148 . British Journal of Learning Disabilities Vol.

25 (1997)

The Importance of
Communication Partnerships:
A Study to Investigate the
Communicative Exchanges
Between Staff and Adults with
Learning Disabilities

Claire Bartlett, Speech and Language Therapist, Riverside Mental Health Trust and Karen Bunning, Department of
Clinical Communication Studies, City University.

A small-scale study was conducted to investigate the as a result of stroke, for example, aphasia (Lesser &
extent to which the verbal communication skills used Milroy, 1993; Perkins, 1995), children with phonological
by adults with learning disabilities were complemented disorders (Gardner, 1997) and people with learning dis-
by those used by their keyworkers during communi- abilities (Couchman, 1997). Importantly, it views com-
cative exchanges. The setting was a community-based munication as collaborative interaction and assigns
day centre. The number of information carrying words equal value to the roles of both the participants in a
(ICWs) used by keyworkers with their clients was communicative exchange, stressing that a successful
measured in two contexts: (A) looking at selected pic- interaction is not just the sum of the two halves, i.e. the
tures; (B) free conversational exchange. These were communication partners, but rather the co-construction
compared with the verbal comprehension level of each of discourse to which both people contribute (Perkins,
client, also measured in ICWs, as assessed by the 1995).
administration of the Derbyshire Language Scheme: Interest in the communication partnerships between
Rapid Screening Test of Comprehension (Knowles & adults with learning disabilities and their support staff
Masidlover, 1982). The results revealed that major dif- has been influenced by a number of issues. Firstly, adults
ferences existed between the communication skills used with learning disabilities are frequently limited in their
by keyworkers, and the comprehension levels of the ability to assume responsibility for their own learning
participants with learning disabilities under both con- and the maintenance of their skills due to the very
ditions. The greater mismatch was evident in the second nature of their collective impairments. Furthermore, the
condition of ‘free conversational exchange’. Some limi- automatic transference of new skills acquired in one
tations of the current study are discussed together with situation, into another, cannot be assumed (Calculator &
the implications for future investigations and interven- Bedrosian, 1988). Adults with learning disabilities are
tion. very often dependent on their support workers for this.
Secondly, work on the development of communication
Introduction stresses the importance of carer responsiveness (Ware,
A communication partnership involves two or more 1996) and indicates that the way staff use their com-
people who exchange ideas and interpret meanings. Each munication skills to support and frame those of adults
person engages in linguistic encoding and decoding and with learning disabilities, is crucial to the maintenance and
makes inferences about the other’s intentions in the progression of their communicative abilities (Vygotsky,
context of available skills, expectations and knowledge 1962; Goldbart, 1996).
(Sperber & Wilson, 1986).Conversation Analysis (CA) is Thirdly, the controversy that surrounds the use of
an approach that is used increasingly in the assessment ’Facilitated Communication’ highlights the importance
and remediation of communicationproblems with various of accurate assessment of the individuals’communication
populations including, people with acquired difficulties skills and appropriate communicative support supplied
 British Journal of Learning Disabilities Vol. 25 (1997) . 149

