Petri, G., Beadle‐Brown, J. and Bradshaw, J. (2020). Redefining Self‐Advocacy: A Practice Theory‐Based Approach. Journal of Policy and Practice in Intellectual Disabilities [Online]. Available at: https://doi.org/10.1111/jppi.12343.
The disabled people's movements have successfully influenced public policies and laws. Self‐advocates who are autistic or have an intellectual disability have been working alongside other advocates for recent decades. Practice theory has rarely been used in disability research. This study explores “practice theory” through the analysis of interviews with advocates and self‐advocates within the autism and intellectual disability advocacy movements. This is a qualitative, empirical study based on interviews and focus groups with 43 participants in two countries. The data were collected in 2016–17. Content analysis was used to identify themes. Data indicate that everyday practices of self‐advocates and advocates such as parent advocates and professional advocates largely overlap. There are five major types of practices that are done by nearly all advocates: “informing and being informed,” “using media,” “supporting each other,” “speaking up,” and “bureaucratic duties.” Contrary to several previous studies on self‐advocacy that emphasized “speaking up” as the main activity in advocacy, this study found that most practices of advocates and self‐advocates are “para‐advocacy” practices that may or may not lead directly to “speaking up.” Practices of self‐advocates are often embedded in other everyday activities people do. The line between practices that belong to self‐advocacy and practices outside self‐advocacy may not always be clear even to self‐advocates. Findings also indicate that hierarchies in the disability movement influence strongly the position of self‐advocates.
Howell, M., Bradshaw, J. and Langdon, P. (2020). A Systematic Review of Behaviour-Related Outcome Assessments for Children on the Autism Spectrum with Intellectual Disabilities in Education Settings. Review Journal of Autism and Developmental Disorders [Online]. Available at: https://doi.org/10.1007/s40489-020-00205-y.
A systematic review was completed to identify assessments used with children with intellectual disabilities to assess adaptive behaviour, challenging behaviour and autism-related behaviour and consider their appropriateness for use by special education teachers with autistic pupils. The findings of this review led to the recommendation that the Pervasive Development Disorder Behavior Inventory, Aberrant Behavior Checklist, Autism Treatment Evaluation Checklist and the Teacher Autism Progress Scale are currently the most appropriate assessments for these purposes, although some limitations of these assessments exist. Additional recommendations included teacher input during the development of robust assessments to show progress for autistic children with intellectual disabilities and further evaluation of commonly used assessments with an appropriate sample in a relevant education setting.
Rand, S., Towers, A., Razik, K., Turnpenny, A., Bradshaw, J., Caiels, J. and Smith, N. (2020). Feasibility, factor structure and construct validity of the easy-read Adult Social Care Outcomes Toolkit (ASCOT-ER). Journal of Intellectual and Developmental Disability [Online] 45:119-132. Available at: http://dx.doi.org/10.3109/13668250.2019.1592126.
Background: The ASCOT-ER is an adapted easy-read version of the ASCOT-SCT4, a selfreport measure of social care-related quality of life (SCRQoL) for social care evaluation. In this study, we investigated the instrument’s feasibility, construct validity and factor structure. Method: Data were collected from 264 service users in England. Feasibility was evaluated by missing data and help to complete the questionnaire. Scale dimensionality was assessed using exploratory factor analysis. Construct validity was evaluated by hypothesis testing. Results: Convergent validity was supported by moderate to strong correlations between ASCOT-ER and personal wellbeing and overall quality of life, as well as with individual characteristics. Exploratory factor analysis indicated that the ASCOT-ER is a unidimensional scale. Low missingness indicates that the instrument is feasible; however, most respondents needed some level of support to complete the questionnaire. Conclusion: The study provides preliminary evidence of the ASCOT-ER’s feasibility, unidimensionality and construct validity.
Beadle-Brown, J. and Bradshaw, J. (2019). Commentary on Consumer behaviour analysis and non-adoption of behavioural interventions: implications for managerial action. Tizard Learning Disability Review [Online] 24:108-112. Available at: https://doi.org/10.1108/TLDR-05-2019-0019.
