assessment of intellectual functioning using either the in‐reach screening protocol, consisting of the Kaufman Brief Intelligence Test – Version 2 (KBIT‐2) and four background questions, the Wechsler Abbreviated Scale of Intelligence (WASI) or the Wechsler Adult Intelligence Scale (WAIS).

It was found that 5.5 per cent of the population had a standard score of less than 70 (significant impairment) and a further 18.6 per cent fell between 70 and 79 (borderline range). The mean standard score of the KBIT‐2 (85.8) was consistent with previous studies of prison populations. The background had a significant but weak association with the KBIT‐2 scores, but lacked sufficient specificity.

Further research is required if these findings are to be generalised to the wider prison population.

Systematic screening for learning disability can be of clinical benefit in identifying the needs of young offenders, which is the first step to addressing these needs.

A number of publications by the Department of Health, the Home Office and third sector organisations have identified the need for services for offenders with a learning disability. In‐reach provision to prisons is still in its infancy and, currently, no gold standard exists for screening tools.

The purpose of this paper is to evaluate a new Intellectual Disability (ID) screening service within a women’s prison in England.

Analysis of prisoner records was carried out to establish characteristics of women entering the prison, rates of screening completion and time intervals for all stages of the assessment pathway.

In total 198 women were received into prison and underwent 202 ID screens. Nine out of ten women completed a screen, almost all on arrival or very soon afterwards. There were 23 referrals for secondary assessment but only four were completed. Most of the women identified for additional screening left the prison before this could be achieved.

This evaluation is the first to show that preliminary screening for ID is feasible in prison. This screening alone is useful for prisons to make the kind of reasonable adjustment required of public bodies by the Equality Act. However, its value is constrained unless resources are also dedicated to the kind of additional screening which might lead to definitive diagnosis and care planning for intellectual disability. This model of assessment would be of considerable value in establishing prisoners at risk by virtue of different levels of intellectual disability and could be used to provide more reliable and routine estimates of prevalence contributing to overall better service planning.

The purpose of this paper is to examine staff views’ of the usefulness of the Her Majesty’s Prison and Probation Service (HMPPS) screening tools for learning disability and/or learning challenges (LDC) on offending behaviour programme selection and programme participant’s learning experiences.

In total, 11 treatment managers (TMs) and 10 programme graduates across 4 prison sites, from a range of HMPPS accredited programmes were interviewed. The interviews were transcribed, analysed and interpreted using Braun and Clarke’s (2006) method of thematic analysis.

Overall, TMs found the screening tools useful in aiding programme allocation decisions, particularly, in terms of the triangulated approach and were, in general, using them in line with the guidance. A number of key factors influenced programme allocation decisions, including participant factors, information gathered from a number of sources and from a range of staff and in collaboration with the individual. The importance of being responsive to the needs of the individual was highlighted. Group participants generally felt they were on the right programme according to their needs and found the programmes responsive. Suggestions for further research and improving programme selection are made.

Data were collected from four prisons, each providing a number of different accredited programmes. Caution is, therefore, needed when generalising the findings.

This research contributes to ensuring that those with LDC have equality of opportunity in reducing their risk of reoffending through accessing HMPPS accredited offending behaviour programmes most responsive to their learning needs. It also contributes to the growing evidence base about the effective use of LDC screening tools in forensic settings.

The purpose of this paper is to identify neurodevelopmental disorders and difficulties (NDD) in a male prison. The study used standardised tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID).

The ADHD self-report scale, 20-item autism quotient and the Learning Disability Screening Questionnaire were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the diagnostic interview for ADHD in adults, adapted Autism Diagnostic Observation Schedule and the Quick Test.

Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic criteria for ADHD, ASD or ID. Most of those with NDD (51 per cent) had previously gone unrecognised and a high proportion (51 per cent) were identified through staff- or self-referral to the study.

The study demonstrated that improving awareness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.

