This image appears courtesy of CHANGE.
Easy Read is one way of making information more accessible to people with learning disabilities. It is about making information easier to understand using simple words and pictures. It is not a simple translation of existing information materials into easier to understand language. Easy Read versions should concentrate on the main points so that people with learning disabilities can understand the main issues and make decisions if necessary.
Easy Read is also a useful format for other groups of people. When tested with people for whom English is a second language, it is found to be a useful way of explaining complex information. This includes British Sign Language users and black and minority ethnic communities. However, you cannot assume that Easy Read is always the preferred format for these groups; user testing will show you whether easy read information meets the needs of other groups.
In the 2001 white paper on learning disability ‘Valuing People’, the government estimated that there are roughly 1.4 million people with a learning disability in England. This figure comprised of approximately 1.2 million people with a mild or moderate learning disability and 210,000 with a severe or profound learning disability. About 18,000 adults with learning disabilities are currently known to Local Authorities in Scotland, 14,800 people with learning disabilities are registered in Wales and 8,700 in Northern Ireland.
People with a learning disability often experience poorer health and poorer healthcare than the general population. Learning disabilities are many and varied and can affect the individual in a very different ways. It’s also common for people with learning disabilities to have physical health problems, communication or sensory difficulties. All of these can affect information needs.
Many people with learning disabilities struggle to access and retain information whether it is given verbally or in written form particularly if there are too many words, references to jargon, statistics and unfamiliar concepts being presented. 20% of people with learning disabilities also have some degree of visual impairment which can also affect their ability to read written information and see images that are unclear or too small. Whether information is being given verbally or in written form it should be simply explained, to the point and supported with relevant images. Ideally information is best given verbally using good quality illustrated supporting materials that can be used to encourage people to identify with and understand issues being discussed, ask questions and later be able to remember and think about the things they have been told.
If people with learning disabilities do not have access to accessible information they are denied their right to make choices, and in some cases life and death decisions about their own health care. For want of support in understanding issues, some people with learning disabilities are deemed to lack the capacity to make decisions. As such they can be denied the chance to undergo life-saving treatments.
Under UK law, public sector organisations have specific requirements to provide accessible information for disabled people, including those with learning disabilities:
- The Disability Discrimination Act (1995) says all service providers must make reasonable adjustments to ensure disabled people can access services
- The Disability Equality Duty (part of the Disability Discrimination Act 2005) says public services must actively promote equality of opportunity for disabled people and eliminate discrimination
- The majority of the provisions in the Equality Act came into effect in October 2010, replacing the Disability Discrimination Act 1995.
CHANGE is an organisation that produces information for people with learning disabilities. They develop materials using emancipatory research led by people with learning disabilities. CHANGE has 20 years of experience working and employing people with learning disabilities to research and develop accessible information and resources covering issues that affect every aspect of our lives, including health. If information is presented in formats that support understanding no topic is too difficult to discuss even if it is about abuse or dying. The important thing is that people get the information they need to be safe and have the same rights in life and death as everyone else.
Accessible information can take many forms, whether it be written in easy words and pictures, audio visual presentations or web based. The key to ensuring that accessible information effectively conveys information lies in the involvement of people with learning disabilities in its development. That is why CHANGE is committed to employing staff with learning disabilities to develop resources and advise the accessible information design team on all commissioned services. You can see their portfolio of work here.
CHANGE also provides ‘Better Communication’ training delivered by trainers with learning disabilities to any organisation wishing to make their services and information more accessible.
- Think carefully about what information you make accessible. Does it cover the things that people really need to know, the things that affect them directly.
- Ask people with learning disabilities what things they feel they need to know more about.
- Get to the point with as little preamble as possible.
- Remove all jargon and support any words with appropriate images. In the case of medical terms which are likely to be used it is better to use the word, along with an explanation of what it means. (See sample left). Change provides a free guide ‘How to Make Information Accessible’
- Give information in bite size chunks. Whether it is written or given verbally too much information at once can be confusing. Also it is important that people are not rushed and encouraged to ask questions if confused. Ask people if they would like you to go over information again. Before moving on to new things, check that people remember what has already been discussed.
- As with any translation, whether into another language or into illustrated form, it is really important that the images are used accurately to support the written words. For people who cannot read well, images are an important cue to what words might be saying. Whether you use photos, symbols or line images it is vital that they depict what the words mean as fully and correctly as possible. Just like a sentence a supporting image should contain nouns, adjectives and verbs where appropriate. Too often a sentence is only supported by a depiction of the subject and there is no indication of what they are doing. So, for example, the image above without the baby in it would be of a doctor only and we would have no clue as to what that doctor might do.
- When you have images that accurately illustrate the words they support it is important to think about how they will appear in print. Like writing if they are too small they will be unclear. If you are using a photograph or coloured image it is important to think about contrast; if there is not enough contrast important details will be missed. Remember that the majority of information ends up being printed out in black and white – are images still clear?
- Remember that people are adults. If information is presented in childish formats many adults with learning disabilities will be put off using it . Most adults with learning disabilities will have experienced all kinds of prejudice from childhood and may be reluctant to tell you that they have difficulty reading. Everyone goes to the doctor at some point therefore doctors are the front line when it comes to identifying people with learning disabilities who have slipped the social care net and have never had their information needs identified. Be proactive and support people to know that it is OK to ask for information in different formats. The important thing is that health messages are understood.
- Don’t forget to update information that has been produced in easy read formats. Make sure you include it in your general information reviews.
- And finally… it is important to remember that no resource can adequately replace face to face discussions with people who have learning disabilities. Resources should be seen as a way of supporting professionals to explain things in an accessible way and people with learning disabilities to focus on what they are being told. You may then ask is it worth making information accessible? The answer would be, if this page disappeared how much of this information could you remember? Most of us take it for granted that we can make notes to help us remember things. If you can’t take notes accessible information is an aid memoir that supports people to revisit things at their own pace. Whether or not you have a learning disability, if you are unwell and being given lots of information about serious life changing conditions any consultation can pass in a bit of a blur. Being able to recap and look at information that is easy to take in is reassuring and will support people to be able to engage better with their doctors asking questions about the things that worry them.
Acknowledgement: Karen Harris, CHANGE
Page last updated: 27/11/12
 Making written information easier to understand for people with learning disabilities: Guidance for people who commission or produce Easy Read information. Department of Health 2010
 Department for Work and Pensions, 2009, ‘Provision of Accessible Information for Disabled and Ethnic Minority Groups’, unpublished
[iii] Health Needs Assessment Report PEOPLE WITH LEARNING DISABILITIES IN SCOTLAND. NHS Scotland 2004
[iv] Local Authority Registers of People with Disabilities, 2010. Welsh Government, http://wales.gov.uk/topics/statistics/headlines/health2010/1010271/?lang=en
[v] Northern Ireland Statistics and Research Agency http://www.nisra.gov.uk