Serving Clients with Speech and Language Disabilities

  • January 01, 2015
  • Joanna Birenbaum and Barbara Collier

In Ontario, the importance of effective communication is recognized and accommodated for people who do not speak English or French through the provision of translation services; people who are Deaf or hard of hearing through the provision of sign language interpreters; people who are Deaf blind through services from Deaf blind interveners. Most lawyers understand how to access accommodations to meet the needs of clients who do not speak English, or who are deaf, deafened or hard of hearing, or deaf-blind. The situation is very different for persons with speech and language disabilities (SLD).  Until recently, there has been no accessible formal communication support for people with SLDs, making it difficult for persons with SLD to access legal services.

There are 165,000 people in Ontario who have speech and language disabilities, not caused by hearing loss. Speech and language disabilities (SLDs) can significantly interfere with a person’s ability to speak and / or understand what others are saying.  Disabilities that affect speech and language can be caused by conditions such as cerebral palsy, stroke, autism, cognitive disabilities, amyotrophic lateral sclerosis, Parkinson’s Disease, multiple sclerosis, acquired brain injury, dementia and other conditions.  Depending on the nature of the disability, a person’s speech may be difficult to understand, or they may have little or no speech and use ways other than speech to communicate.  People who have aphasia, which can occur after a stroke may require assistance to understand what is being said to them. Most people with SLDs do not have a hearing loss or an intellectual disability and the incidence of speech and language disabilities increases with age.

Like everyone else, people who have SLDs have a legal right to full and equal access to services provided by lawyers, police, legal and justice services. Depending on the nature and severity of their disability, people with SLDs can experience a range of barriers within legal and justice settings when communicating about crimes, abuses and violation of rights; the appointment of substitute or supported-decision makers; giving informed consent and participating in legal capacity evaluations or simply asserting their legal right in general. These barriers might include not understanding questions posed to them; not having their message accurately interpreted; not having the vocabulary (e.g. pictures and words) available to them to communicate their intended message; or not being able to understand, read or sign legal documents.

Without appropriate communication supports within these contexts, people with SLDs may be unable to disclose crimes to police, testify in court, instruct counsel or have autonomy over major life decisions. They are at risk for miscarriages of justice, ongoing abuse, and having little or no control over their lives; all of which can mean that their rights are severely compromised. This is why the availability of accommodations for persons with SDL, specifically communication intermediaries, is vital.

Communication Intermediaries

Communications intermediaries (CIs) are qualified Speech-Language Pathologists and members of a regulated health care profession. They have undertaken additional training from Communication Disabilities Access Canada (CDAC) to act as CIs.

A CI may be required if an individual has a SLD that makes it difficult for them to speak; understand what is said; express their thoughts in a clear manner or if they communicate using pictures, symbols, a letter board or device. In some situations a CI is required when a neutral, arms-length qualified person is needed to assist with communication or validate another person’s assistance. A CI can explain how a person communicates; clarify a person’s level of understanding; and assist the person to understand questions and communicate their messages in an accurate and reliable way. CIs provide a similar function as other interpreting services however, they use very different communication supports as required by an individual who has a SLD.

CIs can be used in a range of legal settings where support with communication may be required to accommodate the client, such as legal capacity assessments, creating powers of attorney, consenting to treatment, reporting to police, criminal and civil proceedings and conveying decisions or instructions with legal consequences. 

Communications Disabilities Access Canada, with funding from Justice Canada plays a major role in training CIs so that lawyers, legal, police and justice services can engage appropriate communication accommodations for clients who require these supports to access their services.  Communications Disabilities Access Canada (CDAC) is a national, not-for-profit organization based in Toronto. CDAC promotes accessibility and inclusion for people who have SLDs and has been working over the years with Justice Canada’s Victim Fund to implement national communication supports for victims and witnesses who have SLDs.

Over the past year, CDAC has developed three provincial online rosters of Communications Intermediaries that are now available to assist police, lawyers and other legal and justice professionals in making their services accessible for persons with SLDs. Over the past six months, CIs have been used in legal meetings, court proceedings and capacity assessments. CDAC is currently providing CI trainings across Canada and will be adding to the Ontario roster in 2015.

Using the Roster

The Ontario roster can be used by lawyers and other legal and justice professionals to locate a CI in their area and who best fits the needs of their client in terms of the person’s age and type of communication disability. Professionals can directly contact the CI to negotiate arrangements and fee structures.

The roster is available at  Note that there is a separate link for computers that do not support Javascript.

Joanna BirenbaumBarbara CollierAbout the Authors

Joanna Birenbaum, a lawyer with Ursel Phillips Fellows Hopkinson LLP, is a board member of Communications Disabilities Access Canada.

Barbara Collier Reg. CASLPO, F. ISAAC is executive director of Communications Disabilities Access Canada.

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