Specific learning disabilities and associated emotional-motivational profiles: a study in Italian university students.

In this study, we analyzed the emotional and motivational aspects characterizing the profile of university students with Specific Learning Disorders (SLD). We assessed 61 university students, 32 with SLD (age = 23.6) and 29 in the control group (age = 23.00). The results highlighted that individuals with SLD exhibit higher levels of anxiety and depression and lower resilience compared to the control group. The Multidimensional Perfectionism Scale - Short Form, which explores perfectionism, did not reveal differences between the groups. Conversely, lower scores emerged in SLD students for the intrinsic motivation sub-scales of the Academic Motivation Scale. This indicates less engagement in studying out of personal cognitive curiosity. The Self-Regulated Knowledge Scale - University, which measures various cognitive strategies, showed significantly lower scores in the SLD group for knowledge linking, knowledge training, and knowledge critique. This suggests a lower frequency with which SLD students attempt to connect new knowledge with what they already possess, apply their knowledge, ask questions, and critically analyze what they have learned. Therefore, psychological and motivational consequences are evident in this population and can impact well-being and quality of life.

Improving persuasive writing skills of high school students with specific learning disabilities: STOP and DARE strategy.

Writing skills, crucial for various forms of expression, depend on effective planning and self-regulation. Competent writers emphasise pre-writing activities and self-regulation nevertheless students with Specific Learning Disabilities (SLD) often struggle with writing, impacting their academic achievement. This study explored the efficacy of the STOP and DARE strategy, grounded in the Self-Regulated Strategy Development (SRSD) model, for teaching persuasive writing to four high school students diagnosed with SLD. The study employed a multiple probe across subjects design to assess the impact of STOP and DARE on various persuasive writing skills. The intervention involved rigorous implementation of the strategy over 12-21 sessions, occurring 3 days a week for 80-90 min each day. The results indicated a functional relation between the strategy's implementation and improvements in persuasive essay elements, text length, use of linking words and holistic quality. Moreover, participants expressed a high level of satisfaction with the intervention. Future research could consider investigating functional text elements in addition to basic persuasive text elements. Furthermore, the adaptability of the STOP and DARE strategy to different languages and its applicability in diverse writing types, as well as its effectiveness in varied linguistic and cultural contexts, should be explored.

[Anxiety disorders as comorbid conditions in neuropsychiatric diseases in children]. / Trevozhnye rasstroistva kak komorbidnye sostoyaniya pri psikhonevrologicheskikh zabolevaniyakh u detei.

The variants of heterotypic comorbidity of anxiety disorders (AD) with attention deficit hyperactivity disorder, autism spectrum disorders, speech and language development disorders, specific learning disabilities (dyslexia, dysgraphia, dyscalculia), migraine, tension type headache in children and adolescents are discussed. In cases of heterotypic comorbidity the patients with AD referrals to specialists may be primarily associated with their emotional problems. Meanwhile, the comorbidity of AD with these diseases leads to a deterioration of their clinical manifestations and a worsening of the prognosis, and anxiety symptoms often not only persist, but also increase with age. It should be borne in mind that AD in children with neurodevelopmental disorders contribute to a decrease in the quality of life, academic failure, have a negative impact on peer relationships and the family environment, and in young adulthood, patients have an increased risk of depression and substance abuse. Therefore, early intervention and a comprehensive therapeutic approach with a dynamic assessment of the patient's condition are becoming important. When choosing pharmacotherapy, it is advisable to choose medictions that have a complex effect on the pathogenetic mechanisms of the underlying disease and concomitant AD, which include Tenoten for children.

Investigating the Maintained Motor Skill Achievements in a Visual Praxis Based Occupational Therapy Program: Single Blind Randomized Follow up Study.

To examine the long-term effects of Visual Praxis Based Occupational Therapy Program on the motor skills of children with Specific Learning Disabilities. Ninety-six boys and girls were divided into two groups: Experimental (n = 48) and Control (n = 48). The Experimental group received Visual Praxis Based Occupational Therapy Program in two weekly sessions for 8 weeks. All participants were assessed with the Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form at three-time points; pre-test, post-test, and follow-up. The experimental group showed superior results, Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form's Fine Motor Precision, Fine Motor Integration, Bilateral Coordination, Balance, Speed and Dexterity, Upper Extremity Coordination and Total Score significantly increased after the intervention (p ≤ 0 0.05) and the scores were maintained at the follow-up (p > 0.05). The Visual Praxis Based Occupational Therapy Program intervention provided a retained positive effect in the development of motor skills in children with Specific Learning Disabilities.