The purpose of this paper is to reflect on the difficulties highlighted by Ntinas around supporting change in services for people with intellectual and developmental disabilities.
This commentary examines what is needed for change and reflects on staff culture.
The authors propose that it is not sensible to separate the culture of a service from the implementation of person-centred approaches and attempt to map how the concepts overlap and are interconnected.
Whilst some elements of culture are clearly important in order to start the process of change, other elements will change as an intervention is introduced and embedded.
Morrison, J., Forrester-Jones, R., Bradshaw, J. and Murphy, G. (2019). Communication and cross-examination in court for children and adults with intellectual disabilities: A systematic review. The International Journal of Evidence & Proof [Online] 23:366-398. Available at: https://doi.org/10.1177/1365712719851134.
Courts in England, Wales and Northern Ireland have identified children and adults with intellectual disabilities (ID) as vulnerable witnesses. The call from the English Court of Appeal is for advocates to adjust questioning during cross-examination according to individual needs. This review systematically examined previous empirical studies with the aim of delineating the particular communication needs of children and adults with ID during cross-examination. Studies utilising experimental methodology similar to examination/cross-examination processes, or which assessed the communication of actual cross-examinations in court were included. A range of communication challenges were highlighted including: suggestibility to leading questions and negative feedback; acquiescence; accuracy; and understanding of court language. In addition, a number of influencing factors were identified, including: age; IQ level; question styles used; recall memory; and delays. This review highlights the need for further research using cross-examination methodology and live practice, that take into consideration the impact on communication of the unique environment and situation of the cross-examination process.
Bradshaw, J., Gore, N. and Darvell, C. (2018). Supporting the direct involvement of students with disabilities in functional assessment through use of Talking Mats®. Tizard Learning Disability Review [Online] 23:111-116. Available at: https://doi.org/10.1108/TLDR-01-2018-0004.
Bowring et al. describe ways of using the Behavior Problems Inventory – Short Form, illustrating how to use clinical norms to evaluate change. This commentary focuses on the importance of considering information gained directly from people with intellectual and developmental disabilities (IDD) during assessment. The paper aims to discuss these issues.
A pilot project involved interviews with four children with IDD. A Talking Mats® (TM) framework was used to gather children’s views regarding challenging behaviours (CBs) and variables relevant to a functional behavioural assessment, such as things they found to be reinforcing, things that set the occasion for CB and things that helped prevent this.
The children were able to provide information and insight into several areas that are influential in the maintenance of behaviour that challenges. Some of this information may not have been obtainable from other sources or informants using traditional assessment methods alone.
Gathering the views of people with IDD is important. The Convention on the Rights of Persons with Disabilities (United Nations, 2009) states that people have the right to be heard. Many people with IDD have difficulties communicating. A TM framework is one method by which people may be able to express their views. Taking the views of the individual into account during the process of gathering information about behaviours that challenge should lead to greater understanding of the functions of any behaviours and therefore to more targeted, acceptable and effective forms of support.
Stewart, K., Bradshaw, J. and Beadle-Brown, J. (2018). Evaluating service users’ experiences using Talking Mats®. Tizard Learning Disability Review [Online] 23:78-86. Available at: https://doi.org/10.1108/TLDR-05-2017-0023.
The purpose of this paper is to establish the effectiveness of Talking Mats® (TM) in evaluating service users’ experiences, and explore their views of the implementation of person-centred active support (PCAS).
This is a mixed-methods study, employing qualitative interviewing and observational measures.
Both qualitative and quantitative measures indicated inconsistent implementation of PCAS. It was possible to effectively gain participants’ views on positive and negative aspects of quality of support and quality of life, using TM, across three themes, My life, My support and Self-determination.
Generalisability of the research may be limited due to the sample, and the potential for researcher and interviewer bias is acknowledged.