by significant others. ‘Facilitated Communication’ is a present pattern of ’modular’ training courses can only
technique developed by Crossley (Crossley & McDonald, ever offer a superficial learning experience. This echoed
1980;Crossley, 1996) that involves the physical assistance the sentiments of Daniels & Sandow (1987) who criti-
by a facilitator to a non-verbal person so that psycho- cised the lack of evidence for the effectiveness of this
emotional and/or neurophysiological problems are mini- type of training course, both in the short-term and the
mised and access to communication form is facilitated long-term.
(Batt, 1990).Letter boards or similar technical devices are Generalisation of newly acquired skills to the work set-
commonly used and the individuals’ messages are spelt ting appears to be a particular issue. This was reiterated
out. However, research has shown evidence of facilitator by McLeod et al. (1995), in their study of the effects of
influence over the resulting communications (Prior & communication training on experienced and naive carers.
Cummins, 1992; Datlow Smith et nl., 1994). This has One particular issue for staff was their expressed lack of
led to questions regarding where the communications confidence to try out newly acquired skills. This may
originate from: the communicator or the facilitator? have affected the transfer of learning in the classroom to
Finally, the shift in services for adults with learning dis- the environment of need. Importantly, they found little
abilities over the last two decades has been characterised difference between the skills of both ’experienced’ and
by the closure of residential institutions based on a ’naive’ staff, suggesting that experience alone did not
’medical’ model and the establishment of community- ’teach’ people good practice.
based services. The latter have involved an increase in Van der Gaag & Dormandy (1993) commented that a
the number of people who work with this population lack of training in communication skills facilitation may
who have had limited specialist training (van der Gaag lead staff to make inappropriate judgements about their
& Dormandy, 1993). client’s communicative ability, such that competencies
may be either over-estimated or under-estimated.
Prevalence of Communication Difficulties Johnston & Shook (1993) in their investigation of
It is widely acknowledged that adults with learning training offered to day care officers, reported that the
disabihties experience communication problems, although main emphasis was on the legal, regulatory and ethical
the exact size of the problem is difficult to establish. A standards with a lack of in-service training. Jackson (1988)
survey of clients in day centres and long stay hospitals felt the need to eliminate all aspects of institutional
completed by Blackwell et a2. (1989), concluded a total of practice from current provision in the community has
62% of the population experienced identifiable communi- influenced the type of training on offer. The develop-
cation problems, made up of 29% of the population who ment of community care policies has continued to con-
were non-verbal, 25% with marked problems, and a tribute to staff training provision.
further 8% with some other level of verbal difficulty.
Thirty-three percent had some verbal communication Service Philosophy
difficulty. It was not made clear what percentage of non- Staff training often includes an exploration of the prin-
verbal people were also severely physically disabled, thus ciples of Social Role Valorisation (SRV) (Wolfensberger,
perhaps accounting for a lack of verbal communication. 1983). Originally termed the philosophy of ‘Normalisa-
Nevertheless, it is possible to see the extent of difficulties tion‘ (Wolfensberger, 1972),it was redefined and renamed
in the communication skills of the study population. in order that value could be given to the many different
Another survey by Law & Lester (1991) in a social social roles performed by an individual (Wolfensberger,
education centre found slightly higher levels of need: 1983).A relatively recent definition of SRV was put for-
81% were considered to require support for their com- ward by Wolfensberger (1992):’the enablement, establish-
munication skills with 9.5% being non-verbal and 5.9% ment, enhancement, maintenance, and/or defence of
demonstrating low comprehension and/or low expres- valued social roles for people - particularly for those at
sion. The variations between these two studies may be value risk - by using, as much as possible, culturally
explained by differences in the focal populations, the valued means.’ (p. 32). Thus staff are taught to develop
criterion used for their identification and data collection a style of service delivery that assigns value to the many
methods. roles exercised by adults with learning disabilities in
daily life.
Skill Mix of Staff
Various surveys have reported on the skill mix of staff Tensions
employed within services for adults with learning dis- An analysis of professional-client relationships in rela-
abilities since the shift from institutional care to com- tion to ’normalisation’ suggests that there are two com-
munity reprovision has taken place. The UK Social mon misconceptions regarding ’normalisation’ (Brechin
Services Inspectorate Report (1989) stated that only 13% & Swain, 1988). The first is that ’normalisation’ means
of care staff surveyed had a qualification that related making people normal (Sinha, 1986) although it was
directly to their work with learning disabled people; 17% never intended to deny need in the pursuit of normality.
had trade qualifications and 18%had a generic teaching The second misconception identified by Brechin & Swain
qualification. There was no reported evidence of any (1988) is an overemphasis on image, such as providing
systematic staff training in the community-based services ordinary housing, or using ordinary transport, because
of the survey. these will render the individual as more acceptable to
Jackson (1988) found that the majority of front line society.
staff working with a similar client group were young, A third misinterpretation might be the normalking of
inexperienced and untrained. He further states that the communication acts to adults with learning disabilities,
150 . British Journal of Learning Disabilities Vol. 25 (1997)

