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This piece is dedicated to a remarkable individual I had the privilege of treating for approximately two weeks. 'S' - a young man in his early twenties, from a small village in Assam, India - arrived at our department in a wheelchair, due to the sequelae of a non-traumatic spinal cord injury (SCI). Despite his physical challenges, S displayed an exceptional level of positivity and resilience... S was an aspiring fashion designer, who moved to Delhi to follow his passion. The lack of funds for his higher education forced him to look for a part-time occupation, which led him to take a keen interest in the make-up and beauty industry. Soon, S realised that he had a talent for using knowledge of colour theory in applying make-up and started gathering a small clientele for himself. Tragedy struck with the advent of COVID-19 and, along with many others, S was also a victim of its atrocities. Within time, he was rendered paraplegic, requiring full use of a wheelchair and with 'no possibility of going back to work again'. Clinically, S presented with impairments in: trunk control upper limb strength functional skills wheelchair mobility Recognising his aspirations and potential for rehabilitation, I immediately initiated a comprehensive treatment plan, tailored to address these areas of concern. Our first target was to establish good trunk control and dynamic sitting balance, by engaging him in activities that challenged him in these areas. For example, overhead ball throwing and graded stooping in a high-seated position. Once that was established, we worked on improving upper limb strength and endurance, as it was essential for wheelchair mobility and transfers. Push-ups were a great option and his performance was evaluated based on clearance, endurance and level of assistance provided. Perfecting a static push-up was essential for relieving pressure during long sitting hours, to prevent pressure ulcers. Dynamic push-ups were necessary for independent transfers, from bed to wheelchair and vice-versa. During our therapy sessions, one of the main issues to address was how his current functional status affected his work, to a point of resigning as a make-up artist (MUA). He educated me on all the postural and technical difficulties a male MUA faced, while doing his job in a wheelchair. His biggest challenge was the lack of trunk stability. The other issue he faced was positioning the client to accommodate his wheelchair. He wasn’t comfortable with the idea of leaning over the client’s face with the risk of falling over them while he worked. Another problem he faced was engaging in bilateral activities like hair washing and setting, since it involved him moving all around the client while working. He wouldn’t be able to manoeuvre the wheelchair if his hands were coated in any hair-care products... In order to better understand these hurdles, we conducted a simulation with some modifications, to better suit his functional status. Two of my colleagues assisted as volunteers; we gathered all the basic tools and equipment needed for him to apply basic make-up over a client. We were immediately able to identify some factors that affected his activity performance: The quality of wheelchair used significantly affected his performance. The size, material, state of repair, presence of chest strap, quality of brakes and removable armrests were important aspects to take into account. Environmental factors, like accessibility and open space, were necessary to take into account. Using more handheld tools and gloves helped with prevention of cross-contamination. Having the client, in this case, the volunteer, seated at an inclination instead of lying supine also made a positive difference. A detachable lapboard to place all his tools on was also a better option than the trolley that was usually used by them. Throughout our sessions, S's determination and creativity shone brightly. Despite facing financial constraints and the devastating impact of COVID-19, he remained unwavering in his pursuit of regaining independence and pursuing his passions. With the support of his mother and close friends, S embarked on a journey of self-discovery and adaptation. Incorporating occupational therapy, vocational rehabilitation and physical therapy, our sessions focused on enhancing S's functional abilities, while exploring opportunities for him to re-engage in his interests. Despite initial scepticism, S embraced the idea of utilising his talents in the makeup and beauty industry - leveraging his knowledge of colour theory and artistic skills. Our therapy sessions evolved into a collaborative exploration, of adaptive techniques and strategies tailored to S's unique needs. From mastering wheelchair positioning for optimal makeup application, to implementing pressure relieving techniques during prolonged sessions, each session served as a learning opportunity for both S and myself. As our time together drew to a close, S's remarkable progress and unwavering optimism left a lasting impression on me. His resilience in the face of adversity serves as a testament to the human spirit's capacity for adaptation and growth. S's journey continues, as he undergoes long-term rehabilitation at another branch of our institute. While I may no longer be directly involved in his care, I remain inspired by his tenacity and consistent determination to overcome challenges and pursue his dreams. In conclusion... S's story exemplifies the transformative impact of rehabilitation and the strength of the human spirit. As healthcare professionals, it is both our privilege and responsibility to empower individuals like S, to reclaim their independence and pursue their passions - irrespective of the challenges they may face. Further reading and learning World Health Organization (WHO) (2013) Spinal cord injury (online). Available from: https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury. Accessed 13 April 2024. OT CPD Courses: Fundamentals of Posture, Pressure and Ergonomics (2022, The Occupational Therapy Hub). Plus+ Member access to participate and receive a certificate.