TM provides a mechanism that may facilitate the inclusion of the views and experiences of people with intellectual and developmental disability (PWIDD) who have limited verbal skills. Their views need to be reflected in adaptions made to PCAS.
This study included a population who are often left out of qualitative research because of the methodologies adopted. It also included older PWIDD, where there has been less research about the effectiveness of TM.
Bradshaw, J., Beadle-Brown, J., Richardson, L., Whelton, B. and Leigh, J. (2018). Managers’ views of skilled support. Journal of Applied Research in Intellectual Disabilities [Online] 31:873-884. Available at: https://doi.org/10.1111/jar.12444?.
Background: Quality of life of people with intellectual and developmental disabilities has been found to primarily depend on whether staff are providing facilitative and enabling support that helps to compensate for severity of disability. Managers have a key role in facilitating staff to provide such support.
Method: Qualitative interviews were conducted with 35 managers of supported accommodation services to explore service aims and the nature of, and challenges in providing, skilled support. Key themes were identified using a Thematic Networks Analysis.
Results: Service aims were rarely formalised, were related to the individuals supported and not to the organisation. Managers found it difficult to define skilled support, other than by reference to individuals. Practice leadership roles were challenged as a result of austerity measures.
Conclusions: Front?line managers need more information and training in skilled support, with stronger leadership from senior management to provide the motivation and resources needed.
Petri, G., Beadle-Brown, J. and Bradshaw, J. (2017). “More Honoured in the Breach than in the Observance”—Self-Advocacy and Human Rights. Laws [Online] 6:26. Available at: http://dx.doi.org/10.3390/laws6040026.
Background: Since the adoption of the UN Convention on the Rights of Persons with Disabilities (CRPD), human rights have become central for disability advocacy. The CRPD requires that disabled people and their representative organisations (DPOs) have a prominent role in the implementation and monitoring of the Convention. However, the representation of people with intellectual disabilities or autistic people is still often indirect, carried out by parents or professionals.
Methods: This is a qualitative research which looks at how self-advocates (SAs) with intellectual disabilities or autism participate in DPOs and how they see the role of human rights and laws such as the CRPD in their advocacy. Data was collected in the UK and in Hungary between October 2016 and May 2017. A total of 43 advocates (SAs and other advocates) were interviewed. For the analysis, thematic analysis was used.
Results: findings indicate that most participants have limited knowledge of the CRPD and human rights. Human rights are usually seen as vague and distant ideas, less relevant to everyday lives. SAs may not feel competent to talk about the CRPD. The inclusion of SAs in DPOs is mostly tokenistic, lacking real participation.
Conclusions: The CRPD can only bring meaningful change to SAs if they get full membership in DPOs.
Richardson, L., Beadle-Brown, J., Bradshaw, J., Guest, C., Malovic, A. and Himmerich, J. (2016). I felt that I deserved it - experiences and implications of disability hate crime. Tizard Learning Disability Review [Online] 21:80-88. Available at: http://dx.doi.org/10.1108/TLDR-03-2015-0010.
– The purpose of this paper is to summarise key findings and recommendations from the “Living in Fear” research project focusing on the experiences of people with learning disabilities and autism related to disability hate crime and the experience of the police in dealing with such incidents.
– Methods included: first, a postal survey with 255 people with learning disabilities or autism (or their carers for people with more severe disabilities), of whom 24 also took part in semi-structured interviews; and second, an electronic survey of the knowledge and experience of 459 police officers or support staff.
– Just under half of participants had experienced some form of victimisation. The Police reported problems with the definition of disability hate crime and challenges to responding effectively.
– A case study from the research highlights some of the key findings and is linked to implications for people with learning disabilities and autism, carers, police and other agencies.
– Previous research has highlighted that victimisation is an issue for this group of people, but has never explored the prevalence and nature of such experiences in a representative sample. Neither has previous research brought together the perspectives of so many different agencies to offer recommendations that go across many sectors. The paper will be of interest to people with disabilities and their carers, professionals in health, social care and the Criminal Justice system.
