E D I T O R I A L

Dorothy Atkinson

In many senses, this issue of the journal is about choice: who

gets to choose, and on what basis? The ‘In Conversation’

piece takes us into a dialogue about Direct Payments for

people with learning disabilities. Direct Payments are

intended to enhance the independence and choice of people

who use services, and the White Paper, Valuing People,

supports their wider take-up in the learning disability field.

Whilst the two people in conversation with Andrew Holman

support the principle of greater choice, they raise some

concerns as to whether Direct Payments are the only means

of achieving this. Can everyone be informed well enough to

make choices? If not, who chooses?

The issue of choice is put into even more stark relief when

it comes to questions of ‘life itself’. In a fascinating and

topical paper on new genetics, Linda Ward, Joyce Howarth

and Jackie Rodgers (‘Difference and choice: exploring pre-

natal testing and the use of genetic information with people

with learning difficulties’) describe the approach they took to

enable people with learning disabilities not only to under-

stand the issues raised by developments in genetics, but to

contribute to the debate about ‘the kind of children who are

born and the kind of society in which we want to live’. Two

linked day workshops – where information was made acces-

sible and people were supported to talk through the issues –

were used as a preparation for people to take part in a major

national conference.

Interesting questions about choice are raised by Andy and

Helen Alaszewski in their paper, ‘Towards the creative

management of risk’. Although their focus is on how people

with learning disabilities, carers and professionals perceive

risk, there is an underlying issue about how much choice

people have to take risks. Their research illustrates the multi-

dimensional nature of risk, and the complexity of balancing

choices in everyday living against the perceived need to

manage the risks incurred.

Choice – or lack of it – is an issue in the paper by Frances

Reynolds, ‘An exploratory survey of opportunities and bar-

riers to creative leisure activity for people with learning

disabilities’. Her research examined access to creative leisure

activities, such as art, music, drama and dance. Whatever

people with learning disabilities might choose to do in their

spare time, the research showed that the barriers of lack of

money, support and transport, meant they were in effect

unable to pursue their creative interests outside specialist

settings.

What happens when people are unable to choose? The

final three papers in this issue address ways and means of

supporting people with learning disabilities in key areas of

their lives. Lisa Curtice and Linda Long describe the devel-

opment and use of a ‘health log’ by Sense Scotland. The

health log was designed to assist individuals with complex

communication difficulties to achieve improvements in their

health and well-being. The log is a hand-held record of an

individual’s health history and health-related behaviours,

and has been used successfully as a part of person-centred

planning.

‘Is it time to challenge the use of the term ‘‘challenging

behaviour’’?’ ask Susan Young and John Newland in their

paper on ‘Attention deficit hyperactivity disorder and mild

learning disabilities’. They argue that the term is now used as

an explanatory concept rather than its original use as a

descriptive term. As a result, it may be used to explain

behaviour that has other origins, for example post-traumatic

stress disorder.

The paper by Banat, Summers and Pring highlights the

importance of developing environments that are conducive

to good communication, where interactions between staff

and people with learning disabilities are of crucial impor-

tance. They report the difficulties that staff experienced in

judging the verbal comprehension of the people they were

working with – and how this made interactions difficult (and

pointed to the need for training).

Finally, in this issue, we include a bumper selection of

book reviews. Our strenuous efforts to reduce the backlog of

papers has meant a corresponding accumulation of reviews.

This and subsequent issues of the journal will attempt to

reduce both backlogs. We hope you enjoy the mix and the

diversity of this combination.

# 2002 BILD Publications, British Journal of Learning Disabilities, 30, 47 47