Every now and then, the ambience in our office is disturbed by a member of the public roaring with laughter in the corridor, whilst reading the 'Sleep Office' sign on our door. We prick our ears with a sense of familiarity, anticipating what is coming next. "Sleep Office. Ha ha! What do you think they do in there then, sleep?" While the idea of sleeping on the job sounds amusing to some, to our patients, sleep at any time has often become a living nightmare. Night after night, for years or decades - stuck in a seemingly inescapable cycle of desperately wanting to sleep, yet spending much of the night exhausted and awake. We call this insomnia, which is one of the many sleep disorders we deal with at our sleep clinic. To those who have never struggled with sleep, it is hard to understand the profound impact that sleep disorders have on a person’s life. While they may be seen as a nighttime problem, they have a significant impact - across the full 24-hour spectrum - on: health emotions cognition productivity quality of life You might call me biased, but I think that sleep is the ultimate occupation! Every other occupation is affected by how well we sleep, and similarly, sleep is affected by all our occupations. At the Royal Surrey County Hospital (in the UK), we are a team of three Occupational Therapists, working within an outpatient National Health Service (NHS) sleep clinic to provide assessment and behavioural treatment for sleep disorders. While our respiratory nurse and physiotherapy colleagues provide the sleep disordered breathing service, our primary focus is on delivering treatment for insomnia. We also support patients with circadian rhythm disorders, concurrent insomnia and sleep apnoea (COMISA), nightmare disorder and parasomnias. Our patients range in age from 16-90 years and, unsurprisingly, many have complex medical or mental health issues in addition to their sleep disorder. A day in the life... Today, my day started with a remote clinic. Due to there only being a few NHS Insomnia services in the UK, many of our patients are not local and prefer remote treatment, to avoid long journeys. My first patient was a 45-year-old lady who, for the last 10 years, has taken several hours to fall asleep and then woken for another hour or two overnight. At first assessment, she estimated sleeping around 5 hours on a good night and was feeling desperate. Despite describing herself as a naturally positive person, her life had become a battle. She felt exhausted all the time, had been pulled up for mistakes at work and her relationship with her husband was deteriorating - not helped by their recent 'sleep divorce' (separate bedrooms). We initiated cognitive behavioural therapy (CBT) for Insomnia, which is misleadingly named, as it is nothing like regular CBT. After only a few weeks, her sleep is improving. CBT for Insomnia (CBT-I) is the recommended first line treatment for people with chronic insomnia - although sadly few services exist, which means that most sufferers are fobbed off with no help, or ineffective sleep hygiene. CBT-I has a robust evidence base, demonstrating efficacy in primary and co-morbid insomnia (references 1,2). It is a multi-component intervention, addressing cognitive and behavioural factors that perpetuate sleep disturbance. We deliver our programme in an innovative way, through a combination of treatment videos (which I created, after we were forced to close our service during covid-19) and one-to-one support (to tailor, troubleshoot and top-up video content). While the principles of CBT-I are quite simple, in reality they can be challenging, both to deliver as a healthcare professional and to implement as a patient. For example, techniques such as sleep scheduling can be very daunting. This requires an already-sleep-deprived individual to sacrifice catch-up sleep, get up at a consistent time and temporarily reduce their overall time in bed, in order to increase sleep efficiency. Not surprisingly, occupational therapy coaching skills are extensively employed, including: evaluating motivation explaining rationale instilling hope compassionately acknowledging concerns adapting