McGill, P. and Bradshaw, J. (2015). Editorial. Tizard Learning Disability Review [Online] 21:1-1. Available at: http://dx.doi.org/10.1108/TLDR-10-2015-0041.
Beadle-Brown, J., Leigh, J., Whelton, B., Richardson, L., Beecham, J., Bäumker, T. and Bradshaw, J. (2015). Quality of life and quality of support for people with severe intellectual disability and complex needs. Journal of Applied Research in Intellectual Disabilities [Online] online:0-0. Available at: http://dx.doi.org/10.1111/jar.12200.
Background: People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life.
Methods: Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110 people with severe and profound disabilities and complex needs.
Results: On average, people spent approximately 40% of their time engaged in meaningful activities, received contact from staff 25% of the time (6% in the form of assistance to be engaged). Just over one-third received consistently good active support, which was associated with other measures of quality of support and emerged as the strongest predictor of outcomes.
Conclusions: Quality of life and quality of support were relatively poor, although with about one-third of people receiving skilled support. Consistently good active support was the best predictor of outcome and proposed as a good indicator of skilled support.
Bradshaw, J. and McGill, P. (2015). Commentary on "Why study the history of learning disability?". Tizard Learning Disability Review [Online] 20:11-14. Available at: http://dx.doi.org/10.1108/TLDR-10-2014-0035.
– The purpose of this paper is to introduce practitioners and practice-based academics to the relevance of historical study to learning disability research.
– States need to balance conceptual history against that of learning disabled individuals; reviews existing literature; offers guidelines for prospective historians; gives sample of findings from author's work elsewhere; draws conclusions.
– Research which is conceptually based and goes back before the rise of the long-stay institutions reveals the historical contingency of learning disability not only as a concept but as a supposed “natural kind”, and exposes the more durable historical permanence of the phobia that creates “extreme outgroups”.
– Of the very small amount of historical scholarship that engages with conceptual history before the modern era, none of it till now has sought to enquire about the relevance of its findings to current practice.
Bradshaw, J. (2014). Commentary on ’Evaluation of the impact of supervisory support on staff experiences of training’. Tizard Learning Disability Review [Online] 19:85-89. Available at: http://dx.doi.org/10.1108/TLDR-01-2014-0002.
– The purpose of this paper is to reflect on the findings from Koski et al.'s (2014) research around training staff to communicate effectively.
– This commentary reflects on the needs of people with profound intellectual and multiple disabilities (PIMD). It uses the Five Good Communication Standards (Royal College of Speech and Language Therapists, 2013) as a framework for thinking about good communication.
– Ongoing support is certainly important in enabling staff to develop and maintain good communication partnerships with the people they are working with. This first requires agreement from all involved regarding what good communication partnerships look like and how they can be measured.
– This paper focuses on the Five Good Communication Standards and how these might be interpreted with people with PIMD. It uses information from Goldbart and Caton's (2010) review of communication and people with the most complex needs to reflect on what is known from research and practice about each of these five standards. It concludes that more research is needed and greater implementation is needed where evidence is strong. We need to know what “good” could look like with people with PIMD so services support staff can then be facilitated to build successful communication partnerships and maintain these over time.
Bradshaw, J. (2014). Music, Language and Autism. Tizard Disability Learning Review [Online] 19:154-155. Available at: http://dx.doi.org/10.1108/TLDR-09-2013-0042.
Bradshaw, J. (2014). Clear communication is the key. Challenge [Online]:1-1. Available at: http://www.challengingbehaviour.org.uk/learning-disability-files/CBF-Challenge-Winter-2014-Final-Web.pdf.
Bradshaw, J. and Goldbart, J. (2013). Staff Views of the Importance of Relationships for Knowledge Development: Is Training by Specialists a Waste of Money?. Journal of Applied Research in Intellectual Disabilities [Online] 26:284-298. Available at: http://dx.doi.org/10.1111/jar.12020.
