Forensic and Expert Witness Services
Communication is the basis of our being. It is how we convey ideas, converse, express ourselves, and maintain our existence. Communication is used to think, explain, describe, learn, and reason. Beyond the complex physiological aspects of creating vocal sounds and oral movements that form syllables-words-sentences, communication importantly entails an intricate symbol system that is organized within our brains. Receptively we take in sensory information, process, and comprehend. Expressively, we use that same symbol system to generate meaningful information for others to understand. On an inner or central level, we use language to think to ourselves, make decisions, and act.
Cognitive aspects such as memory, attention/concentration, and executive functions along with communication are closely tied together. They comprise the area of Cognitive-Communication that is well identified in the medical literature and has ICD-10 codes. The DSM-5 also recognizes hundreds of conditions relating to speech-language-voice-fluency and cognitive-communication dysfunction.
Any number of injuries, disease processes, developmental, medical, and environmental conditions can affect communication and a person’s ability to function, reason, speak, work, attend school, and think. Despite imaging results such as CT-scan and MRI after an accident, cognitive-communication, motor-speech, swallow function, visuospatial and/or personality changes may exist on mild to severe levels. The functions of reading, reading comprehension, writing/keyboarding, and calculation may be impaired too. Thinking or language processing speed may be slow or delayed. Dr. Shute works forensically with attorneys, L&I, and insurance companies to objectively evaluate, determine severity, and professionally treat speech-language-cognitive dysfunctions when needed after accident or injury. Since many cases are convoluted, Dr. Shute is able to tease out premorbid factors and offer realistic, objective, and supported analysis.
The areas of Speech-Language-Swallowing Pathology and Cognitive-Communicative deficits cannot be overlooked after injuries. They may be subtle or severe. Whatever the case, such problems heavily impact lives, families, employers, and others. Dr. Shute has the expertise and tools to help support or discount claims in this area. This service effectively helps you build a strong case, supports patient/client deficits or the absence of them, is cost effective, and leaves parties with treatment options where applicable. The following are some examples of where Dr. Shute has been helpful in legal cases:
- 30 year-old man, reclusive, with agoraphobia and pragmatic language deficits needing objective assessment for successful SSDI hearing/determination.
- 42 year-old man with premorbid attention impairment and seen after motor vehicle accident with post-concussive syndrome and accusations of malingering.
- 40 year-old female in a motor vehicle accident who reportedly 13 months later was unable to work due to newly acquired dysarthria and memory problems. Her communication difficulties were unrelated to the accident.
- 38 year-old developmentally disabled woman tested to determine feasibility of costly therapies.
- 55 year-old man involved in a head-on collision with cognitive-communication deficits, dyscalculia, and PTSD needing evaluation to determine damages and care.
- 56 year-old female hit below the hips in a crosswalk by a hit and run driver. Never fell or hit her head. CT-scan unremarkable. Unable to function at home or work as a teacher. Subsequent moderate deficits in short term memory, new learning, word finding, severe light sensitivity, visuospatial deficits, and accused of malingering.
- 16 year-old boy hit by a car in a crosswalk, smashed the windshield, somersaulted over the car, and landed on his head/shoulder. Moderate subsequent cognitive-communicative impairments and personality changes, evaluated, treated, and submitted as beneficial evidence.