Stress, resilience, and emotional well-being in children and adolescents with specific learning disabilities.

This article reviews the prevalence of stress and explores resilience factors in children and adolescents with specific learning disabilities (SLDs). We show that the increased stress and emotional challenges faced by this group are likely due to societal pressures and stigma. Recent findings on neuroendocrine changes in this population are discussed, suggesting a predisposition to psychiatric disorders. This review advocates for a societal shift towards the neurodiversity paradigm, which recognizes SLDs as natural variations in brain function, emphasizing individual strengths and promoting a more inclusive approach that values cognitive diversity. Such advocacy is likely important to combat stress and stigma in those with SLDs. This article also reviews recent work identifying resilience-promoting factors, such as perception of self and peer/teacher relationships, for enhancing emotional well-being and mental health for children and adolescents with SLD.

Examining Texting in the Classroom Between Adolescents Without and With Learning Disabilities: Do Classroom Climate and Academic Boredom Matter?

The present study investigated texting in the classroom through written (SMS) and instant (social media) messages comparatively between adolescents without and with LD. Also, applying the Social Cognitive Theory, the role of perceived classroom climate and academic boredom in texting in the classroom was co-examined through an explanatory mediation model. Overall, 439 students (59% girls) without LD and 408 students (47% girls) with LD, who both attended randomly selected Greek junior high schools of Mainstream Education and used a mobile phone, completed self-reported scales about the variables involved with reference to the Modern Greek language course. The results showed that texting in the classroom (through written/instant messages) was above average for both student subgroups, regardless of their gender. However, within a comparative perspective, texting in the classroom through instant (social media) messages was higher for students with LD. Furthermore, in the relationship between perceived classroom climate and texting in the classroom (through written/instant messages) academic boredom proved a full mediator for students without LD and a partial mediator for students with LD. The findings imply the need for psychoeducational interventions in the context of specific school courses, to strengthen differentiated dimensions of psychosocial classroom climate for adolescents without and with LD. Thus, positive academic emotions and minimized disruptive texting in the classroom could be achieved.

Prevalence of developmental dyslexia among primary school children in Arab countries: a systematic review and meta-analysis.

BACKGROUND: Dyslexia is one of the most common learning disabilities. It poses challenges in reading skills development and can have a lasting impact in other areas of learning. AIMS: To investigate the prevalence of developmental dyslexia among primary school children aged 6-13 in Arab countries, and to explore associations with gender and residency. METHOD: Following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, we included studies up to December 2023 that were found in English and Arabic research database searches. Random-effects proportional meta-analyses determined the prevalence of dyslexia in Arab countries, with a direct comparison between girls and boys using odds ratios. RESULTS: The meta-analysis included 18 studies with 30,243 participants: eight studies (44 %) from Egypt, four (22 %) from Saudi Arabia, and six (34 %) from other Arab countries. The pooled prevalence of dyslexia for children aged 6-13 in these studies was 11 %. The odds ratio for girls vs. boys was 0.85 (95 %). Geographical variations were notable, with eight studies (44 %) from Asia and ten (56 %) from Africa. Eight studies (44 %) were from the Gulf region, while ten (56 %) were from non-Gulf region. Prevalence of dyslexia was significantly higher in Arab countries in Asia (24 %) than in Africa (12 %), and the prevalence in non-Gulf countries was 13 % which was nearly half in comparison to Gulf countries (24 %). CONCLUSIONS: The prevalence rates of dyslexia in primary school children varies across the Arab world, with higher rates among boys, Arab countries in Asia, and Gulf countries. Further research is needed to include both genders and standardized diagnostics across more Arab countries to understand and address dyslexia effectively.

Behavioural interventions to treat anxiety in adults with autism and moderate to severe intellectual disabilities: The BEAMS-ID feasibility study.