The provision of skilled support is dependent on staff knowledge and understanding (Beadle-Brown J., Beecham J., Mansell J., Baumker T., Leigh J., Whelton R. & Richardson L, unpublished data). Influencing staff knowledge and understanding is an important component of interventions.
Materials and Methods:
Fourteen individual semi-structured interviews elicited staff views and experiences of knowledge development. These were analysed using a thematic network analysis (Attride-Stirling 2001, Qualitative Research 1, 385–405).
Three global themes were identified; skills are developed from experience, service aims influence service delivery and practice is more important than theory. This article focuses on the first of these themes. Relationships between staff and service users played a central role in enabling development of knowledge. Although some skills were seen as transferrable, experience of a particular service user was described as being essential.
Support staff may not see the relevance of research findings, professional knowledge or training, unless these have involved direct work with the service user in question.
Bradshaw, J. (2013). The use of augmentative and alternative communication apps for the iPad, iPod and iPhone: an overview of recent developments. Tizard Learning Disability Review [Online] 18:31-37. Available at: http://dx.doi.org/10.1108/13595471311295996.
Purpose – The purpose of this paper is to provide an overview of the communication applications (apps) that can be used with devices such as the iPad, iPod and iPhone to support augmentative and alternative communication (AAC).
Design/methodology/approach – A brief discussion of the research into the use of high-technology communication aids is followed by an introduction to the iPad, iPod and iPhone AAC apps.
Findings – These devices and apps clearly have a role within the spectrum of AAC devices currently available. They may have some distinct advantages in cost, ease of use and acceptability but more research into their use is needed.
Originality/value – This article starts with a model of communicative competence and presents some recent research into barriers in the use of high-technology AAC. It suggests some ways in which AAC apps may address some of the barriers to implementation and functional use. Finally, the need for individual assessment to determine specific communication needs is stressed. These devices and apps may not always be the best solution for people with complex communication needs.
Bradshaw, J. (2013). Commentary on “Communication is the key: improving outcomes for people with learning disabilities.” Tizard Learning Disability Review [Online] 18:141-145. Available at: http://dx.doi.org/10.1108/TLDR-03-2013-0027.
Purpose – The purpose of this article is to provide a commentary on Lewer and Harding's article about the use of “the open communication tool”(OCT).
Design/methodology/approach – This article reviews the OCT as a method of both developing shared goals and understandings and identifying implementation issues.
Findings – The OCT can provide a useful model when working in services. It might be enhanced by also including ways of systematically addressing the views of the person with a learning disability and their family members.
Originality/value – Indirect interventions delivered in the way described may be problematic in that some research suggests that staff teams place greater value on knowledge that is directly gained by experience of working with the person. This raises questions relating to the model within which clinical services are often delivered to supported housing settings and whether this needs to change
Bradshaw, J., Beadle-Brown, J., Beecham, J., Mansell, J., Bäumker, T., Leigh, J., Whelton, B. and Richardson, L. (2013). Quality of communication support for people with severe or profound intellectual disability and complex needs. Communication Matters 27:24-26.
This paper describes the differences in communication strategies between good and poor services for people with severe or profound intellectual disability and complex needs.
As part of a wider research project into skilled support (Beadle-Brown et al, in submission), information about communication was collected using a range of measures. This included observations of alternative and augmentative communication, reviews of written information, and interviews with managers.
Most staff did not use appropriate and effective ways of communicating with people they supported. Despite staff rating 60% of people they supported as non-verbal, less than 20% of observed staff communication involved the use of AAC. A third of people were being supported in a team where communication was rated as good and appropriate most/all of the time. Services providing good support in terms of providing choice, assistance and higher levels of activity were also better at communicating with people.
Communication partnerships were significantly better in services which are providing skilled support in other areas. Person-Centred Active Support is one way in which staff can acquire these skills. This type of intervention, which aims to give staff the core skills necessary, may be necessary to ensure the success of communication interventions.