guidance to overcome barriers or resistance In spite of patients’ initial scepticism, CBT-I literally changes lives within a matter of weeks. That was the case for my first patient. Only four weeks after first seeing me, she was surprised to find that she was falling asleep within 30 minutes - and getting back to sleep quickly during the night. Her average sleep duration had already increased to 6.5-7 hours a night. I explained the next steps and congratulated her on the positive spiral she was creating - where increased sleep consistency produces greater confidence, which in-turn promotes calm at bedtime and consequently promotes more sleep! My next patient was a 62-year-old man, whom I was speaking to for the first time. He explained that his sleep had been poor for years; as is the case for many of our patients, his physical and mental health was suffering. After initially describing symptoms suggestive of insomnia, he flippantly disclosed violent dreams associated with thrashing around and dream-related movement. Further questioning revealed a history consistent with REM Behaviour Disorder (RBD). Sadly, around 70% of those with RBD develop Parkinson’s Disease within 12 years (reference 3). RBD is not something that can be treated behaviourally and a formal diagnosis requires a laboratory sleep study, which we do not have available at our hospital. So I inform the gentleman on good sleep practices, recommend safety measures to avoid injury overnight, advise the GP to remain vigilant to other prodromal Parkinson’s symptoms and refer him to a London clinic, for a formal diagnosis. Other activities during the day include setting up a respiratory sleep study for a lady with insomnia - but whom I suspect has sleep apnoea too. Plus talking to a young woman with a severely delayed sleep rhythm (4am - 1pm) about light therapy. That and wading through an endless stream of admin, triaging referrals, attending a multidisciplinary (MDT) meeting and cursing the new electronic records system that isn’t cooperating... As my day draws to an end, I am left utterly convinced that when we help our patients sleep, we help them live. If this article has inspired you to think more deeply about sleep, I would encourage you to start building your knowledge of sleep, through reading or training. From there, your most powerful tool is to ask your patients about their sleep. In the words of Jane, a former patient and former insomniac: "Life feels so much brighter, better and happier when you’ve slept well!" Struggling to sleep? Listen up! This free 30-minute one-off podcast will provide insights and evidence-based techniques, to help you and your clients sleep better tonight! If you are struggling to fall asleep or stay asleep, please listen in below. Created by article author Louise Berger, the talk will cover: How you are not alone and there is hope What to do when you are having a few bad nights The difference between a few bad nights and full-blown insomnia How insomnia develops The vicious cycle of trying too hard to sleep The two systems that determine how well you sleep - sleep drive and hyper-arousal The difference between being sleepy and tired Practical ways to increase sleep drive, so you can fall (and stay) asleep more easily Ways to reduce alertness and anxiety at bedtime and overnight Why you don’t have to sleep 7-8 hours every night Why your insomnia isn’t going to take you to an early grave References Trauer, J.M., Qian, M.Y., Doyle, J.S., Rajaratnam, S.M.W. and Cunnington, D. (2015) Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Annals of Internal Medicine. 163 (3): 191-204. doi: 10.7326/M14-2841. Edinger, J.D., Arnedt, J.T., Bertisch, S.M. et al. (2021) Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine. 17 (2): 263-298. Roguski, A., Rayment, D., Whone, A.L., Jones, M.W. and Rolinski, M. (2020) A neurologist's guide to REM sleep behavior disorder. Frontiers in Neurology. Jul 8; 11:610. Berger, L. (2024) Say Goodnight to Insomnia Podcast. Royal Surrey NHS Foundation Trust: Occupational Therapy > Insomnia Clinic. Available online: https://www.royalsurrey.nhs.uk/saygoodnight. Accessed 15 February 2024.