even though it may involve an overestimation of their Method of Investigation

skills, i.e. a mismatch between the skills of the person The role of carers and other communication partners
with a learning disability and those of the carer. The is of major importance to the collaborative construction
tension for staff may be the desire to communicate in an of discourse with people with learning disabilities who
age-appropriate manner with the individual whilst also also have impaired communication. The aims of the study
providing meaningful support for the communicative were:
attempts by the person with a learning disability. Just
as O'Brien's original Vicious Circle (1981) illustrated the (i) To investigate the extent to which the verbal compre-
risks of responding negatively to the person with a hension of adults with learning disabilities is comple-
developmental delay (Figure l), a belief in the normal or mented by the verbal expressive skills used by their
ordinary adult life may lead to high expectations of the keyworkers during discourse.
individual's communication skills and unrealistic oppor- (ii) To compare the verbal output of the staff participants
tunities being provided for the person. This may result under two separate conditions (looking at selected
in failure and thus establish negative or diminished pictures us free conversation exchange).
experiences which, in turn, will lead to more restricted (iii)To compare the mean number of 'Information Carry-
communication skills use. The overall effect of this ing Words' (ICWs) used by participants across the two
pattern of devaluation is likely to be poor self-esteem conditions.
and isolation of adults with learning disabilities and (iv)To review the range of ICWs used by participants
their exclusion from communication partnershps. This across the two conditions.
is illustrated in Figure 2.
Participants were selected in chronological order of their
Figure 1 The Vicious Circle (or 'Deviancy Career') referral to the Speech and Language Therapy service. The
first six people referred who had some verbal means of
communicating, ranging from single words to simple
Initial achievement phrases, were accepted for the study. Each one was in a
delay pair with an appropriate keyworker. The age range of
L the clients was 26 to 48 years. Keyworkers had been in
Prejudiced contact with their clients for a continuous period of no
less than six months.
7 The study focused on the use of verbal communication
skdls. The chosen unit for communication analysis was
More severe expectations 'Information Carrying Words' (ICWs). Each participant
performance delay was assessed using an adapted version (i.e. adult objects
replaced toys) of the Derbyshire Language Scheme Rapid
Screening Test of Comprehension (Knowles & Masidlover,
Opportunity 1982) to establish the level of information carrying words
(ICWs) understood. An 'Information Carrying Word' is
defined as a word which carries a key meaning within a
message. They are the minimal words required for under-
standing an utterance.
Source: O'Brien. 1981 Each keyworker was asked to initiate a conversational
exchange with the appropriate participant under two
Figure 2 The Vicious Circle (or 'Over-estimation separate conditions. In condition A, the keyworker was
Career') asked to discuss a selection of picture cards with the
appropriate participant and in condition B, the keyworker
Learning disability and impaired was asked to develop a free conversational exchange with
communication skills the appropriate participant. Some topic guidelines were
given, e.g. clothes, day centre activities, television, etc.
A tape recorder was used to record communicative
Philosophy of exchanges. There were no time restrictions for either
'normalisation' and belief condition as it was recognised that this may have added
of the 'ordinary life' pressure to the conversational exchanges. For consistency
across participants, a ten-minute sample of each recorded
exchange was isolated for analysis.
High expectations
More restricted
communication Data Analysis
skills use The data were transcribed in traditional orthography
within three hours of each session. A number of utter-
Unrealistic ances were omitted from the data sample. These con-
opportunities tained linguistic redundancies such as courtesy markers
Negative or diminished and rhetoricals. The words that were essential for under-
experiences standing meaning and for responding appropriately
(ICWs) were counted. This was carried out separately
for each condition.
 British Journal of Learning Disabilities Vol. 25 (1997) . 151

