The evaluation of a training course to enhance intellectual disability awareness amongst law enforcement officers: a pilot study

Abstract Objectives: Disability awareness training is mandated by the United Nations Convention on People with Disabilities (UNCRPD), but there is a paucity of evidence regarding the systematic evaluation of the effectiveness of such training. This study describes the evaluation of a pilot intellectual disability awareness programme for law enforcement officers (LEOs) in Ireland. Methods: Pre-and post-training Likert scales and a semi-structured survey were used to evaluate the effectiveness of an intellectual disabilities awareness programme delivered to LEOs. Quantitative differences in Likert scores and thematic analyses of practice-based responses were used in evaluation. Results: Twenty-two LEOs participated in the training and 11 completed the evaluation cycle. Statistically significant improvements were found in participants’ self-rated knowledge of intellectual disability, their understanding of the challenges faced by people with intellectual disabilities in law enforcement interactions, their communication skills and their knowledge of how to approach a person with a disability in crisis. Thematic analysis excavated potential practical application of learning around pre-arrest considerations, recognition of disability, communication skills and need for procedural safeguards. Conclusions: An approach grounded in the views of people with intellectual disabilities and with emphasis on recognition of disability, communication, accessibility of information and providing appropriate support in custody, appears to promote improvement in self-reported knowledge and prospective application in LEOs. The findings of this study are potentially applicable to countries that have ratified the UNCRPD.


Introduction
People with intellectual disabilities are over-represented in the criminal justice system at all stages of the criminal justice pathway (Gulati et al. 2018;Hellenbach et al. 2017;Young et al. 2013) and face barriers in accessing justice equally (Gulati et al. 2021a;Gulati et al. 2021b;Schatz, 2018).They report difficulties in understanding and communicating information in police custody and a paucity of appropriate supports in this setting (Gulati et al. 2020b).Law enforcement officers (LEOs) report an unmet need for specialised training, difficulties associated with identifying people with intellectual disabilities, the absence of procedural safeguards and communicative challenges when interacting with individuals with intellectual disabilities (Gulati et al. 2020c).All state signatories to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) are required to provide disability awareness training for LEOs as a stipulation under Article 13(2).It has been argued that the provision of such training to LEOs could help address the over-representation of people with intellectual disabilities in the criminal justice system (Gulati et al. 2020a).
There is limited evidence from the evaluation of training programmes internationally.A systematic review of 13 databases regarding disability sensitivity training programmes provided to police officers globally between 1980 and 2015 reported only three available studies in the field including two evaluating intellectual disability training (Viljoen et al. 2017).This review found 'limited evidence for the effectiveness of training programmes in improving knowledge and skills of police officers towards people with disabilities', highlighted the need for 'custom-designed training' and recommended that further research 'should be conducted to develop, implement and evaluate such programmes' (Viljoen et al. 2017).The two studies included in the Viljoen review (2017) were conducted in Northern Ireland and involved role-play exercises in which police officers in the treatment group were allocated roles as people with intellectual or learning disabilities with observation by the remaining participants and subsequent discussion (Bailey et al. 2001;McAllister et al. 2002).They used the 'Attitudes towards Mental Retardation and Eugenics (AMRE)' scale as a pre-and post-test Both studies found 'more favourable' attitudes towards people with intellectual disabilities in the training group compared to a control group of LEOs who did not undertake the training.A broader systematic review (Booth et al. 2017) found additional studies focusing on 'mental health awareness' for police officers that, however, incorporated only a single study specific to intellectual disabilities (Bailey et al. 2001).A systematic review evaluating effectiveness of training for LEOs relevant to autism awareness found only two studies, including a pilot study conducted in Ireland (Murphy et al. 2017) and a randomised controlled trial in the United States (Teagardin et al. 2012).The review authors noted the scarcity of evidence despite the 'state mandated' necessity for such training in the United States (Railey et al. 2020).In addition, the evaluation of a 45-minute course provided to London (UK) borough commanders not included in the above reviews found that disability awareness training improved self-reported knowledge and confidence levels in police officers in interacting or communicating with people with intellectual disabilities and autism spectrum disorder (Racza et al. 2014).
Against this backdrop, the current study describes evaluation of a pilot intellectual disability awareness programme for LEOs (term used interchangeably with police and 'An Garda Síochána') in Ireland.