How often have we heard: "Sign up for an activity!" "You should get out more." "Don't you think you spend a lot of time doing nothing? Go for a walk" "You need to start a new routine." or "I'm worried about you." These are expressions commonly used to attempt to 'motivate' someone to do something. However, a number of questions come to my mind: What am I signing up for? When? Where? How? With whom? And why?... What we do is part of who we are I am writing this as an occupational therapist (OT). I wonder why people know so much about the properties of aspirin, for example, but not about the make-up and importance of occupation, sleep, habits, roles and routines; certainly not about the properties of everyday life activities. Four years ago, I started a journey through a 'strange' world. I am an occupational therapist, specialising in mental health. My PhD in Psychology focused on researching the daily lives of people diagnosed with a rare disease: Variant Transthyretin Amyloidosis. I started by studying the condition, although after some time I became immersed in others, such as other Amyloidoses, Tuberous Sclerosis, Familial Spastic Paraparesis and Epidermolysis Bullosa (known as 'Butterfly Skin'). How lucky I was! Daily life Variant Transthyretin Amyloidosis is a rare genetic disease, complex to understand and with a variable prognosis. It was first described in 1952 by the Portuguese neurologist Corino Andrade as a peculiar form of peripheral neuropathy. In Europe, the incidence of Variant Transthyretin Amyloidosis varies widely. In Portugal, Sweden, Majorca and Cyprus, Variant Transthyretin Amyloidosis with Polyneuropathy is endemic and one particular mutation predominates - Val30Met. Low prevalence, little research and therefore little understanding. That is the reality. First symptoms of the disease usually appear in the third decade of life. Patients usually experience severe physical limitations due to the genetic mutation - but psychological, social and occupational effects have also been described (Luigetti et al., 2020). Existing research suggests that being diagnosed affects activities of daily living (Buades-Reinés et al., 2016). However, in addition to the clinical approach, no type of intervention has been described that focuses on the maintenance, improvement and adaptation of the daily life of patients and their carers after the diagnosis - a competence that sits within the discipline of occupational therapy. Specifically, my PhD project aims to analyse the effectiveness of an occupational intervention in patients with Variant Transthyretin Amyloidosis. The objectives were to have concrete understanding of: what the benefits of this intervention would be in which parameters of the daily life of patients these benefits would be realised what the magnitude of their impact would be I wanted to illustrate the impact of this disease on the occupational dimension and on daily life - to open up avenues for future research, to stimulate reflection on possible lines of intervention and to highlight the importance of a differentiated multidisciplinary team - complemented by professionals in the psychosocial field, such as occupational therapists. It is the journey that is important, not the destination During these four years I have worked with people in group and individual sessions, to work on daily living and understand how the body works as a whole. Studying, adapting, changing or starting new occupations have been my goals during my time specialising in rare diseases. I discovered that the occupational therapist is the key to motivation, planning and understanding the basic and not-so-basic aspects of daily life. And that it is not about people doing things; it is about having a meaningful life, without being conditioned by a diagnosis. I understood that occupation is not a luxury for a few; it is a right for all. Asociación Balear de la enfermedad de Andrade (ABEA) To make contact regarding this research: Aina Gayá Barroso ainabarroso@gmail.com Instagram: gaya_terapiaocupacional References Ando, Y., Coelho, T., Berk, J.L., Cruz, M.W., Ericzon, B-G., Ikeda, S-I., Lewis, W.D., Obici, L., Planté-Bordeneuve, V., Rapezzi, C. et al. Guideline of transthyretin-related hereditary amyloidosis for clinicians. Orphanet Journal of Rare Diseases. 2013, 8, 31-38. [Google Scholar] [CrossRef] [PubMed] Asociación Balear de la enfermedad de Andrade (ABEA). Available online: https://andradebalear.es/ Connors, L.H., Lim, A., Prokaeva, T., Roskens, V.A. and Costello, C.E. Tabulation of human transthyretin (TTR) variants. Amyloid. 2003, 10, 160-184. [Google Scholar] [CrossRef] Damy, T., Adams, D., Bridoux, F., Grateau, G., Planté-Bordeneuve, V., Ghiron, Y., Farrugia, A., Pelcot, F., Taieb, C., Labeyrie, C. et al. Amyloidosis from the patient perspective: The French daily impact of amyloidosis study. Amyloid. 2022, 29, 165-174. [Google Scholar] [CrossRef] [PubMed] Estébanez, C.T., Soriano, C.S., Escrich, A.G. and Segura, S.R. Late-onset familial amyloid polyneuropathy in the Safor (Valencia) area: Four case reports. Rev. Clín. Esp. 2007, 207, 75-76. [Google Scholar] [CrossRef] Gayà-Barroso, A., González-Moreno, J., Rodríguez, A., Ripoll-Vera, T., Losada-López, I., Gili, M. and Cisneros-Barroso, E. Accessibility to Occupational Therapy Services for Hereditary Transthyretin Amyloidosis. Int. J. Environ. Res. Public Health. 