Search results

Based on a literature and practice review, the purpose of this paper is to examine the theoretical and clinical basis for using wordless books with patients who have intellectual disabilities (ID) and/or autism.

A literature review identified seminal peer-reviewed English language articles relating to the neuroscience of information and emotion processing for adults with ID and/or autism. In addition to published examples, illustrative case examples were contributed by clinicians regularly using wordless books.

Many people, including those with ID, selectively attend to visual information. Minimising the cognitive load by using wordless pictorial narrative reduces anxiety, and empowers the patient. Clinicians using such resources describe positive clinical outcomes. Only the Beyond Words wordless books have been identified in published clinical trials.

Although existing evidence suggests a strong positive impact, further research into the use of wordless books for people with ID is needed.

Wordless books are reported to help develop staff skills and empathy for supporting adults with ID. The books facilitate some legally required reasonable adjustments to increase service access. Staff training is needed for effective use of wordless books.

Wordless books specifically designed with and for adults with word processing difficulties, ID and/or autism to enhance health literacy and explore their own narratives and emotional responses around health experiences and personal traumas are a unique approach. This paper may also offer the first exploration of their neuropsychological underpinnings.

The purpose of this paper is to introduce the social and scientific rationale for book clubs, whose members read wordless books together, and give examples of storytelling with picture books in libraries and other community settings for people with intellectual disabilities and autism.

The authors consider the impact of book clubs reading picture books without words, alongside an understanding of the underlying neuroscience (see Table I for search strategy). The authors compare differences in the neuroscience of information and emotion processing between pictures and words. Accounts from book club facilitators illustrate these differences in practice.

Many readers who struggle with reading and comprehending words, find pictures much easier to understand. Book clubs support community inclusion, as for other people in society. A focus on visual rather than word literacy encourages successful shared reading.

No research has been published about the feasibility and effectiveness of wordless books in community book clubs or shared reading groups. There is very little research on the impact of accessible materials, despite a legal requirement for services to provide reasonable adjustments and the investment of time and resources in developing storylines in pictures, or “translating” information into easy read formats.

Book clubs whose members read picture books without words are growing in number, especially in public libraries in the UK. Expansion is dependent on funding to pay for training for librarians and volunteer facilitators.

There is a shortage of fully accessible activities for adults with intellectual disabilities in mainstream community settings with a primarily social purpose.

To the authors’ knowledge, this is the first paper describing the theory and impact of wordless book clubs for people who find pictures easier to understand than words.

Historically, professionals did not consider that people with learning disabilities could make use of psychoanalytic psychotherapy because of limitations of intelligence (Symington, 1981; Symington, 1993; Sternlicht, 1965). Additionally, many believed that people with learning disabilities enjoyed immunity from emotional stress and psychiatric disturbances (Fletcher, 1993). Maladaptive behaviours were perceived as a manifestation of the condition of learning disability and not as a possible sign of psychiatric disorder or emotional problems. However, over the last decade there has been a growing realisation that people with learning disabilities have emotional problems in the same way as others, but are in some ways more vulnerable to developing psychiatric and psychological disturbances. Psychoanalytic practitioners wishing to undertake outcome research have experienced difficulties in finding a measuring device that understands the subtleties of change in the internal psychological structure over time. PORT and DMT (the Percept‐genetic Object Relation Test and the Defence Mechanism Test) are two projective tests that have been extensively validated in Sweden. This paper explores the use of the PORT and DMT outcome measures in the context of Anglo‐Swedish psychotherapy research.

This paper explores access to palliative care services by people with learning disabilities. It is based on a study of specialist palliative care professionals in London, involving 32 semi‐structured interviews and 543 postal questionnaires. We focus on one aspect of the findings, related to the current use of specialist palliative care services by people with learning disabilities. The results indicate that such services are under‐used by this group. We discuss possible reasons for low referral rates, including late diagnosis and lack of understanding among both learning disability services and palliative care services about each other's roles. We highlight the importance of collaboration, and the need for further staff training.

Individual psychodynamic psychotherapy for people with learning disabilities has been more available since the 1980s, with numerous case studies and reports of effectiveness, yet little is know about the history of psychodynamic psychotherapy. This paper is a historical account of the international development of psychodynamic psychotherapy for people with learning disabilities. It discusses some of the clinicians' case reports, views and conclusions. It is important that, as therapists, we continue to learn and develop. This is a story of ‘opportunities lost’. Although a number of therapists were well‐placed to develop psychotherapy as a valuable treatment option, it did not happen. The paper discusses the reasons, ranging from widespread therapeutic pessimism to inability in the therapist to process the ‘disability transference’. It outlines the various British contributions before and since the ground‐breaking and well‐known work of Valerie Sinason, whose 1992 book is still the most influential contribution. Psychodynamic psychotherapy has developed more of a tradition than other therapy approaches in this field, but there is still only sparse literature on and recognition of this work.

After a varied and confused period from the days of Freud to the 1980s, psychotherapy for people with disabilities began to be recognised as having value. Several strands of development occurred at the same time and came together in the early 1980s. These strands will be discussed, the way they came together and what has happened since.