Bradshaw, J. (2012). Commentary on “The People in Control Conference at City University, London: ‘We have opinions to share about our lives’. Tizard Learning Disability Review [Online] 17:177-183. Available at: http://dx.doi.org/10.1108/13595471211272523.
Purpose – The purpose of this article is to provide a commentary on Harding et al.'s article about the involvement of people with learning disabilities in university teaching and conference presentations.
Design/methodology/approach – The article reviews research into communication strengths and needs and into communication partnerships between service users and members of staff with a view to identifying communication barriers to the involvement of people with learning disabilities.
Findings – The generally poor communication environments in which people are supported are likely to limit opportunities for involvement.
Originality/value – It is suggested that increased involvement is likely to result from increased quality of daily communication. This may best occur as part of general service-wide approaches to improving service quality, such as person-centred active support.
McGill, P., Bradshaw, J. and Hughes, A. (2007). Impact of extended education/training in positive behaviour support on staff knowledge, causal attributions and emotional responses. Journal of Applied Research in Intellectual Disabilities [Online] 20:41-51. Available at: http://dx.doi.org/10.1111/j.1468-3148.2006.00338.x.
Background: This study sought to gather information about the impact of extended training in positive behaviour support on staff knowledge, causal attributions and emotional responses.
Methods: Students completed questionnaires at the beginning, middle and end of a University Diploma course to measure changes in their knowledge of challenging behaviour, their causal attributions and their emotional responses.
Results: Students' knowledge significantly increased across the three data points. Students became less likely to attribute challenging behaviour to emotional causes. Changes in respect of making more behavioural attributions varied across different measures. Negative emotional responses reduced especially those related to depression/anger.
Conclusions: The training course presented here was associated with changes in student knowledge, attributions and emotional responses that are likely to be associated with better staff performance and better outcomes for people with intellectual disabilities.
Bradshaw, J., McGill, P., Stretton, R., Kelly-Pike, A., Moores, J., Macdonald, S., Eastop, Z. and Marks, B. (2004). Implementation and evaluation of active support. Journal of Applied Research in Intellectual Disabilities [Online] 17:139-148. Available at: http://dx.doi.org/10.1111/j.1468-3148.2004.00190.x.
Objectives: Active support was implemented in three community houses (active support houses), with 11 service users with severe learning disabilities.
Methods: This was evaluated with reference to changes in levels of engagement, challenging behaviour (major and minor) and staff contact, measured against three comparison services (non-active support houses).
Results: All measures increased for the active support houses. Significant increases in activity levels were found in one house. Statistically significant increases in activity and minor challenging behaviour were also found when all active support houses were compared with all non-active support houses. In the non-active support houses, all measures decreased, with the exception of mean level of staff contact in one house.
Conclusions: Unlike previous research findings, those service users who were less able did not receive comparatively more support from staff post-training and changes appeared unrelated to staff contact.
Bradshaw, J. and Carnaby, S. (2002). Talking normalization: the role of communication in integration. Journal of Community & Applied Social Psychology [Online] 12:298-302. Available at: http://dx.doi.org/10.1002/casp.680.
Deinstitutionalization has generally had a positive impact on the lives of people with learning disabilities, although provision of appropriate and individualized support in the community has proved difficult. Communication is often seen in isolation, its role within integration passing unacknowledged. This paper suggests an integrated framework around individual needs.
Bradshaw, J. (2001). Complexity of staff communication and reported level of understanding skills in adults with intellectual disability. Journal of Intellectual Disability Research [Online] 45:233-243. Available at: http://dx.doi.org/10.1046/j.1365-2788.2001.00318.x.
Staff reports of the communication acts taking place with 22 adults with intellectual disability were compared with video observations of the communication acts used by staff with 12 of these service users. The interactions were coded in terms of the form of communication used, the function of the act and the level of complexity. The results show that staff tend to underestimate their own use of verbal communication and overestimate their use of non-verbal communication. The findings also indicate a mismatch between the reported level of understanding of the service user and the level of complexity of the language used. Staff appeared unable to adapt their communication to the skills of the service user and an average of 45% of communicative acts were outside the reported understanding skills of the individual. The implications of these findings are discussed and possible explanations for staff behaviour are suggested.