2022, 19, 4464. 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Clinical and analytical variability in cases of familial amyloidotic 331 polyneuropathy (PAF-TTR): Comparison between healthy carriers and symptomatic 332 patients. Med. Balear. 2015, 30, 31-36. [Google Scholar] Matyjasik-Liggett, M. and Wittman, P. The Utilization of Occupational Therapy Services for Persons with Charcot-Marie-Tooth Disease. Occup. Ther. Health Care. 2013, 27, 228-237. [Google Scholar] [CrossRef] Munar-Qués, M., Saraiva, M.J., Viader-Farré, C., Zabay-Becerril, J.M. and Mulet-Ferrer, J. Genetic epidemiology of familial amyloid polyneuropathy in the Balearic Islands (Spain). Amyloid. 2005, 12, 54-56. [Google Scholar] [CrossRef] [PubMed] Raya-Cruz, M., Buades-Reines, J. and Gállego-Lezaun, C. Variabilidad clínica y analítica en casos de polineuropatía amiloidótica familiar (PAF-TTR): Comparación entre portadores sanos y pacientes sintomáticos. Med. Balear. 2015, 30-33, 31-36. [Google Scholar] [CrossRef] Reinés, J.B., Vera, T.R., Martín, M.U., Serra, H.A., Campins, M.M.C., Millán, J.M.D., Lezaun, C.G. and Cruz, M.R. Epidemiology of transthyretin-associated familial amyloid polyneuropathy in the Majorcan area: Son Llàtzer Hospital descriptive study. Orphanet Journal of Rare Diseases. 2014, 9, 29. [Google Scholar] [CrossRef] Said, G. Diagnostic pitfalls in sporadic transthyretin familial amyloid 346 polyneuropathy (TTR- FAP). Neurology. 2007, 69, 693-698. [Google Scholar] [CrossRef] Sakellariou, D. and Pollard, N. Occupational Therapies without Borders: Integrating Justice with Practice. 2nd ed., Elsevier: Amsterdam, The Netherlands, 2017, pp. 102-108. [Google Scholar] Van Deusen, J. and Harlowe, D. The efficacy of the ROM Dance Program for adults with rheumatoid arthritis. Am. J. Occup. Ther. 1987, 41, 90-95. [Google Scholar] [CrossRef] [PubMed] Voortman, M., Fritz, D., Vogels, O.J.M., Eftimov, F., van de Beek, D., Brouwer, M.C. and Drent, M. 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As Occupational Therapists, we are always trying to identify activities that a client might connect with. Gardening is an accessible, adaptable pastime, that many clients have experienced and which an intervention can be built around. However, barriers exist with many mental health conditions, such as volition and fatigue, that need to be overcome in order to engage. Take this short course to explore these themes further. Questions and self-reflection will follow content, to help test your knowledge and provide evidence of learning.

Introduction As Occupational Therapists, we are always trying to identify activities that a patient or client might connect with. Gardening is an accessible, adaptable pastime, that many clients have experienced and which an intervention can be built around. However, for many mental health conditions, there are barriers such as volition and fatigue, that need to be overcome in order to engage. These can be minimised by using techniques to encourage engagement, predominantly appropriate for Occupational Therapists, but also Social and Therapeutic Horticulturists. A brief overview of depression Depression (also known as major depression, major depressive disorder, or clinical depression) is a debilitating mood disorder and mental health condition. It can affect people of all ages, races, ethnicities and genders, often presenting itself with low mood and cognitive distortion (Gonzalez et al, 2009). Characteristics often impact the ability to engage with others and in daily life activities, such as sleeping, eating, or working. Although men, women and people of all genders can feel depressed, how they express symptoms - and the behaviours used to cope with them - may differ. An individual with depression is likely to experience some (but not all) of the following signs and symptoms, most of the day, nearly every day: Persistent sad, anxious, or 'empty' mood Feelings of guilt, worthlessness or helplessness Feelings of irritability, frustration or restlessness Decreased energy, fatigue or feeling slowed down Difficulty concentrating, remembering, or making decisions Difficulty sleeping, waking early in the morning, or oversleeping Becoming withdrawn and detached; isolating from family and friends Loss of interest or pleasure in hobbies and activities Problems with sexual desire and performance Changes in appetite or unplanned weight changes Physical aches or pains, headaches, cramps, or digestive problems (no clear physical cause) Thoughts of death or suicide, or suicide attempts [National Institute of Mental Health, 2023] Depression interferes with day-to-day functioning and causes significant distress for the person experiencing it. Statistically, 4-10% of people in England (for example) will have depression at some time (NICE, 2011), with 7.8% being diagnosed alongside anxiety (HSCIC, 2009). The World Health Organisation (WHO, 2008) predicted that depressive conditions would be the second major cause of disability in the world by 2020. As symptom severity is highly variable, any effective intervention should be appropriate to the degree of depression. Evidence that gardening is beneficial for