Table 1 Comprehension level of participants with pants under the two conditions. Examination of the
learning disabilities in relation to mean number of raw frequencies show that the keyworkers used more
ICWs produced under the two conditions utterances in the second condition (free conversational
exchange) apart from one case (participant 4) although
Compre- the difference was non-significant when tested with a
hension Mean Wilcoxon Matched Pairs Test [ Z = -1.3628, p < 0.1730
Condition Level (Rapid No. (2 tailed)].The adult with learning disabilities in this part-
A = Picture Screening of lCWs Amount nership (participant 4) had the most severely restricted
B = Con- Test): Per of communication skills of the sample and it is, therefore,
Participant versation No. of lCWs Utterance Difference
possible that the keyworker found the first condition
A 1.65 +0.65 (looking at pictures) more accessible due to its concrete
1 B 1 3.26 +2.26 content.
Table 2 also shows that the staff used more ICWs in the
A 2.93 +0.93 free conversational time (Condition B), without a specific
2 B 2 4.57 +2.57 context, than when looking at pictures (Condition A),
A 2.94 +0.94 with a specific context with the exception, once again, of
3 B 2 3.56 +1.56 participant 4. Again, statistical analysis based on a rank
A 1.99 +0.99 comparison was non-significant [Z = -1.7724, p < 0.1159
4 B 1 2.51 +1.51 (2 tailed)]. However, a comparison of the mean ICWs
under the two conditions was significant [ Z = -2.2014, p
A 2.40 +0.40 < 0.03 (2 tailed)].
5 B 2 3.63 +1.63 It is important to note that with this very small num-
A 2.22 +0.22 ber of participants, one pair that goes against the trend
6 B 2 3.14 +1.14 (e.g. participant 4) is bound to have a disproportionate
effect on the analysis. Examination of the raw data shows
that there is a consistent trend for the number of utter-
ances and ICWs to be greater in conversation than picture
Table 2 Staff initiated utterances under the two description.
conditions: Number of utterances;number of ICWs; Finally, the range of ICWs per utterance shows the
mean number of ICWs; and range of ICWs per variability in the staff’s communications in each context.
utterance
Conclusion
Range
Mean of The number of participants involved in the research
Condition No. ICWS was limited and, therefore, the results should be viewed
A = Picture No. No. of lCWs per as preliminary findings. The study restricted its focus to
B=Con- of of per Utter- the use of verbal communication skills, specifically the
Participant versation Utterances lCWs Utterance ance use of ICWs and has ignored other aspects of verbal com-
munication, e.g. pragmatics. Furthermore, no attention
A 17 28 1.65 1-3 has been paid to the use of non-verbal communication
1 B 72 235 3.26 1-7 skills. It is recognised that future research on the com-
A 15 44 2.93 1-7 municative exchanges between adults with learning
2 B 66 201 4.57 1-7 disabilities and their keyworkers needs to examine the
use of multi-modal communication skills, e.g. gesture,
A 18 53 2.94 1-6 sign, facial expression, objects of reference, etc., in the co-
3 B 25 89 3.56 1-8
construction of discourse.
A 72 143 1.99 1-6 However, some preliminary findings may be reported.
4 B 41 103 2.51 1-4 The degree of communication skills mismatch between
A 30 72 2.40 1-5 participant and keyworker is greater in the unstructured
5 B 54 196 3.63 1-9 situation (i.e.open conversation).The concreteness offered
by looking at pictures appears to focus the staff members’
A 18 40 2.22 1-4 communications more appropriately to meet their parti-
6 B 21 66 3.14 1-7
cipant’s communication needs. The context appears to
have affected the staff’s linguistic input to the participant
in terms of the amount of information expressed and this
may be important for the participant’s eventual under-
Results standing.
Table 1shows the difference between each participant’s
comprehension level and the number of ICWs used by the The Communication Partnership
keyworkers. The resulting communications of each staff A number of initial issues for discussion are raised
member are shown to consistently over-estimate the com- which relate to the formation of communication part-
prehension level of the individual participant. nerships between adults with learning disabilities and
Table 2 summarises the number of utterances initiated members of staff. Firstly, if context is important to both
by staff members when addressing individual partici- staff and adults with learning disabilities, alternative
 152 . British Journal of Learning Disabilities Vol. 25 (1997)

ways of rendering a context ’more concrete’ should be References

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Square, London EClV OHB. Publishers.
 British Journal of
Learning Disabilities