Bradshaw, J. (2001). Improving services quality through linked services development. Tizard Disability Learning Review [Online] 6:12-18. Available at: http://dx.doi.org/10.1108/13595474200100034.
The University Affiliated Programme (UAP) aims to improve service quality by working in partnership with local services. This article Reports on the establishment and development of linked services: three services for people with learning disabilities, living in small community houses that opened in late 1999 and early 2000. The focus of resources on a small number of linked services was designed to maximise the effectiveness of the involvement of the Tizard Centre, along with the Subscriber Network. It was intended that work in the linked services would be disseminated through this network. The UAP has worked with service users and providers since 1996, during which time users have moved from a long-stay NHS hospital to community services. The service provider is also now a private organisation. The article outlines some of the projects which have been introduced or developed in these linked services and discusses some of the issues that have arisen while working in partnership with them. The benefits of working through a UAP will also be identified.
Bradshaw, J. (2001). Communication partnerships with people with profound and multiple learning disabilities. Tizard Learning Disability Review [Online] 6:6-15. Available at: http://dx.doi.org/10.1108/13595474200100012.
There are many definitions of profound and multiple learning disabilities. Most definitions include having a high degree of learning disability in conjunction with at least one other severe impairment, such as visual, auditory or physical impairments (Male, 1996; Ware, 1996; Lacey, 1998). Bunning (1997) adds that people with such disabilities are very reliant on others for support, including support in taking part in communicative events. Establishing reliable and consistent methods of communication may be exceptionally difficult (Florian et al, 2000). However, it is important to consider the individuality and extreme diversity of this population (Detheridge, 1997; Hogg, 1998), which includes variability in communication strengths and needs (Granlund & Olsson, 1999; McLean et al, 1996). Communication is often given little attention when services are planning ways of supporting individuals to participate, develop independence and make choices (McGill et al, 2000). While the individual's communication strengths and needs should remain central within any discussion, the significant others and the environment will also have an important influence. This article explores some of the communication issues experienced by people with profound and multiple learning disabilities and highlights the importance of the communication partnership within interventions
Bradshaw, J. (2000). A Total Communication Approach Towards Meeting the Communication Needs of People with Learning Disabilities. Tizard Learning Disability Review [Online] 5:27-30. Available at: http://dx.doi.org/10.1108/13595474200000005.
Bradshaw, J. (1998). Assessing and intervening in the communication environment. British Journal of Learning Disabilities [Online] 26:62-66. Available at: http://dx.doi.org/10.1111/j.1468-3156.1998.tb00050.x.
An approach to implementing a total communication environment with a man who has severe learning disabilities, a profound hearing loss and challenging behaviour is described. This involved teaching the staff team visual modes of communication and supporting staff to use these methods. The intervention was evaluated by conducting observations of the communication acts taking place prior to and one year after the intervention.
Improvements were found in the amount of communication acts which were accompanied by signs and the range of communication functions employed. Changes were also reported in the communication skills set of the person with learning disabilities. Staff's perception altered from seeing him as someone who was challenging, to someone who was challenged by his hearing loss and communication difficulties.
Oven, R., Batchelor, S., Ashworth, D., Gelder, D. and Bradshaw, J. (1995). Iterative Refinement Technique for Reconstructing Refractive-Index Profiles from Mode Indexes. Electronics Letters [Online] 31:229-231. Available at: http://dx.doi.org/10.1049/el:19950156.
A method is presented whereby the refractive index profile of a planar, surface, dielectric optical waveguide may be reconstructed from a measured set of effective refractive indices in a way that is consistent with the Helmholtz equation. Profiles are compared with those obtained by conventional techniques which use the Wentzel-Kramers-Brillouin (WKB) approximation.