depression Soga, Gaston and Yamaura (2016) carried out a statistical quantitative research review of the health benefits of gardening and concluded it can provide a reduction in depression. This supports many of the qualitative experiences of the benefits of gardening with depression. "Gardening is a constant boost to my consciously nurtured optimism, as I am surrounded by the natural world, which pursues life with eager enthusiasm." (Mind, 2017) Gonzalez et al (2009) evaluated the impact of therapeutic horticulture on clinical depression, by measuring changes in the severity of the depression and the participants' perceived capacity for attention. They found a correlation between the extent to which attention was captured and the reduction in depression. They deduce that this was a result of the disruption to the participant’s rumination and the effortless attention involved in engaging in gardening. Berg and Custers (2011) demonstrated that gardening increased positive mood, reducing cortisol levels and enabled participants to handle acute stress better (Kings Fund, 2016). Rostami et al (2014) noted that visitors of gardens felt that the experience reduced their depression by 94%. Providing access to a garden environment - even visiting public areas - can have positive effects on well-being, evoking a sense of identity, meaning and reducing stress. The MIND charity and University of Essex (UK) have developed an eco-therapy project - including gardening and food growing - to support mental health conditions, including depression. They found 69% of people experienced significant increases in wellbeing by the time they left the Ecominds project. Their survey of GPs stated that the eco-therapy was a valid and suitable treatment for anxiety (52%) and depression (51%) (University of Essex, 2013). Thrive (2017) suggest that gardening is an activity that enables a person to often connect with their past, while developing personally through their growing horticultural knowledge. It provides essential physical exercise, social connectedness and environmental connectedness (Sempik et al, 2005).

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< Specialisms Resources + Services Portal Learning (Intellectual) Disabilities + Useful resources and services, for your care and career. This is an expanding directory and community suggestions are not definitive. K now of a resource or service that should be featured? Suggest an entry 'Confidential Enquiry into Premature Deaths of People with Learning Disabilities' (CIPOLD) Report (Heslop, et al. 2013) This report follows Death By Indifference, also listed on this page. This confidential enquiry looks further into to why people with learning disabilities sometimes live shorter lives than other people - and what we can do to change this. ​ [UK CHARITY REPORT; INFORMATION APPLICABLE WORLDWIDE] Visit > 'Death By Indifference' (Mencap, 2007) This report will set out why we believe there is institutional discrimination within the NHS, and why people with a learning disability get worse healthcare than non-disabled people. We present the stories of six people who we believe have died unnecessarily. We do so because healthcare professionals need to realise the serious - even fatal - consequences of their lack of understanding. We do so to point out that these professionals must work to ensure that such tragedies can never happen again' (Mencap, 2007). ​ ​ Easy read PDF ​ [UK CHARITY REPORT; INFORMATION APPLICABLE WORLDWIDE] Visit > 'How Social Care Staff can use Reasonable Adjustments to support the health of people with Learning Disabilities' (Public Health England 2017) Reasonable adjustments are the changes the law says people or services must make so disabled people can use services as easily as everybody else. Putting reasonable adjustments in place can help people with learning disabilities get better healthcare and live longer. This document lays out some tips and advice about how we can ensure individuals with learning disabilities have the reasonable adjustments they need in order to access healthcare safely and effectively. ​ [UK GOVERNMENT DOCUMENT; INFORMATION APPLICABLE WORLDWIDE] Visit > 'Improving Healthcare Access for People with Learning Disabilities' This link provides access to copies of government guidance to support your practice and build your skills. This includes information around common health needs, reasonable adjustments, mental capacity act, hospital admissions, pain management, dementia and palliative and end of life care for people with learning disabilities. ​ [UK GOVERNMENT WEBSITE; INFORMATION APPLICABLE WORLDWIDE] Visit > 'Occupational Therapy for People with Learning Disabilities: Findings from a research study' (2010) Authors:Lillywhite, A. and Haines, D. (2010) Published by:(Royal) College of Occupational Therapists This highlights key points from research undertaken by the (then) College of Occupational Therapists' 'Specialist Section: People with Learning Disabilities'. The research was commissioned with the aim of exploring and documenting the nature of occupational therapy with people with learning disabilities across the United Kingdom, from the perspectives of occupational therapists and support workers. [UK PROFESSIONAL BODY; PDF