BACKGROUND: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. METHOD: Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. RESULTS: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. CONCLUSION: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.

Reducing parenting stress in Chinese parents of children with learning disabilities with a mindful parenting program: A randomized controlled trial.

BACKGROUND: Parents raising children with Learning Disabilities (LDs) often face multiple challenges and high levels of parenting stress, especially in societies with intense academic competitions. Mindful parenting (MP) is an emerging approach that brings mindful awareness to parent-child interactions and is found effective in reducing parenting stress in various parent populations. AIMS: This study examined the effectivenesss of an 8-week online MP program on Chinese parents of children with LDs. METHODS AND PROCEDURES: A MP program was adapted and implemented in an online format with 69 parents of children with LDs. A randomized controlled trial design was used to examine the efficacy of the mindful parenting group compared with a wait-list control group. Parenting stress, mindful parenting and self-compassion were assessed pre- and post-intervention. OUTCOMES AND RESULTS: Compared with the wait-list control group, the MP group participants showed decreased parenting stress (d = 0.62, p < 0.05), improved mindful parenting (d = 0.63, p < 0.05), and increased self-compassion (d = 0.61, p < 0.05). CONCLUSIONS AND IMPLICATIONS: These findings support the effectiveness of an online MP intervention in reducing parenting stress and increasing mindful parenting and self-compassion among Chinese parents of children with LDs. The behavioral and intrapersonal aspects of MP are more amenable to improvement, whereas the attitudinal and interpersonal aspects, particularly non-judgmental acceptance and compassion towards the child, are resistant to change. Future studies should explore strategies to enhance these attitudinal aspects and interpersonal processes of MP.

Effectiveness of the Use of Virtual Reality Rehabilitation in Children with Dyslexia: Follow-Up after One Year.

Dyslexia is a common learning disorder that hinders reading fluency and comprehension. Traditional treatments can be tedious for children, limiting their effectiveness. This study investigated the one-year effects of rehabilitation treatment with a virtual reality rehabilitation system (VRRS) on children with dyslexia. Twenty-four children were divided into control (CG) and experimental (EG) groups. The CG underwent conventional neuropsychological treatment (CNT), while the EG underwent VR neurorehabilitation training (VRNT) using the VRRS. Neuropsychological evaluation was conducted before treatment, after six months, and again after one year for both groups. Compared to the control group, children who received VR training showed significant improvement in reading skills, especially in non-word reading and reading speed, even after one year without further VR intervention. VRRS can improve treatment adherence and minimize symptoms by offering engaging activities for children. These findings suggest VRRS may be a valuable tool for dyslexia rehabilitation with long-lasting effects.

Effect of Repeated Reading on Reading Fluency for Adults with Specific Learning Disabilities.

The current study implemented an alternating-treatments design with Standard Celeration Charting. The applied experiment occurred via telecommunication and assessed the effectiveness of repeated reading (RR) on reading fluency for two adults with specific learning disabilities using high-level and low-level reading passages. Participants reread each passage until they met a predetermined fluency criterion. We measured participants reading fluency using correct words per 1 min (CWPM) and assessed for retention at 1 week, 2 weeks, and 1 month. Both participants reached their fluency aims and maintained their progress postintervention. • RR can improve reading fluency for children and adults with reading deficits. • RR practice sessions require minutes to implement, which offers great flexibility for scheduling. • Telecommunication represents an effective modality for implementing RR procedures for adults with reading disabilities. • Participants in the study retained their fluency gains post-intervention, supporting that time spent on RR may represent a good investment for clinicians.

AI-Enhanced Dyscalculia Screening: A Survey of Methods and Applications for Children.

New forms of interaction made possible by developments in special educational technologies can now help students with dyscalculia. Artificial intelligence (AI) has emerged as a promising tool in recent decades, particularly between 2001 and 2010, offering avenues to enhance the quality of education for individuals with dyscalculia. Therefore, the implementation of AI becomes crucial in addressing the needs of students with dyscalculia. Content analysis techniques were used to examine the literature covering the influence of AI on dyscalculia and its potential to assist instructors in promoting education for individuals with dyscalculia. The study sought to create a foundation for a more inclusive dyscalculia education in the future through in-depth studies. AI integration has had a big impact on educational institutions as well as people who struggle with dyscalculia. This paper highlights the importance of AI in improving the educational outcomes of students affected by dyscalculia.