Index
Volume 25
1997

Editor
John Harris

Book Review Editor

Beryl Smith
 AUTHORS
Adams, R. See: Moore, E., Adams, R., Elsworth, J. and Vol. 25.3: 117-122.
Lewis, J. March, J. Steingold, B. and Justice,S. with Mitchell, P.
Allt, J., Fenner, S. and Marvell, C. The Introduction oj Follow the Yellow Brick Road! People with Learning
Role-play to a Group of Women with Learning Dificulties as Co-researchers.Vol. 25.2: 77-80.
Disabilifes: Graded Stages in Developing Role-play Marvell, C. See: Allt, J., Fenner, S. and Marvell, C.
Skills and Some Practical Hints for Facilitating Mathewson, Z. See: Kelman, L.V., Lindsay, W.R,
Role-play. Vol. 25.4: 144-148. McPherson, F.M. and Mathewson, Z.
Bartlett, C. and Bunning, K. The Importance of Matthews, D. and Hegarty, J. The OK Health Check: A
Communication Partnerships: A Study to Investigate Health Assessment Checklistfor People with Learning
the Communicative Exchanges Between Staff and Disabilities. Vol. 25.4: 138-143.
Adults with Learning Disabilities. Vo125.4: 148-153. May, D.S. See: Male, D.B. and May, D.S.
Bunning, K. See: Bartlett, C. and Bunning, K. McPherson, F.M. See: Kelman, L.V., Lindsay, W.R,
Cambridge, P. and Knapp, M. A t What Cost? Using McPherson, F.M. and Mathewson, Z.
Cost lnformation for Purchasing and Providing McVilly, K.R. Residential Staff: How They View Their
Community Carefor People with Learning Disabilities. Training and Professional Support. Vol. 25.1: 18-25.
VOI. 25.1: 7-12. Meddis, R. See: Holland, A. and Meddis, R.
Cheseldine, S. See: Walker, T. and Cheseldine, S. Mitchell. P. See: March, J., Steingold, B. and Justice, S.
Clarke, D.J. Towards Rational Psychotropic Prescribing with Mitchell, P.
for People with a Learning Disability. Vol. 25.2: 46-52. Moore, E., Adams, R., Elsworth, J. and Lewis, J. An
Cullen. P. See: Lavis, D., Cullen, P. and Roy, A. Anger Management Groupfor People with a Learning
Elsworth, J. See: Moore, E., Adams, R., Elsworth, J. Disability. Vol. 25.2 53-57.
and Lewis, J. Pendaries, C. Pilot Study on the Development of the
Elsworth, J.D. See: Rikberg Smyly, S. and Elsworth, Learning Disability Healthcare Resource Groups. Vol.
J.D. 25.3: 122-126.
Fenner, S. See: Allt, J., Fenner, S. and Marvell, C. Pennell, D. See: Sigafoos, J., Pittendreigh, N. and
Freeman, S. Treating a Dog Phobia in a Person with Pennell, D.
Down’s Syndrome by Use of Systematic Phillips, G. See: Redworth, M. and Phillips, G.
Desensitisation and Modelling. Vol. 25.4: 154-157. Pittendreigh, N. See: Sigafoos,J., Pittendreigh, N. and
Goodman, W. See: Leggett, J., Hurn, C. and Pennell, D.
Goodman, W. Raczka, R. See: Hussain, F. and Raczka, R.
Hegarty, J. See: Matthews, D. and Hegarty, J. Redworth, M. and Phillips, G. Involving People with
Holland, A. a n d Meddis, R. People Living in Learning Disabilities in Community Care Planning.
Community Homes: Their Views. Vol. 25.2 68-72. Vol. 25.1: 31-35.
Hum, C. See: Leggett, J., Hurn, C. and Goodman, W. Rikberg Smyly, S. See: Gardner, A. and Rikberg
Hussain, F. and Raczka, R. Life Story Workfor People Smyly, S.
with Learning Disabilities. Vol. 25.2: 73-76. - Rikberg Smyly, S. and Elsworth, J.D. Interviewing
Justice, S. See: March, J., Steingold, B. and Justice, S. Clients: A Project to Explore Client Views About a
with Mitchell, P. Change in Service Provision. Vol. 25.2 64-67.
Kelman, L.V., Lindsay, W.R., McPherson, F.M. and Roy, A. See: Lavis, D., Cullen, P. and Roy, A.
Mathewson, Z. Smoking Education for People with kmker, J. Gender, Race and Sexual Behaviour: lssues in
Learning Disabilities. Vol. 25.3 95-99. Service Responses to HIV/AIDS. Vol. 25.2: 58-63.