INFORMATION APPLICABLE WORLDWIDE] Visit > 'Valuing People Now: a new three-year strategy for people with learning disabilities' (Department of Health, 2009) Valuing People Now was published in 2009 as the UK Government's three-year strategy to improve and promote the rights, choice, inclusion and independence of individuals with learning disabilities. ​ Easy read report (PDF) ​ [UK GOVERNMENT REPORT; INFORMATION RELEVANT WORLDWIDE] Visit > A Picture Of Health (NHS South of England) Easy read information that can help people with learning disabilities better understand health, illness, lifestyle and treatments. This website has easy read information about lots of different health conditions. ​ [UK NATIONAL HEALTH SERVICE WEBSITE; INFORMATION APPLICABLE WORLDWIDE] Visit > Beyond Words Empowering people through pictures. ​ Beyond Words provides books and training to support people who find pictures easier to understand than words. Whether supporting somebody with a learning disability or communication difficulty, their products empower people through pictures. ​ [UK-BASED SERVICE; SERVICES AVAILABLE INTERNATIONALLY] Visit > Brandon Trust Our charity exists to enable children, young people and adults with learning disabilities and autism to live life in the way they choose. We do that by providing high-quality, individualised support that focuses on enabling people to achieve their dreams and truly live free. Visit > British Institute of Learning Disabilities (BILD) Professor Gerry Simon set up BILD in 1971, because he was convinced there could be better support in the community for people with disabilities. They’ve been championing the rights of people with disabilities ever since. BILD uses its skills, knowledge and experience to turn policy into practice, solve problems and improve support. In working with Government departments, local authorities, health trusts, service providers and mainstream organisations, our aim is to improve the quality of the lives of people with disabilities (BILD 2017). The BILD website has a range of resources for service users, family, carers, support workers and professionals around how to effectively support and work with individuals with learning disabilities. ​ [UK CHARITY; INFORMATION APPLICABLE WORLDWIDE] Visit > Care Farming UK Up-to-date website that allows you to search for your nearest Care Farm, by postcode. Visit > Challenging Behaviour and Learning Disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges (NICE Guidelines, 2015) This guideline covers interventions and support for children, young people and adults with a learning disability and behaviour that challenges. It highlights the importance of understanding the cause of behaviour that challenges, and performing thorough assessments so that steps can be taken to help people change their behaviour and improve their quality of life. The guideline also covers support and intervention for family members or carers. ​ [UK PUBLIC BODY GUIDELINES; INFORMATION APPLICABLE WORLDWIDE] Visit > Communicating with people with a learning disability (Mencap) This information is designed to provide a brief introduction to communication and the problems faced by someone with a learning disability. It also contains tips on how you can be a better communicator, and how you can help someone with a learning disability get their message across. ​ [UK CHARITY; INFORMATION APPLICABLE WORLDWIDE] Visit > Down's Syndrome Association The only organisation in the UK focusing solely on all aspects of living successfully with Down’s syndrome. ​ [UK CHARITY; INFORMATION APPLICABLE WORLDWIDE] Visit > Easy Health This website has lots of easy read resources around health, food and exercise and videos that are accessible for use when working with individuals with learning disabilities. ​ [UK WEBSITE; INFORMATION APPLICABLE WORLDWIDE] Visit > Easy-Read Information about Mental Health (Peter Bates) Some people with learning disabilities need to use mental health services, but can find that these services are not well informed about how to support them. One part of good support is the provision of easy read information about mental health services, human rights and psychiatric treatment. ​ [UK WEBSITE; INFORMATION APPLICABLE WORLDWIDE] Visit > Foundation for People with Learning Disabilities Our aim is to ensure that people with learning disabilities continue to get better lives. We do this by gaining knowledge, improving practice and influencing of policy through our work directly with people with learning disabilities. We believe that people with learning disabilities should have the same rights and the same choices as everyone else in society” (Foundation for People with Learning Disabilities, 2017). The Foundation for People with Learning Disabilities work in the following key areas: Employment and education Family, friends and community Rights and equality Health and Well Being Getting the right support Changing service delivery ​ [UK CHARITY; INFORMATION APPLICABLE WORLDWIDE] Visit > Learning Disability England Learning Disability England is a charity and membership organisation working to make life better for people with learning disabilities and their families. Learning Disability England brings together people with learning