Evidence of mutual non-verbal synchrony in learners with severe learning disability and autism, and their support workers: a motion energy analysis study.

Introduction: Some research indicates that neurodivergent people are less likely than "neurotypical" people to adapt their movements to a partner's movements to facilitate interpersonal motor synchrony. Researchers therefore suggest synchrony deficits underlie the social differences associated with autism and other neurodivergences. Intensive Interaction (II) is a client-led approach, where Learning Support Workers (LSW) follow the lead of learners to create balanced and reciprocal interactions. Methods: We aimed to examine the balance of synchrony in learners with autism and Severe Learning Disabilities and their LSWs in a special education college where learners had prior experience with II. Using Motion Energy Analysis, we assessed the degree to which each partner acted as a leader, and hence which partner acted as a follower, during moments of close synchrony. Results: Overall, learners and LSWs showed higher than chance synchrony. There were no differences in the degree to which each partner led the moments of synchrony, or the amount pairs synchronized with zero-lag, where there was no delay between each partners' movements. Discussion: The equal balance of leading and following in the learner and LSW pairs demonstrates that both partners consistently adapted their movements to their partner's movements to facilitate synchrony. The findings tentatively challenge the notion of a synchrony deficit in autism and suggest synchrony can be present in cross-neurotype pairs in comfortable and engaging conditions. We discuss the potential for client-led, movement-based approaches to support smooth interactions across neurotypes.

Do Mathematics and Reading Skills Impact Student Science Outcomes?

Establishing validated science programs for students with or at risk for learning disabilities requires testing treatment effects and exploring differential response patterns. This study explored whether students' initial mathematics and reading skills influenced their treatment response to a whole-class, second-grade science program called Scientific Explorers (Sci2). The original Sci2 study employed a cluster randomized controlled design and included 294 students from 18 second-grade classrooms. Differential effects of the program by initial mathematics and reading skill levels were not observed for an interactive science assessment and a distal science outcome measure. However, based on initial reading skill levels, moderation results were found on a science vocabulary measure, suggesting the effects of Sci2 were greatest for students with higher initial reading skills. Similar results were found using initial mathematics skill levels as a predictor of differential response such that students with higher mathematics skills reaped stronger treatment effects on the vocabulary measure. Further, we found initial mathematics skills also influenced outcomes on the proximal science content assessment, where students with higher initial mathematics skills led to higher outcomes. Overall, findings suggest Sci2 produced robust effects for all students (g = 0.24-1.23), regardless of initial skill proficiencies. Implications for exploring differential response in science intervention research are discussed.

Assessing Beliefs About Intrinsic and Extrinsic Determinants of SLD: Evaluating the Factor Structure of a Novel Instrument.

Schools conduct comprehensive psychoeducational evaluations to identify students with specific learning disabilities (SLDs) and determine whether they qualify for special education services. This decision-making process is complex and research has documented many factors influencing SLD identification decisions. One such factor may be decision-makers' beliefs about the underlying causes of SLD, including intrinsic and extrinsic factors. However, no studies to date have examined the underlying factor structure of the responses to prompts about the causes of SLD from intrinsic and extrinsic perspectives. This study was conducted with a sample of 521 school psychologists as part of a larger study examining decision-making during SLD identification. Using confirmatory factor analyses (CFA) to compare two theoretically plausible models, results suggested that a single latent factor best captured variability in responses to these prompts. Implications for assessing beliefs and how they impact the psychoeducational assessment process to identify SLDs are discussed, along with areas for future research.

Mental health services use among learning disabilities: data from a population-based study.