The purpose of this paper is twofold. First to ascertain the efficacy of current police reception screening to detect detainees with intellectual disability (ID). Second to assess the validity of a short targeted screen for ID among police custody detainees.

The study comprised three stages. First, 248 police custody detainees were assessed for a range of health morbidities, including a pragmatic clinical evaluation of ID. For those with suspected ID, the police custody screens were scrutinised for evidence that this had been detected. Second, a new police health screen, incorporating a short screen for ID, was piloted. Totally, 351 detainees were assessed in the same way as in part 1 with the new screens being scrutinised for evidence that ID had been detected where relevant. Third, the new police screen for ID was validated among a sample of 64 inpatients, some with ID and some without, from forensic inpatient services. Parts 1 and 2 were carried out in the Metropolitan Police Service, London. Part 3 took place in one NHS Trust.

In parts 1 and 2, the rate of detainees with suspected ID was 2-3 per cent. The standard police screen detected 25 per cent of these detainees in part 1. When the new screen was introduced in part 2, the sensitivity for ID increased to 83 per cent. However, there was no requisite improvement in the proportion of detainees with ID receiving an Appropriate Adult. In the inpatient study, the new screen showed a good level of sensitivity (91 per cent) and reasonable specificity (63 per cent).

It is possible to improve the detection rate of detainees with suspected ID by introducing a short ID screen into the police custody officers’ reception health screen.

The Health Screening of People in Police Custody (HELP-PC) study is a project evaluating screening for health morbidity among police custody detainees. Other data from this study have been reported elsewhere, but this is the first time the data pertaining to ID screening has been reported in detail.

The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying cognitive impairment in correctional facilities.

A targeted literature review identified peer-reviewed articles on screening of adults in jails, prisons, police watch-houses, custody suites, rehabilitation facilities and forensic settings or community settings for offenders. Validation of screening tools in secure settings, psychometric properties and cultural discrimination is included in this review.

Eight screening tools are considered suitable for use in correctional settings. Two screening tools are recommended for cognitive impairment, one is recommended for adaptive functioning assessment and one is recommended for screening of brain injury. Two screening tools are noted to be subject to piloting and further development for use with First Nations people, and two screening tools for cognitive impairment are noted for positive consideration.

Recommendations for screening tools are based on review only and evaluation was infeasible.

Short, reliable measures of cognitive ability for use in correctional facilities are needed. Such tools must be appropriate with respect to their purpose, feasible within the clinical capability of staff and sufficiently cheap to administer to allow widespread use.

Screening of prisoners for cognitive impairment allows early detection to facilitate rehabilitation and therapy. This research is at the systems level. Therefore, the authors do not purport to provide guidance for individual clinicians.

It is known that about seven per cent of the prison population have a learning disability, but historically very little has been done to support these individuals through the Criminal Justice System. Valuing People Now (DH, 2009) acknowledged that people with a learning disability within the Criminal Justice System should be included within the local implementation of the strategy. This article explores what has been achieved since Valuing People Now and what still needs to be done.

While individuals with an intellectual disability form a significant minority in the worldwide prison population, their healthcare needs require specialist attention. In Ireland, services for prisoners with intellectual disabilities need development. However, there is little substantive data estimating the prevalence of intellectual disabilities within the Irish prison system. The paper aims to discuss these issues.

The authors systematically review published data relating to the prevalence of intellectual disabilities in prisons in the Republic of Ireland. The authors searched four databases, governmental websites and corresponded with experts.

Little published data were elicited from searches except for one nationwide cross-sectional survey which reflected a higher prevalence than reported in international studies. Studies from forensic mental health populations are narrated to contextualise findings.

This study found that there is little data to accurately estimate the prevalence of intellectual disabilities in the Irish prison system and the limited data available suggests that this is likely to be higher than international estimates. The authors highlight the need for further research to accurately estimate prevalence in this jurisdiction, alongside the need to develop screening and care pathways for prisoners with an intellectual disability.