Knapp, M. See: Cambridge, P. and Knapp, M. Sigafoos, J., Pittendreigh, N. and Pennell, D. Parent
Lavis, D., Cullen, P. and Roy, A. Identification of and Teacher Ratings of Challenging Behaviour in
Hearing Impairment in People with a Learning Young Children with Developmental Disability. Vol.
Disability: From Questioning to Testing. Vol. 25.3: 25.1: 13-17.
100-105. Simons, K. Residential Care, or Housing and Support?
Leggett, J., Hurn, C. and Goodman, W. Teaching Vol. 25.1: 2-6.
Pyschological Strategies for Managing Auditory Steingold, B. See: March, J., Steingold, B. and Justice,
Hallucinations. Vol. 25.4: 158-162. S. with Mitchell, P.
Lewis, J. See: Moore, E., Adams, R., Elsworth, J. and I’hurman, S. Challenging Behaviour Through Communi-
Lewis, J. cation. Vol. 25.3: 111-116.
Lindsay, W.R. See: Kelman, L.V., Lindsay, W.R, rowell, D. Promoting a Better Life for People with
McPherson, F.M. and Mathewson, Z. Learning Disabilities and Their Families: A Practical
Link, H.M. Auditoy Integration Training ( A n ) : Sound Agenda for the New Governmnt. Vol. 25.3: 90-94.
Therapy? Case Studies of Three Boys with Autism who Nalker, T. and Cheseldine, S. Towards Outcome
Received AlT. Vol. 25.3: 106-110. Measurements: Monitoring Effectiveness of Anger
Male, D.B. and May, D.S. Burnout and Workload in Management and Assertiveness Training in a Group
Teachers of Children with Severe Learning Difficulties. Setting. Vol. 25.4 134-137.
SUBJECTINDEX
Aberrant Behaviour Checklist 13-17 New Government 90-94
Adult 64-67,95-99, 138-143
AIT 106-110 Outcome Measurement 134-137
Alternative Therapies 106-110
Anger Management 53-57,134-137 Participant Evaluation 53-57
Assessment 13-17,138-143 Participation 64-67, 77-80
Auditory 106-110 Partnership 148-153
Autism 106-110 Pharmacology 46-52
Philosophy 148-153
Burnout 117-122 Planning 7-12,31-35
Policy Proposals 90-94
Casemix Costs 122-126 Prevalence 100-105
Challenging Behaviour 13-17,111-116,117-122 Pre-school Children 13-17
Cognitive-Ekhavioural Techniques 158-162 Priorities 90-94
Commissioning 122-126 Professionals 18-25
Communication 111-116,148-153 Providing 7-12
Community Care 31-35 Psychosis 158-162
Community Services 68-72 Psychotropic 46-52
Contract 122-126 Purchasing 7-12
Costings 7-12
Qualitative Research Outcomes 68-72
Disability 64-67
Dog Phobia 154-157 Race 58-63
Down’s Syndrome 154-157 Registration and Inspection 2-6
Regulation 2-6
Evaluation 18-25,64-67 Relationships 26-30
Relaxation 154-157
Families 77-80 Research 77-80
Residential Care 2-6,18-25
Gender 58-63 Role-Play 144-148
Generalisation 154-157
Group Work 134-137,158-162 Satisfaction 18-25
Self-Advocacy 77-80
Hallucinations 158-162 Services 64-67
Health Education 95-99 Severe Learning Disability 111-116,117-122
Healthcare 122-126,138-143 Sexuality 58-63
Hearing Impairment 100-105 Skill Mix 148-153
HIV/AIDS 58-63 Smoking 9599
Housing and Support 2-6 Speech and Language 111-116
HRGs 122-126 Staff 138-143
Staff Client Interaction 26-30
Integration Training 106-110 Strategies 31-35
Interview 64-67 Stress 117-122
Involvement 31-35 Supported Living 2-6
Systematic Desensitisation 154-157
Keyworker Involvement 53-57
Teachers 117-122
Learning Difficulties Therapy 111-116
Learning Disabilities 58-63,73-76,77-80, Training 18-25
95-99,100-105,138-143,144-148 Transitions 73-76
Life Story Work 73-76
Loss and Bereavement 73-76 Valuing 26-30
Views 68-72
Market 7-12
Medication 46-52 Womens’ Group 144-148
Methodology 100-105 Workload 117-122
Mild Learning Disability 158-162 Workshop 26-30
Multidisciplinary 111-116
BOOK REVIEWS
Ail About Attention Deficit: Symptoms, Diagnosis Sex Education for Parents: A Resource Pack for
