Accessible summary• This research aimed to find out how many people in a big English prison had a learning disability. • One-tenth of the people in the prison were chosen to take part. There were 140 prisoners involved in the study. • The prisoners were asked questions about their lives and took tests to see if they had a learning disability. • The researchers found there were more people with learning disabilities in prison than people had thought before. • People in prison who have a learning disability need extra help.• People who have a learning disability also need special help when they leave prison and go back to live in the community. SummaryOver-representation of people with learning disability in prisons has been demonstrated in many Western jurisdictions. This was the first comprehensive research in a UK prison. The research used a random 10% sample of a prison population (n = 140). A semi-structured interview, the Wechsler Adult Intelligence Scale -III (UK version) and the Vineland Adaptive Behavior Scales (VABS) Interview Edition were administered. On the Wechsler Adult Intelligence Scale -III, UK version (WAIS-III (UK)), 7.1% of participants achieved standard scores below 70 and a further 23.6% were in the 70-79 (borderline) range. The VABS results indicated that 10.1% had standard scores below 70 and a further 33.3% were in the borderline range. The results indicate that the prevalence of intellectual (or learning) disability as measured on either or both of the WAIS-III (UK) or the Vineland Adaptive Behavior Scales is higher than previous research in the UK has indicated. The results have implications for provision of services in prison and post-release.

Background People with an intellectual disability are significantly over-represented in the criminal justice system in many Western jurisdictions; early identification in the system is important if they are to receive appropriate services, protection, diversion and rehabilitation. Methods The Kaufman Brief Intelligence Test (KBIT) and the Vineland Adaptive Behavior Scales (VABS) were compared with the Hayes Ability Screening Index (HASI), developed from a battery of items. In total, 567 adult and juvenile offenders, in custodial and community settings, were tested. Results Receiver operating characteristic (ROC) curve analyses showed that the final version of the HASI was as effective as the KBIT or the VABS in predicting results on the other test. Correlation coefficients between the HASI, the KBIT and VABS were significant. Conclusions The HASI is an effective screening instrument for determining offenders who may have an intellectual disability and need to be referred for full-scale diagnostic assessment.

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Concern is often expressed about the English language proficiency (ELP) of students engaged in professional training. This report assesses the ELP of the 1990 and 1991 intakes into medicine at the University of Sydney. A quick screening test and individual in-depth tests were used in a two-stage design. Admission to the course is highly competitive and most students are selected from the top 0.75% of Higher School Certificate results but 15% and 19% of the year cohorts were found to be below average in ELP. English proficiency was found to be consistently correlated with first- and second-year university results. Initiatives taken to support students with language disadvantages and to ensure that graduates will be able to communicate effectively with patients are outlined.