On Fitness to Plead: When the Accused is Speech-less

Kok Keong Leong, Yee Chin Chai, Johari Khamis, Nur Syuhada Hosni, Norhameza Ahmad Badruddin


Forensic psychiatric evaluation of a suspected mentally disordered offender includes diagnosis, treatment whenever applicable, criminal responsibility and most importantly, the determination of the fitness to plead. The evaluation would be more challenging in a person with aphasia. Herein, we present a case of transcortical mixed aphasia (TMA) that was sent by court for forensic psychiatric evaluation. We describe the process of helping the suspect to stand trial with the guidance from the speech language therapist (SLT) through alternative communication methods (ACM). The presence of aphasia remains a challenge to the assessment and its validity of fitness to plead for the accused. Hence a multidisciplinary approach is essential to assess and subsequently assist the accused in his fitness to plead.

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Traumatic Brain Injury; Fitness to Plead; Aphasia; Alternative Communication Method

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