and Treatment/Children and Adults. Vol. 25. 3: Professionals to Support Parents in their Role as
128-129. Sex Educators. Vol. 25.3: 130-131.
Approaches to People with Challenging Behaviour: Sexuality, Learning Difficulties and Doing What’s
A Distance Learning Package for Direct Care Staff. Right. Vol. 25.2: 84.
Vol. 25.4: 167-168. Sexuality and Learning Disability:The Way Forward.
Assessor Workbook: Guidance and Practice in Vol. 25.2: 84.
Vocational Assessment. Vol. 25.1: 37-38. Sexuality and Young People with Learning
Autism Focus: The Training Workbook for Carers. Difficulties. Vol. 25.2: 84.
Vol. 25.2: 83. Still an Chance to Learn? A Report on the Impact of
The Autistic Spectrum: A Guide for Parents and the Further & Higher Education Act (1992) on
Professionals. Vol. 25.2: 85. Education for Adults with Learning Difficulties.
BILD Seminar Papers, Number 4. People with Vol. 25.4: 169.
Learning Difficulties at Risk of Physical and Support for Families. Vol. 25.3: 127.
Sexual Abuse. Vol. 25.1: 36. Supported Living: A New Paradigm? Vol. 25.1: 38.
Blackstone’s Guide to the Disability Discrimination Taking A Break: Liverpool’s Respite Services for
Act 1995. Vol. 25.4. 167. Adult Citizens with Learning Disabilities. Vol.
Brothers, Sisters and Learning Disability. Vol. 25.4: 25.1: 38.
169-170. Talkabout. Vol. 25.3: 129-130.
Community Care in Transition. Vol. 25.1: 38. Values and Visions: Changing Ideas in Services for
Developing Personal Safety Skills in Children with People with Learning Difficulties. Vol. 25.3: 131.
Disabilities. Vol. 25.2: 83. What Can We Do? The Legal Framework of
Disabilty Politics: Understanding Our Past, Community Care Services for Adults with
Changing Our Future. Vol. 25.3: 130. Learning Disabilites in England and Wales. Vol.
Dramatherapy for People with Learning Disabilities. 25.1: 38.
Vol. 25.1: 37. Working with Children in Education: The Impact of
Everyday Skills Pack: ’New Opportunitues for Head Injury (Information Pack). Vol. 25.3: 130.
People with a Learing Disability’: Road Safety
Pack. Vol. 25.3: 128.
LETTERS
Going to the Doctor. Vol. 25.4: 168.
’Have a Good Day’ Units 1-8:An Independent Study Cardiff Universities Social Services. Vol. 25.1: 40.
for Staff Working with People with Learning f i e Derek Ricks Fellowship. Vol. 25.1: 40-41.
Disabilities in Day Services. Vol. 25.4: 168. Health Promotion. Vol. 25.4: 171.
Healthy Sexuality, HIV and People with Learning Learning Disability Resettlement Re-admissions.
Difficulties. First National Conference Report Vol. 25.1: 40.
1992. Vol. 25.1: 36-37. +en Days 1997. Vol. 25.3: 132.
HIV & AIDS ’It isn’t an issue here! ... is it?: jchizophrenia and Learning Disability: A Response.
Information for People Working in Residential Vol. 25.1: 39.
Settings. Vol. 25.2: 84. Strategies for Independent Wayfinding. Vol. 25.1: 40.
Interactive Approaches to Teaching: A Framework
for INSET. Vol. 25.4: 170. CONFERENCE REPORTS
Invisible Victims: Crime & Abuse Against People
with Learning Disabilies. Vol. 25.3: 129. f i e BILD 1997 International Conference ‘Services
Literacy: Programs for Adults with Developmental Challenged by Complex Needs’. Vol. 25.4: 163.
Disabilities. Vol. 25.4: 169-170.
Music for All. Vol. 25.2: 85. OBITUARIES
Pupils with Severe Learning Disabilities who Present
Challenging Behavious: A Whole School 3r Ann Craft. Vol. 25.2: 81-82.
Approach to Assessment and Intervention. Vol. ios Fraser. Vol. 25.4: 164.
25.3: 127. 3orothy Jeffree. Vol. 25.4: 164-165.
Refined Competencies. Vol. 25.1: 38. 4lbert Kushlick. Vol. 25.4: 165-166.
 British Journal of Learning Disabilities Vol. 25 (1 997) . 153

