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言语、语言和沟通需求的青年与少年司法及其相关费用的相互作用。

Interactions with youth justice and associated costs for young people with speech, language and communication needs.

机构信息

University of Technology Sydney, Sydney, NSW, Australia.

出版信息

Int J Lang Commun Disord. 2021 Jul;56(4):797-811. doi: 10.1111/1460-6984.12628. Epub 2021 May 27.

Abstract

BACKGROUND

Individuals with speech, language and communication needs (SLCN) are at greater risk of contact with the criminal justice system. Diagnosis and appropriate treatment of SLCN reduces these risks, leading to better life outcomes for the individual as well as broader social and economic benefits. These youth represent a particularly high-priority group for research into language deficits, as the juvenile justice system involves situations with a high risk or serious consequences that rely upon the application of effective language skills. Whilst some studies have established some gains in speech and communication from speech pathology (SP) interventions during custody, there is limited evidence on the long-term impact of these gains following release from custody. Similarly, few studies have directly measured the cost savings associated with early SP on subsequent youth antisocial behaviour and crime.

AIMS

To estimate the youth antisocial behaviours, youth justice (YJ) contacts and associated costs (from a justice perspective) of childhood SLCN.

METHODS & PROCEDURES: Using 12 years of data from a longitudinal study of Australian children and young people, we employ a panel fixed-effects model to explore the relationship between SLCN and youth antisocial behaviour and youth offending between 12 and 17 years of age. Using these results, we estimate the cost of SLCN and subsequent cost savings associated with identification of SLCN.

OUTCOMES & RESULTS: The results showed that the annual cost of SLCN to the YJ system (exchange rate as at 9 December 2020) is A$875 (95% confidence interval (CI) = A$195, A$1916) (US$$649, €536, £485) per person who participates in youth crime, which is due to higher rates of youth antisocial behaviour and youth offending. Identification of SLCN (defined by SP treatment) appears to have a positive impact on youth antisocial behaviour and crime, mediated through improved language and communication. On average, young people with a history of 'identified' SLCN incur A$188 (95% CI = A$42, A$412) lower YJ costs (US$$140, €105, £115), compared with the same individual, before identification. Over the lifetime of the individual, this equates to A$9.2 million (95% CI = A$2.05 million, A$20.2 million) (US$$6.8 million, €5.6 million, £5.1 million) cost savings to the YJ system (A$3389 per person with SLCN) (2020 Australian dollars) (US$2513, €2074, £1880).

CONCLUSIONS & IMPLICATIONS: Overall, the findings revealed that young people with SLCN have an elevated risk of youth antisocial behaviour and crime. However, the identification of SLCN (and subsequent treatment) leads to changes in the offending risk trajectory for these individuals, resulting in lower rates of youth antisocial behaviour and consequently lower rates of crime and its associated justice costs.

WHAT THIS PAPER ADDS

What is already known on the subject It is well documented in the literature that young people in contact with the justice system have much higher rates of previously undiagnosed SLCN than those of the general population. There is less known about whether the identification of SLCN (and subsequent treatment) leads to changes in the offending risk trajectory for these individuals, leading to lower rates of youth antisocial behaviours and crime. What this paper adds to existing knowledge This study uses a longitudinal survey of 5000 children and young people to track the antisocial behaviour and crime-risk trajectory of children and young people with SLCN. The study finds evidence that young people with 'identified' SLCN report less juvenile antisocial behaviour and lower YJ contacts after intervention. The potential lifetime cost savings associated with intervention is A$9.2 million (95% CI = A$2.05 million, A$20.1 million) (US$$6.8 million, €5.6 million, £5.1 million). What are the potential or actual clinical implications of this work? The findings of this study can quantify the effects (in terms of cost savings to the justice system) of the early identification and subsequent intervention for young people with SLCN.

摘要

背景

有言语、语言和沟通需求的个体(SLCN)与刑事司法系统接触的风险更高。诊断和适当的 SLCN 治疗可降低这些风险,从而改善个人的生活结果,以及更广泛的社会和经济效益。这些年轻人是语言缺陷研究的一个特别高优先级群体,因为少年司法系统涉及到风险高或后果严重的情况,需要运用有效的语言技能。虽然一些研究已经确定了在拘留期间言语病理学(SP)干预可以改善言语和沟通,但关于从拘留中释放后的这些改善的长期影响的证据有限。同样,很少有研究直接衡量与早期 SP 相关的青少年反社会行为和犯罪的成本节约。

目的

估计儿童言语语言障碍的青少年反社会行为、青少年司法(YJ)接触和相关成本(从司法角度)。

方法与程序

使用澳大利亚儿童和年轻人纵向研究 12 年的数据,我们采用面板固定效应模型来探讨 12 至 17 岁时 SLCN 与青少年反社会行为和青少年犯罪之间的关系。利用这些结果,我们估计了 SLCN 的成本以及识别 SLCN 相关的后续成本节约。

结果

结果表明,参与青少年犯罪的人的 YJ 系统的 SLCN 年度成本(截至 2020 年 12 月 9 日的汇率)为每人 875 澳元(95%置信区间(CI)= 195 澳元,1916 澳元)(US$$649,€536,£485),这是由于青少年反社会行为和青少年犯罪率较高。识别 SLCN(由 SP 治疗定义)似乎对青少年反社会行为和犯罪有积极影响,这是通过改善语言和沟通来实现的。平均而言,有“识别”SLCN 病史的年轻人与同一人相比,在 YJ 成本方面(US$$140,€105,£115)降低了 188 澳元(95% CI = 42 澳元,412 澳元)(A$188,95% CI = A$42,A$412)(US$$140,€105,£115),在个人的一生中,这相当于 YJ 系统节省了 920 万澳元(95% CI = 2050 万澳元,2020 万澳元)(6800 万美元,5600 万欧元,5100 万英镑)(A$3389 澳元/有 SLCN 的人)(2020 年澳元)(US$$2513,€2074,£1880)。

结论与意义

总体而言,研究结果表明,有 SLCN 的年轻人有更高的青少年反社会行为和犯罪风险。然而,识别 SLCN(和随后的治疗)会改变这些个体的犯罪风险轨迹,导致青少年反社会行为的发生率降低,从而降低犯罪率及其相关的司法成本。

这篇论文的贡献是什么

这篇论文在现有的文献中已经有了很好的记录,即与司法系统接触的年轻人比一般人群有更高的以前未被诊断出的 SLCN 发生率。对于识别 SLCN(和随后的治疗)是否会改变这些个体的犯罪风险轨迹,导致青少年反社会行为和犯罪率降低,知之甚少。本研究使用对 5000 名儿童和年轻人的纵向调查,追踪了有 SLCN 的儿童和年轻人的反社会行为和犯罪风险轨迹。研究发现,有“识别”SLCN 的年轻人在干预后报告的青少年反社会行为和 YJ 接触较少。与干预相关的潜在终身成本节约为 920 万澳元(95% CI = 2050 万澳元,2020 万澳元)(6800 万美元,5600 万欧元,5100 万英镑)。这项工作的潜在或实际临床意义是什么?这项研究的结果可以量化早期识别和随后干预对有 SLCN 的年轻人的影响(以司法系统的成本节约为衡量标准)。

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