PURPOSE: People with learning disabilities have complex challenges and needs that differ from people without these conditions. Accessing needed health and mental health care may be affected by level of independence and severity of learning challenges. Our study examined factors and associations which impact help seeking and satisfaction with mental health care in a Canadian nationally representative sample. METHODS: Logistic regression and multinomial logistic regression was used to analyze the 2012 Canadian Community Health Survey- Mental Health (CCHS 2012) cross-sectional survey. We investigated the odds of distressed individuals (1) perceiving a need for mental health care, (2) seeking out professional mental health care, and (3) if their needs were met by mental health services. The presence of a learning disability was assessed as a moderator variable in all models. RESULTS: Distressed adults with learning disabilities did not perceive a need for mental health care as often as distressed adults without a learning disability (OR = 3.82;95%CI:1.64,8.93 vs. OR = 12.00;95%CI:9.19,15.67). Distressed adults with a learning disability weren't as likely to seek out mental health services, but were more satisfied with the mental health care they received as compared to adults without a learning disability. CONCLUSION: The findings suggest that adults with learning disabilities have unmet needs. They are less likely to perceive a need for treatment, or to seek treatment, when they are distressed. Future investigation is necessary to understand the factors that influence perceived need and treatment seeking in this under-served population.

Learning disability awareness training for undergraduate midwifery students: Multi-method evaluation of a co-produced and co-delivered educational intervention in England.

BACKGROUND: Midwives lack the confidence and competence to identify and support people with learning disabilities, putting this population at risk of inequitable maternity care. OBJECTIVES: To co-produce, co-deliver and evaluate maternity focused learning disability awareness training for student midwives, in collaboration with experts-by-experience (people with learning disabilities). DESIGN: Multi-methods study evaluating the impact and acceptability of learning disability awareness training. SETTINGS: University in south-east England, UK. PARTICIPANTS: 83 midwifery students and 7 experts-by-experience. METHODS: Midwifery students completed pre-post training surveys and a follow-up survey 3 months post training to substantiate longer-term impact. Experts-by-experience took part in qualitative interviews post training. RESULTS: Student-reported learning disability awareness was significantly higher across all domains post training and sustained at follow up. Students reported the most notable aspect of training was learning with and from people with learning disabilities. Three inter-related themes were constructed from interviews with experts-by-experience: reasonable adjustments to training and research processes; a positive social, emotional and learning experience; and perceptions of impact. CONCLUSIONS: Findings from this study suggest that co-producing and co-delivering resources and education to an undergraduate midwifery workforce with people with lived experience, can have a profound impact on students and is also a positive experience for people with learning disabilities. The co-produced resources used in this training are free and accessible [https://www.surrey.ac.uk/togetherproject]. Further evaluation will explore acceptability and perceived impact of training and resources on other healthcare professionals working with maternity services.

Arithmetic fluency and number processing skills in identifying students with mathematical learning disabilities.

BACKGROUND: Students with mathematical learning disabilities (MLD) struggle with number processing skills (e.g., enumeration and number comparison) and arithmetic fluency. Traditionally, MLD is identified based on arithmetic fluency. However, number processing skills are suggested to differentiate low achievement (LA) from MLD. AIMS: This study investigated the accuracy of number processing skills in identifying students with MLD and LA, based on arithmetic fluency, and whether the classification ability of number processing skills varied as a function of grade level. METHODS AND PROCEDURES: The participants were 18,405 students (girls = 9080) from Grades 3-9 (ages 9-15). Students' basic numerical skills were assessed with an online dyscalculia screener (Functional Numeracy Assessment -Dyscalculia Battery, FUNA-DB), which included number processing and arithmetic fluency as two factors. OUTCOMES AND RESULTS: Confirmatory factor analyses supported a two-factor structure of FUNA-DB. The two-factor structure was invariant across language groups, gender, and grade levels. Receiver operating characteristics curve analyses indicated that number processing skills are a fair classifier of MLD and LA status across grade levels. The classification accuracy of number processing skills was better when predicting MLD (cut-off < 5 %) compared to LA (cut-off < 25 %). CONCLUSIONS AND IMPLICATIONS: Results highlight the need to measure both number processing and arithmetic fluency when identifying students with MLD.

Improving support and planning ahead for older people with learning disabilities and family carers: a mixed-methods study.

