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This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow assessment, providing information on the demographic characteristics, referral trends, co-occurring health conditions and reasons for referrals highlighting the complex health-care needs of this population.

This study used a standardised patient data extraction method over a six-month period involving 74 adults with ID referred to speech and language therapy for swallow assessment.

This study revealed a high prevalence of dysphagia among adults with ID referred to speech and language therapy for swallow assessment. Increasing age and severity of ID were associated with an increased likelihood of swallowing difficulties. Co-occurring health conditions such as mobility difficulties, epilepsy and gastrointestinal conditions were prevalent, suggesting that adults with ID and swallowing difficulties are often living with complex health conditions. Choking incidents and hospital admissions were primary reasons for referral.

This study stresses the pressing need for strategies to mitigate risks associated with choking incidents and hospital admission among this vulnerable population. Possible limitations include a reliance on referral and the focus being on a single service over a short period which may limit generalisation to the wider ID population.

This study emphasises the need to understand each person’s unique profile of health needs and the value of a specialised speech and language therapy service.

The importance of increasing awareness among caregivers and medical experts is highlighted.

The findings underscore the importance of tailored assessment, caregiver involvement and heightened interdisciplinary awareness to effectively manage dysphagia in individuals with ID.

With the growing need for employees to be innovative, public-sector organizations are investing in employee training. This study aims to examine the effects of a combined Lean Six Sigma and innovation training, using action learning, on public-sector employees’ creative role identity and innovative work behavior.

The authors studied a public service agency in Singapore in which a five-day Lean Innovation Training was implemented, using a combination of Lean Six Sigma and Creative Problem-Solving tools, with a simulation on day one and subsequent team-based project coaching, spread over six months. The authors administered pre- and postintervention surveys among all the employees, and initiated group interviews and observations before, during and after the intervention.

Creative role identity and innovative work behavior had significantly improved six months after the intervention, enabled through senior management’s transformational leadership. The training induced managers to role-model innovative work behaviors while cocreating, with their employees, a renewal of their agency’s core processes. The three completed improvement projects contributed to an innovative work culture and reduced service turnaround time.

Starting with a role-playing simulation on the first day, during which leaders and followers swapped roles, the action-learning type training taught all the organizational members to use various Lean Six Sigma and Creative Problem-Solving tools. This nimble Lean Innovation Training, and subsequent team-based project coaching, exemplifies how advancing the staff’s creative role identity can have a positive impact.