Development and delivery of training
In keeping with the UNCRPD, the content of the training examined in our study was grounded in the findings of a systematic review of the views of people with intellectual disabilities in respect of interactions with law enforcement agencies (Gulati et al. 2020b).This study was supplemented by an Irish survey sent to representative organisations for people with intellectual disabilities and law enforcement agencies about barriers for people with intellectual disabilities accessing justice in Ireland as well as informing the content of the training in Ireland.The survey findings recommended that the key aspects of training for LEOs should focus on recognition of disability, communication skills and provision of information that is easy to understand and in accessible format and mechanisms for offering support to people with intellectual disabilities through the initial criminal justice pathway (Gulati et al. 2021a).The training programme in our study was developed jointly by the research team, which included a specialist in forensic mental health, a specialist in the field of intellectual disabilities, a specialist in translational research, a specialist in governance and ethics and two experts in law with particular expertise in vulnerable suspects and police procedures.
The key learning objectives of the training were to:

Evaluation
The evaluation protocol was approved by an Ethics Committee and consisted of pre-and post-training questionnaires.The pre-training questionnaire was a structured survey evaluating agreement on five statements across a five-point Likert scale.The post-training questionnaire comprised a semi-structured survey evaluating the degree of agreement with the same five statements using the same scale, supplemented by free-text feedback with general and practice specific questions (Supplementary tables S3 and S4).Practice-specific questions asked participants how their practice would change as a result of the training at all stages of the criminal justice pathway (pre-arrest/arrest/custody/interview/charge/court).A six-step thematic analysis (Braun & Clarke, 2006) of practice-based responses was used for qualitative analysis.
See Supplementary Figure SF1 for a flow diagram of methodology.Following the training, participants reported perceptible increases in knowledge across the four domains studied: understanding intellectual disabilities, understanding challenges for people with intellectual disabilities, communication skills and approaching a person with an intellectual disability in crisis (Table 1).The majority identified a need for further training, possibly as a component of continuing professional development (CPD) activity for LEOs.

Twenty
In light of the number of post-training responses (n = 11), fulltext of all responses are presented (Supplementary Tables S1, S2).A six-step thematic analysis (Braun & Clarke, 2006) of practicebased responses (from Supplementary Table S2) identified four major themes of LEO learning including pre-arrest considerations, recognition of disability, communication and procedural safeguards.Themes and subthemes from the analysis are represented in Fig. 1.
Participant responses demonstrated learning around pre-arrest considerations including considerations of alternatives to arrest: 'It will allow me to question more, rather than drawing a conclusion, and to help the person in crisis as opposed to possibly making things worse.I will also try to find out more about the person pre-arrest, in order to avoid an arrest : : : .'

Participant responses demonstrated learning around awareness and recognition of intellectual disability:
Learning about communication skills was evident: 'The techniques to use.Calling them by their name, using it more to ease them, also if becoming agitated, bring the conversations back to a more common (neutral) neutral topic and to make sure I understand that the interview procedure will take a lot longer than with a person who does not have an intellectual disability, simple questions, especially nonleading : : : ' Learning around procedural safeguards, such as the responsible adult or the presence of a solicitor was evident in practice-based post-training responses: 'Making sure to obtain as much information as possible and record it on the C72 (S) to make sure I meet the person's needs and also assess their ability for interview and if an appropriate adult may be required' (C72(s) refers to a notice of rights in custody)

Irish Journal of Psychological Medicine
'Have an appropriate person there to make certain they understand.Explain in plain simple, and clear language the charge and what they have to do next' Feedback from the exercise identified three key areas of improvement for any future training.These included the need to incorporate the participation of a person with an intellectual disability in the delivery of training; additional real-life scenarios with a procedural focus and the need to facilitate greater access amongst frontline LEOs to accessible medical expertise.The latter finding has specific implications for training of medical practitioners attending police custody suites (Gulati et al. 2021b).

