Accessible summaryTitle: Saying 'yes' or 'no' to research • People with learning disability should get the chance to say 'yes' or 'no' to taking part in research. • This can be hard if you have difficulty in understanding or speaking.• This paper is about how we tried to find ways to help people understand and say what they felt about taking part in research. • We found:-people with learning disability need more time to make decisions about research -researchers need to be good at communicating and getting to know people -researchers need to use different ways to communicate -not just speech SummaryResearch in the field of learning disability presents particular ethical challenges when obtaining consent from participants. This is further exacerbated when the nature of the research requires participation at all ability levels and involves people with communication impairments. The process of obtaining consent in a research study with 48 participants at four levels of comprehension ability is discussed in this paper. The specific issues of recruitment, seeking consent, ongoing consent and feedback are detailed as are the adaptations made in this project to research methodology and the accessible methods of communication employed. Implications for researchers and future directions for further studies are presented.

Accessible summary• It is hard for the views of people with learning disability to be listened to.• Talking Mats uses pictures to help people say what they feel about their lives. • This study asked 48 people with learning disability to use Talking Mats to find out how well it works. • The study found that most people found Talking Mats helped them to understand and to say what they feel. • Talking Mats is a useful tool to help find out what people with learning disability feel about their lives. Summary People with intellectual disability have significant difficulties in ensuring their voice is heard. Talking Mats is a low tech communication resource which helps understanding and supports expression. This study examined the effectiveness of the resource for people with intellectual disability. A mixed method quantitative and qualitative study involving 48 people at four levels of comprehension was designed to compare the effectiveness of Talking Mats with the individual's main communication method. Thirty of the 48 participants were identified as using Talking Mats effectively. Effective use of Talking Mats was associated with functional comprehension. The study found that scores on all indicators of communication effectiveness were higher when using Talking Mats compared to main communication methods. This study identified that Talking Mats can be an effective communication resource for many people with intellectual difficulty and can help them express their views by increasing both the quantity and quality of information communicated.

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Objective To explore consultation between people with communication disability and General Practice (GP) staff from the perspectives of both patients and staff.Background Communication disability causes a particular problem in primary care. This issue has not yet been investigated from the perspective of both patients and GP staff.

Policy guidelines insist that people with dementia should be involved in decisions about key life choices and transitions. However, as dementia affects both cognitive and communication difficulties, it becomes increasingly difficult to do this, and innovative and effective ways to support people with dementia and their carers to interact with each other are needed. This project, funded by Joseph Rowntree Foundation, examined if Talking Mats, a low-tech communication framework, could support family carers and people with dementia to discuss issues around daily living with each other. The fieldwork phase took place from September 2008 to May 2009. Eighteen couples (person with dementia and their family carer) from Scotland and the North of England were involved. The couples were visited in their own homes and asked to discuss together four topics (Personal Care; Getting Around; Housework; Activities) under two different conditions: (i) using the Talking Mats framework and (ii) using their usual communication methods (UCMs). After the interviews, each participant was asked separately to complete a short questionnaire (Involvement Measure), which included five questions to evaluate how involved s/he felt in each type of discussion and a final question to measure satisfaction with the overall discussion. The findings show that both people with dementia and their carers feel more involved in discussions about how they are managing their daily living when using the Talking Mats framework, compared with their UCM. They also feel more satisfied with the outcome of those discussions. The use of Talking Mats could result in increased well-being and positive adjustment to accepting increasing levels of care for people with dementia. In addition, it could improve the relationship between the person with dementia and family carers, if all involved feel that the views of the person with dementia and the family carer have truly been acknowledged.