McLeod, H., l-Iouston, M. and Seyfort, B. (1995)

Communicative interactive skills training for caregivers
of nonspeaking adults with severe disabilities.
bild publications
International J o i i r d of Practical Approaches to Disability Now Available in Paperback!
9 (l), 5-11.
O’Brien, J. and Tyne, A.(1981) The Principle ofNornmlisation: Challenging Behaviour and Intellectual
A Fo~rndafionfor l:ffective Semices. London: Values into
Action. Disability: A Psychological Perspective
Parks, K. (1997) Using objects o f reference: A review of the Edited by Robert S P Jones and Caroline B Eayrs
literature. E~iropeanJournal of Special Needs Education 10
(l), 40-6. This collection of papers addresses key topics
Perkins, L. (1995) Applying conversational analysis to for those concerned with the management of
aphasia: Clinical implications and analytic issues. challenging behaviours. With contributions from
Eiiropean Jonrnai of Disorders of Conimunicafion 30 (3),
372-83. leading researchers, it covers the identification
Prior, M. and Cummins, R. (1992) Questions about facilitated and analysis of challenging behaviour, service
communication and autism. Journal of Aiitisnz and responses, theoretical issues, and future
Developmental Disorders 22 (3), 331-7.
Sinha, C. (1986) Psychology, education and the ghost Kaspar
directions.
Hauser. Disability, Handicap and Society 1, 245-59.
Social Services Inspectorate (1989) Inspection of Day Servicesfor Important topics include:
People with a Mental Handicap. London: DOH. + Assessment using functional analysis
Sperber, D. and Wilson, D. (1986) Relevance, Cognition and
Commiinication. Oxford: Blackwell.
+ Self-injury
van der Gaag, A. and Dormandy, K. (1993) Commiinication and
+ The management of violence and aggression
Adults with Learning Disabilities. London: Whurr + Gentle teaching
Publishers. + Ordinary housing
Vygotsky, L. (1962) Tlioiiglit and Langiiage. Cambridge MA:
MIT Press. f14.95 + 75p p&p 1993 Paperback
Walker, M. (1972) The M a h t o n Vocabiilary Development Project. ISBN 1 873791 63 1
Camberley, Surrey.
Ware, J. (1996) Creating a Responsiue Environment ,for People
7uith Profound and Multiple Learning Difficulties. London: Available from: BlLD Publications,
David Fulton Publishers. Plymbridge Distributors, Estover Road,
Wolfensberger, W. (1972) The Principle of Nornzalisation in Plymouth, PL6 7PZ. TelOl752 202300
Human Services. Toronto: National Institute on Mental
Retardation.
Wolfensberger, W. (1983) Social role valorisation: A proposed
new term for the principle of normalisation. Mental
Retardation 21, 234-9.
Wolfensberger, W. (1992) A Brief Introduction to Social Role
Valorisation as a High-order Concept for Strirctiiriiig H u m a n
Services. USA: Syracuse University.

bild British Institute of Learning Disabilities

presents

From t h e margin
I t o t h e centre
ONE DAY CONFERENCE
This one day conference considers the services that are offered to people with learning
disabilities who are from ethnic backgrounds. A range of services and the cultural needs
of people with learning disabilities will be discussed.
Speakers:
Razia Aziz & Aqeela Alam, Limbed Spencer, Harriet Uvanney & Jackie Downer
TUESDAY 5TH MAY 1998, THE CAVENDISH HOTEL, EASTBOURNE
€79.90 inc VAT
Wolverhampton Road, Kidderminster, Worcs. DY 10 3PP Tel: 01562 850251