Discussion
This study sought to add to the extremely limited international research base regarding the evaluation of an intellectual disability awareness training programme for LEOs.Whilst multiple awareness programmes can be found to exist worldwide (e.g. in the US, UK and Canada), there is little evidence of formal evaluation (Viljoen et al. 2017).In parallel, there is a paucity of tools available to evaluate the effectiveness of training in respect of knowledge, and perceived practical application of knowledge from such training.The evaluation tool used in this study appears to be feasible in demonstrating perceptible quantitative qualitative changes and is not jurisdiction specific.It is attached as supplementary material (Supplementary tables S3 and S4) to the manuscript to allow for use by other researchers.
The current study found that content grounded in the views of people with intellectual disabilities, specifically developed for each jurisdiction and aimed at procedural awareness, resulted in improved confidence levels amongst LEOs in understanding what an intellectual disability is, the challenges for people with intellectual disability, appropriate communication strategies and best practice crisis approaches.A need for further training was almost universally identified prior to the training and almost all participants highlighted the need for continued training afterwards.Learning around communication skills, recognition of disability, and procedural safeguards were evident in practice-based responses.Prior research had identified 'recognition-communication-information-support' as a quadripartite model for developing learning objectives (Gulati et al. 2021a) and the current study provides early evidence of the relevance and effectiveness of this model.Additionally, the results of the current study offer empirical support for the effectiveness of disability training for LEOs in keeping with the findings of existing literature (Racza et al, 2014;Viljoen et al. 2017) whilst highlighting the potential application of such training to policing practice.

Strengths and Limitations
Recruitment to the current study was voluntary, and analysis examined both qualitative and quantitative feedback.The generalisability of the study is limited by the relatively modest sample size and response rate and a potential response bias.Finally, the study methodology did not employ a control group such as those used in two previous studies (Bailey et al, 2001;McAllister et al, 2002).

Conclusions
The current study adds to existing literature about intellectual disability awareness training for LEOs and lends clear empirical support for the need, as legally mandated by the UNCRPD, to ground training initiatives in the lived experience and views of people with disabilities.Similar training provided to all LEOs, accompanied by a temporal evaluation procedure may allow the exploration of the tangible (e.g.reductions in arrest, increases in diversion rates, and increased use of safeguards such as responsible adults) and intangible benefits of training (such as improved experiences of interactions with LEOs among people with intellectual disabilities).The approach used in this study may usefully inform police training initiatives in Ireland and internationally.

a.
Understand the legal and policy issues in the field (suspects and victims), b.Recognise when a suspect might have an intellectual disability, c.Provide information to the vulnerable suspect, d.Improve communication skills including crisis situations, and e. Support the person with an intellectual disability in custody.The training was delivered by three researchers who used an interactive seminar format (90-minute duration) with vignettes and included video interviews of people with an intellectual disability in reference to law enforcement interactions.The training was conducted online due to restrictions linked to the COVID-19 pandemic.Participation in the training was voluntary, as was completion of pre-and post-training questionnaires.
-three LEOs (n = 23) completed the pre-training questionnaire; 22 attended the training (n = 22) and 11 completed the posttraining questionnaire (n = 11).All participants were current active members of a police force either enrolled in a programme of further education (Bachelor of Arts in Applied Policing or Masters in Serious Crime Investigation) (n = 11) or members of the 'Crime Legal Office' (n = 11).Participants ranged in rank from entry level officers (Gardaí) to an Assistant Commissioner (the third most senior police rank in Ireland).