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Transcript of EDITORIAL
EDITORIAL
Dorothy Atkinson and Jan Walmsley
The ®ve papers in this edition are linked by a common
thread. They re¯ect the universal human need to interact
and engage with others ± they testify in their separate and
diverse ways to the importance of communication for emo-
tional, psychological and social well-being. Communication
is central to our lives as social beings. It is how we
exchange ideas, share knowledge, pass on information, give
advice and a thousand-and-one other day-to-day interac-
tions but, at a more fundamental level, it is how we make
our wishes and needs known, and it is how we reach out to
and make contact with others
But communication for people with learning disabilities
may be problematic. For all sorts of reasons it can be dif®-
cult for people with learning dif®culties to reach out in this
way and make contact. This edition of the journal is in two
parts. The ®rst three papers look at interventions in peo-
ple's lives to facilitate and support communication, and
thus to improve the overall quality of their lives. The last
two papers look at how to enhance communication so that
people with learning disabilities have the means to make
their wishes and needs known to others.
The ®rst three papers, then, look at what happens when
there are barriers to communication. The authors identify
situations where people's wishes and needs cannot be
expressed in ways readily understood by others but,
instead, ®nd distorted expression in, for example, violent
incidents or other manifestations of challenging behaviour,
or in depression, or in potentially self-mutilating and dan-
gerous sexual practices. What interventions have proved
bene®cial to the people concerned? What lessons can others
learn from these results?
The ®rst paper, by George Rowland and Simon Treece,
on `Violent incidents', looks at the role communication ± or
lack of it ± played in the lives of four men with severe
learning disabilities, and `severely challenging behaviour'.
The authors' retrospective evaluation of the purpose-built
specialist unit where the men were placed on their dis-
charge from a long-stay hospital, found that the emphasis
there was on promoting communication, in its widest possi-
ble sense. This had the effect, over a six-year period, of
reducing the number of violent incidents and the need
therefore for reliance on antipsychotic medication to control
them.
The second paper, by Karen Long, Harry Wood and Nan
Holmes, looks at assessing and treating depression in a
young woman, Ms X, `with learning disability and autism'.
Ms X, aged 19, had `extremely limited communication
skills' that prevented her from expressing her wishes and
needs effectively and that found expression instead in chal-
lenging behaviour. The picture was further complicated by
an underlying depression that was dif®cult to detect but,
once diagnosed, could be treated not only by medication
but by enhanced opportunities to develop activities, net-
works and family contacts. At the heart of this programme
was the detailed and personalised work of the speech and
language therapist in working with Ms X on developing her
means of effective communication with others.
The third paper, by Alison Williams, Linda Phillips, and
Zed Ahmed, focuses on their work with Joe, aged 20, who
had a history of engaging in auto-erotic practices. They
reduced his sexual behaviour through `environmental stra-
tegies'. This entailed strict monitoring and control of Joe's
sexual behaviour whilst at the same time a male support
worker worked with him to develop his social life and
activities, and to extend his relationships.
The last two papers in this edition focus on how commu-
nication can be improved or enhanced. One way is to look
at how people with learning disabilities in a local area actu-
ally use words and phrases, what vocabulary they draw on,
and which topics of conversation they cover, in order to
extend the range and quality of their communication with
others. This is what Judy Graves set out to do, and in her
paper on `Vocabulary needs' she describes how she
involved staff and service users in local residential and day
settings in holding conversations, and recording in diaries
the main topics covered. She found that the major talking
points were interests, leisure, day activities, food and drink.
Very few conversations were about feelings.
Emotional needs can ®nd expression, but perhaps they
require a vocabulary which allows or encourages them to
be expressed. The work of Isabel Hernadez-Halton and her
colleagues at the Tavistock Clinic in London, reported in
their paper `A psychotherapy service', demonstrates with
examples that people with learning disabilities can be sup-
ported in learning to convey their feelings and thoughts in
order to understand them better.
= 2000 British Institute of Learning Disabilities, British Journal of Learning Disabilities, 28, 89 89