Kim Irby urges courts to use communication supports so people with aphasia can participate

Kim Irby, a speech pathologist with the National Aphasia Association, told New Mexico Courts staff in a virtual briefing that people with aphasia — a language disorder most often caused by stroke — can participate meaningfully in legal proceedings when courts provide basic communication supports.

Irby said aphasia affects speaking, understanding, reading and writing but "does not impact intelligence," and she urged court staff to use simple tactics — short sentences, extra response time, keywords, gestures and multimodal options — to verify what people with aphasia mean rather than equating communication difficulty with incapacity.

A nut graf: Irby summarized a literature review and several court cases to argue courts frequently encounter people with aphasia, documented accommodations are rare, and judicial competency determinations can be inconsistent. She cited Section 504 of the Rehabilitation Act and a Department of Justice bulletin that require covered entities, including state courts, to provide aids and services to ensure effective communication when reasonable.

Irby defined aphasia and demonstrated two common presentations with short video clips: nonfluent aphasia, where words are hard to retrieve and extra prompting helps, and fluent aphasia, where speech may sound effortless but lacks clear meaning. She told attendees that needs vary by person and recommended a strategy called "supported conversation for adults," which begins by acknowledging the person’s competence and then reduces distractions, uses simple phrasing, allows more response time and confirms meaning through repetition or visuals.

Irby offered concrete courtroom tactics: pause and give a person time to answer (she suggested counting to five before intervening), ask permission before suggesting words or paraphrasing, offer closed or multiple-choice formats when appropriate, provide written keywords or diagrams, and consider qualified readers, note-takers or personal support persons to assist verification of understanding. She noted that some supports (for example CART captions or electronic court documents for advance review) help many people but may distract others, so staff should ask the person which aid they prefer when possible.

Summarizing research, Irby said a multi-decade review of court cases showed a mix of case types involving people with aphasia (large shares in Social Security and family law) and that documented accommodations were uncommon. She reported that the review found about 3.6 percent of cases had documented accommodations and that competency findings varied across hearings — in one set of competency hearings roughly 49 percent were found incompetent and 39 percent competent — which, she said, reflects a lack of a consistent evaluation standard.

Irby described three cases she flagged for discussion: Ruby McDonough (a Massachusetts case she said resulted in reinstated competency after appeal and highlighted that judges can appoint independent experts in communication disorders), People v. Baker (2020), in which a police interview of a person with severe aphasia was admitted and contributed to conviction alongside DNA evidence, and State v. Harvey (2020), an Ohio case where clinical and judicial competency assessments diverged; Irby used the examples to illustrate how courts have handled testimony, interviews and accommodations differently.

On legal obligations, Irby noted Section 504 of the Rehabilitation Act protects individuals from disability-based discrimination and that DOJ guidance requires effective communication with covered entities, including state courts. She stressed that accommodations must be reasonable and should not be denied absent a showing of undue burden or fundamental alteration of proceedings.

Irby recommended the U.S. Department of Labor plain-language checklist for structuring documents and communications (active voice, simple grammar, clear organization, larger fonts and extra white space) and shared resources including the National Aphasia Association, the American Stroke Association materials, CommunicationFIRST and an aphasia simulation from Voices of Hope. She provided contact emails and links for follow-up.

Irby closed by offering continued education and assistance to court staff and emphasizing that, with straightforward accommodations and verification practices, people with aphasia can better understand and participate in court processes.

The briefing ended with Irby inviting questions and offering her organisation’s materials and contacts for courts wishing to develop specific tools for common scenarios such as arrest, arraignment, mediation, deposition and trial.