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The purpose of this paper is to present an evaluation of a programme of training and support provided to staff, which aimed to encourage supported communication environments for people with learning disabilities.

Training, monitoring and support for communication, specifically augmentative and alternative communication (AAC) strategies, was provided by speech and language therapy staff to two residential services over 46 weeks. Staff and service user communications were observed pre- and post-intervention.

In one provision there was an increase in service user initiations and the use of some AAC strategies by support staff. In the other provision there was no change in service user initiations and a decrease in the range of AAC strategies used. It appears that some forms for AAC remain challenging for staff to implement.

This evaluation explores ways of using specialist support services to improve communication environments for people with learning difficulties. Possible reasons for differences in the outcome of the intervention are discussed. Future research into the types of communication interactions experienced by people with learning disabilities across the range of communication styles may be useful so that support staff can be better helped to provide sustained and enriched communication environments.

The purpose of this paper is to provide some thoughts following on from reading “Evaluating service users’ experiences of using Talking Mats®”.

This commentary outlines some considerations for the continued discussions about how to engage people who have profound and multiple learning disabilities.

The literature is not clear on the involvement of people with more profound and multiple learning disabilities, or for those who do not use much spoken language. Some papers have explored the notions of involvement and interpretation of pre-intentional communicators’ desires and interests.

There needs to be a robust discussion across carer, academic and service user communities to consider what the communication rights and needs are for people who have profound and multiple disabilities.

The purpose of this paper is to provide a commentary on Alix Lewer's and Celia Harding's research on the factors influencing the success of speech and language therapy intervention in residential homes and day centres for people with learning disabilities.

The article reflects on the issues raised by Lewer and Harding, in the light of the literature on implementation and the author's own research on the implementation of behaviour support plans.

Similar barriers underlie problems of implementation of programmes related to communication and behaviour support.

Professionals need to improve their understanding of implementation problems and ensure that their role includes providing support to frontline staff to initiate and maintain changed practices.

The purpose of this paper is to provide some thoughts following on from reading: “Experiential learning: changing student attitudes towards learning disability”.

This commentary outlines some considerations for the continued development of using service users in tertiary education as educators.

The literature is not clear on the involvement of people with more profound and multiple learning disabilities, or for those who do not use much spoken language in tertiary level teaching.

A further cultural shift is needed to ensure that all people with learning disabilities regardless of their communication style have the opportunity to share their experiences within a teaching and learning context.

This paper aims to introduce the open communication tool (OCT) as described in “From ‘What do you do?’ to ‘a leap of faith’: developing more efficient indirect intervention for adults with learning disabilities”.

Qualitative data from a study identifying barriers to effective intervention was used to create a model of working practice.

This paper introduces a model of addressing intervention which could be used by the broader multidisciplinary team to increase successful intervention outcomes and pinpoint concerns about care providers who do not enhance communication effectively.

The authors suggest that a more consistent and robust approach to delivering indirect intervention could be used to bridge communication gaps between healthcare providers and commissioners/monitoring bodies of services for people with learning disabilities.

This review explores some of the key issues relevant to children and adults who have dysphagia, or eating, drinking and swallowing difficulties, and a learning disability. It explores the methods for attempting to identify this area of difficulty effectively, and reflects on some of the other issues that may affect management, such as carer support and training and use of appropriate communication strategies to support and enable participation from the client with learning disability.

The purpose of this paper is to consider the benefits of service users contributing to university teaching and having opportunities to present at a conference, both for student learning and clinical development objectives as well as for the service users themselves.

With reference to current policies and good practice guidelines, the article reflects on the experiences of both the students and the service users in relation to the literature and the events that led to the People in Control Conference.

Students valued the experience in terms of developing knowledge and insight into different techniques to facilitate both receptive and expressive communication. Students also had opportunities to think about their own perceptions of disability. Service users have gained in communication confidence and competence as well as getting opportunities to have their voices heard.

Increased opportunities for service users have cultural and clinical benefits for all involved.

For infants and children who have difficulties with eating, drinking and swallowing (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the instrumental method of assessment used to exclude or confirm aspiration. The purpose of this paper is to investigate parental and referrer perceptions of the reasons for and the outcomes of videofluoroscopy.

Data were gathered through the use of structured telephone interviews before and after videofluoroscopy.

Four key themes emerged: first, the importance of identifying specifically the problems with swallowing; second, understanding the rationale for videofluoroscopy; third, preparing a child for videofluoroscopy; and fourth, using videofluoroscopy to inform management. Referrers used videofluoroscopy to confirm their concerns about a child’s ability to swallow safely.

Parents understood that the purpose of videofluoroscopy was to identify specific swallowing difficulties. They reported anxieties with managing the child’s positioning during the procedure and whether the child would eat. They also had concerns about outcomes from the study. Some of these issues raise questions about the true value and benefits of videofluoroscopy.

This is the first study that considers parent views of an instrumental assessment. For some parents of children with learning disabilities, mealtimes are an important social occasion. Further studies that focus on decision making about children with learning disabilities who find feeding difficult are warranted as parents feel loss and disempowerment when decisions are made about non-oral feeding.

The purpose of this paper is to analyse some of the factors which affect the implementation and outcomes of indirect intervention for people with learning disabilities in residential homes and day centres.

Data were gathered through a series of semi‐structured interviews which were transcribed and analysed according to the principles of grounded theory. In total, four carers/support workers and three speech and language therapists (SLTs) were interviewed.

Analysis of the data indicated distinct areas where intervention breakdown could occur, some of which were within the SLTs' control and some of which were not.

This paper builds on previous research to identify barriers to successful therapy outcomes and develops a way of looking at these barriers which can inform intervention planning and delivery.