Background: People with learning disabilities are living longer. Despite government policy to encourage people to lead supported lives in their community, family carers often maintain support due to dissatisfaction with services. This can lead to people moving from the family home in a crisis. Objectives: (1) Find out what is known about health needs and resources for older people with learning disabilities (aged ≥ 40 years); (2) identify exemplars of good services for older people with learning disabilities; (3) explore service exemplars through ethnographic case studies; (4) evaluate support for older people with learning disabilities and their families through co-producing and testing future planning tools and (5) co-produce recommendations and resources. Design and methods: Work package 1 rapid scoping reviews - three reviews focused on the health and social care needs of older people with learning disabilities and 'behaviours that challenge others', and family carers, and the co-ordination of support for this group. Work package 2 scoping and mapping exemplars of good practice - analysis of published service standards to assess excellence criteria, by mapping services, interviews (n = 30), survey (n = 9) and informal discussion with commissioners. Work package 3 ethnography of case studies of exemplar provision; independent supported living (n = 4); residential/nursing home (n = 2); day activities (n = 1), Shared Lives (n = 2). Fieldwork (20 days per model), interviews (n = 77) with older people with learning disabilities, family carers, support staff and commissioners. Work package 4 - co-producing and testing resources for older people with learning disabilities and their families involved interviews and focus groups with 36 people with learning disabilities, parents, and siblings, and experience-based co-design with 11 participants. Eight families evaluated the resources. Work package 5 - three stakeholder workshops co-produced service recommendations. Findings: The reviews confirmed an inadequate evidence base concerning the experiences and support of family carers and older people with learning disabilities and 'behaviours that challenge others'. Criteria of excellence were produced, and a shortlist of 15 services was identified for consideration in work package 3. The ethnographic work found that environmental, organisational and social factors were important, including supporting independence and choice about who people live with, matching staff to people, consistent relationships and adapting to ageing. Practices of institutionalisation were observed. In work package 4, we found that families were worried about the future and unsupported to explore options. 'Planning Ahead' cards and a booklet to record discussions were produced, and the evaluation was positively rated. Finally, formative discussion informed recommendations. Outputs include training packages, a carers' forum, a film, a podcast and academic papers. Conclusions: There is little focus on older people with learning disabilities and family carers. Services vary in their approach to planning for older-age support. Families are unsupported to plan, leaving people without choice. 'Behaviours that challenge others' was found to be unhelpful terminology. Recommendations: A new strategy is recommended for older people with learning disabilities and family carers that encompasses commissioning practices, professional input and peer learning, proactive support in ageing well and excellent service design. Limitations: The COVID-19 pandemic created recruitment challenges. Reliance on providers for recruitment resulted in a lack of diversity in work package 3. Families' plans, and therefore change, may be frustrated by insufficient service resources. Future work: Given the lack of focus in this area, there is a range of future work to consider: experiences of older people with learning disabilities from diverse ethnic backgrounds; supporting people to age and die 'in place'; best practice regarding designing/commissioning services, including housing; the role of social workers; access to nature; accessing mainstream support; and evaluation of the 'Planning Ahead' cards. Trial registration: This trial is registered as ISRCTN74264887. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129491) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 16. See the NIHR Funding and Awards website for further award information.

People with learning disabilities are living longer, but most live with their families, who are also getting older. This is because there are not enough suitable places for people with learning disabilities to live, and family carers worry that the person will not get the right support and have a good life. Our research aimed to improve support for people with learning disabilities and their family carers to plan ahead for a good life. We focused on people who are labelled with 'behaviours that challenge others'. We read what has been written about this area. We looked for and found examples of excellent support for older people with learning disabilities. Researchers and people with learning disabilities and family carers spent time hanging out with people where they live or spend their days to see what support they get. Then we had three meetings with everyone involved and discussed our research findings with people with learning disabilities, family carers, and professionals. We found that people can be supported to live good lives as they grow older. This can be living alone or with people they choose, and it means having staff they like and who like them and being supported to be active. However, we found that ageing of people with learning disabilities is often ignored, and some people were not living good lives. We also found that the label of 'behaviours that challenge others' is unhelpful. We worked with people with learning disabilities and family carers to make a set of cards with pictures and questions to help people plan ahead for a good life. We produced resources and made recommendations to create a new plan for older people with learning disabilities to support people to lead good lives. This is very important because there is a lack of attention to and support for people with learning disabilities as they age.