disabilities, families and friends and organisations so that we can do more and shout louder. ​ [UK-BASED CHARITY] Visit > LearningDisability.co.uk We aim to provide information, education, resources, advocacy and services for those working with adults with learning disabilities. ​ We are committed to the social inclusion for all people with a learning disability into mainstream society. This can be achieved through the wider education and training of all communities in understanding learning disabilities, it’s impact upon the individual, the family and equality of life. ​ [UK-BASED ORGANISATION; INFORMATION APPLICABLE WORLDWIDE] Visit > Look Hear Australia Look Hear Australia focuses on bringing the top resources and resource pages, on children with complex and additional needs, together under one site. Our motto is "it's not hard to make it easy" and we strive to make the search for quality information, programs, equipment and resources easy. [AUSTRALIA-BASED RESOURCE; INFORMATION APPLICABLE WORLDWIDE] Visit > MyLiferaft MyLiferaft is an online place for an individual’s health and well-being information that helps to connect them to you and others in their care circle. All their information is stored safely and easily, allowing only those that they choose to be able to access it. It’s not just about the facts and figures; they can store information such as “I love a cup of tea with my medication!” or “I’m scared of injections!” This allows those that care for them to know what helps them to feel better, and their care circle to feel better informed to support them. ​ [UK: SOUTHAMPTON-BASED SERVICE; AVAILABLE NATIONWIDE] Visit > NICE Guidelines and Quality Standards (Learning Disabilities) NICE Guidelines - Review the evidence across broad health and social care topics: Care and support of people growing older with learning disabilities Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges Learning disabilities and behaviour that challenges: service design and delivery Mental health problems in people with learning disabilities: prevention, assessment and management Quality Standards - Set out priority areas for quality improvement in health and social care: Learning disabilities: challenging behaviour Learning disabilities: identifying and managing mental health problems ​ [UK-BASED ORGANISATION; INFORMATION APPLICABLE WORLDWIDE] Visit > RCOT Specialist Section: People with Learning Disabilities We organise educational events, act in an advisory and consultative capacity and provide updates on developments in national policies affecting learning disability services. We support each other's professional development and work cooperatively to shape and influence learning disability national policy. Our networks create links between occupational therapists and students who have an interest in people with learning disabilities (Royal College of Occupational Therapists 2017). ​ [UK PROFESSIONAL BODY; PAID MEMBERSHIP LOG IN REQUIRED] Visit > Safeguarding: Easy-read leaflets (Newham London) Some easy read leaflets about hate crime, keeping safe at home and keeping safe while out and about, to support individuals with learning disabilities to better understand these issues, and how they can stay safe. [UK BOROUGH COUNCIL WEBSITE; INFORMATION RELEVANT WORLDWIDE] Visit > Scottish Commission for Learning Disability The Scottish Commission for Learning Disability (SCLD) is the lead strategic partner to the Scottish Government in the delivery of learning disability strategy and policy. Visit > Sensory World Sensory world was set up as a tool to support individuals with learning disabilities to learn to use computers and to fill a gap in provision of an accessible website for adults with learning disabilities. Sensory World is designed to be a fun place to learn, with a wide range of stimulating and appropriate activities. [UK WEBSITE; INFORMATION APPLICABLE WORLDWIDE] Visit > The Learning Disabilities Elf The Learning Disabilities Elf aims to bring you the latest learning disabilities evidence that is published each week. ​ We scan the most important websites, databases and journals and select evidence that is relevant to health and social care professionals with an interest in learning disabilities. ​ [UK-BASED ORGANISATION; INFORMATION APPLICABLE WORLDWIDE] Visit > The Learning Disabilities Mortality Review The Learning Disabilities Mortality Review (LeDeR) programme was established to support local areas to review the deaths of people with learning disabilities, identify learning from those deaths, and take forward the learning into service improvement initiatives. Visit > Yellow Submarine (Oxford) Yellow Submarine is an award-winning Oxfordshire charity, that believes people with learning disabilities and autism deserve to live life to the full. ​ We tackle the problem that many people with learning disabilities leave school with limited life skills and as a result poor life chances. This often leads to isolation and being marginalised. Our projects start working with young people in community settings from the age of 11 onwards, to build their social skills, confidence, independence and ultimately their employability. ​ [UK: OXFORD-BASED SERVICE] Visit >

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