Making reasonable adjustments

Tizard Learning Disability Review

ISSN: 1359-5474

Article publication date: 11 January 2013



McGill, P. (2013), "Making reasonable adjustments", Tizard Learning Disability Review, Vol. 18 No. 1.



Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited

Making reasonable adjustments

Article Type: Editorial From: Tizard Learning Disability Review, Volume 18, Issue 1

Many of the articles in the current issue draw attention to the question of how we make “reasonable adjustments” in a range of settings to enable greater inclusion and more positive outcomes for people with learning disabilities. Warren Oldreive and Mary Waight (and Jan Walmsley in her commentary) discuss how information can be presented in a more accessible form. It is common practice now to find “accessible” versions of policy and other documents. Yet it is clear from these articles that giving a document an “accessible” label does not necessarily mean it is genuinely accessible to the majority of people with learning disabilities. Different people will have different requirements when it comes to accessing information and Oldreive and Waight present a strong case for taking a much more individual approach to these issues in which the mode of presentation of important information matches the individual’s physical and intellectual capacities. Of course, policy (and similar) documents cannot be issued in the multiple formats that might be required. But, where access to specific information is very important to an individual, Oldreive and Waight’s article shows how this can be done.

The latest Trends article from the Learning Disability Public Health Observatory focuses on the provision of annual health checks in England. While the data on increasing provision over the last four years are encouraging, there remains huge variation across the country and it looks as though the rate of increase is slowing. It remains something of a scandal that, in the light of the continuing evidence of poor quality healthcare and across-the-board poorer health outcomes, it is taking so long to achieve what the authors describe as “probably the most important reasonable adjustment” in the provision of primary health care to adults with learning disabilities.

In one sense, making reasonable adjustments in the realms of information provision and healthcare is likely to be relatively easier than in the broader, and more social, realms of communication and relationships. Jill Bradshaw’s article reviews the increasing usage of devices such as the iPad to support alternative and augmentative communication. While noting a number of concerns and limitations, the article also points out the potentially great value of using “cool”, highly valued and socially acceptable approaches with people with learning disabilities. Communication is, of course, a two way thing and creating a context in which one person’s “reasonable adaptation” promotes rather than discourages communication from others may well be extremely useful.

Communication is the basis of social relationships. Stacey and Edwards’ article on loneliness illustrates how the relationships of adults with learning disabilities may be impoverished, resulting in loneliness and a range of other negative outcomes. We have made great strides in the UK and many other countries in supporting people with learning disabilities to live better lives in community settings. Yet, very many research studies of community living over the past 30 years have noted the difficulty of promoting true social inclusion. Karl Nunkoosing’s use of the social model of disability in his commentary should lead us to ask how we can make “reasonable adjustments” that promote social integration and inclusion. It seems likely that these will require not just changes in bureaucratic procedures (as in the establishment of health checks) but changes in our own behaviour. This must be one of the most significant challenges facing us, both because of its difficulty and its importance – is there anything more important than “belonging”?

Call for submissions – country profiles

Currently, most of the articles published in TLDR are written by UK based authors and focus on service development and research in the UK. As a result the journal is particularly relevant to readers in the UK and in other countries whose service systems are similar. In a sense this is the journal’s “niche” and we have no plans to change it. TLDR does, however, have growing international usage and there is increasing scope to learn from and draw inspiration from diversity. The Editorial Board, therefore, wishes to encourage the publication in TLDR of an increasing number of articles emanating from outside of the UK.

Initially, we seek submissions for an occasional “country profile” section of the journal. Articles of approximately 4,000 words are sought which profile the lives of people with learning disabilities (or sub groups) in a country outside of the UK. We are happy to consider a variety of contributions which meet this overall objective but articles might be structured along the following lines:

  • Brief introduction to the country emphasising particular aspects (historical, geographical, political, religious, etc.) which have an impact on the lives of people with learning disabilities (intellectual and developmental disabilities).

  • History of attitudes towards/services provided for people with learning disabilities.

  • Current patterns of living/service provision.

  • Critical and comparative appraisal of the current position of people with learning disabilities.

  • Future challenges and opportunities.

Articles will be reviewed in the normal way and commentaries sought. The editor would be happy to discuss ideas at an early stage and can be contacted by

Submissions to TLDR are now made using ScholarOne Manuscripts, the online submission and peer review system. Registration and access is available at: Please visit the journal web site for further details and author guidelines –

Peter McGillTizard Centre, University of Kent, Kent, UK

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