Guide to making information accessible for people with a learning disability

There are different ways to make information accessible to people with a learning disability. The best way to find out the preferred format is to ask the person or the people who will be the audience.

Easy-read is information which is written using simple words supported by images. Easy-read aims to be easier to understand than standard documents, mainly for people with a learning disability. It can also be useful for other people too, for example people with low literacy levels and/or English as a second language, people who have had a stroke or people with dementia. The images used to create easy-read documents vary, for example photographs, drawings or symbols. Different people are used to different styles of easy-read, in different sectors and use of different easy-read providers across the country.

Pros:

• Easy-read will help some people to read information independently
• Easy-read can help people to remember information from conversation
• The images should support people to understand the text

Cons:

• Some people cannot read
• Does not replace conversation and some people will need support to read the document
• Can be produced badly; it’s important to test your easy-read document with your target audience to make sure it’s accessible
• Some people find the pictures distracting
• Lots of different styles to choose from; need to decide on the best approach for your audience.

This is the basis for easy-read. Not everyone with a learning disability wants easy-read. For example, some autistic people might find images distracting. It is similar to ‘plain English’, but uses simpler and shorter words and sentences.

Pros:

• Quicker to produce than easy-read
• Helps you think about the key messages.

Cons:

• Not everyone can read
• Does not replace conversation and some people will need support to read the document
• Not accessible to everyone; have to ask whether someone needs images
• Need to consider presentation to make sure the document is appealing.

Video can be a good alternative to an easy-read document. A video is accessible to most people if it has closed captions or subtitles, not just people with a learning disability. It is quick, easy and cost effective to film a short video –it can be done on most smartphones.

Pros:

• Useful for groups to watch together and discuss the information
• People can watch on their own; can be entertaining as well as informative

Cons:

• Many people with a learning disability do not have a computer or have poor access to the internet.

An audio recording of information is another alternative to a document. This could be a podcast or MP3 file that is available online for people to listen to, or a recording onto a CD or cassette tape. Where the information is just for an individual, it can even be a voice recording onto someone’s smartphone.

Pros:

• Audio can be good for people who do not read
• People can rewind and repeat information that they missed or did not understand
• Can be very quick and cheap to produce.

Cons:

• People might need support to download or play audio formats
• Many people with a learning disability do not have a computer or have poor access to the internet, so they cannot download or listen to files on a website.

Meeting with someone means that people can ask and respond to questions, and you can check understanding. This could be one to one if the topic is just relevant to one person, or it could be a workshop or focus group if it is for a few people. You could ask a local self-advocacy group to help you run the workshop. You should be very clear about why you are holding a workshop or focus group-whether you are sharing information or want people’s ideas.

Pros:

• You can check people’s understanding and repeat or rephrase things as necessary.

Cons:

It is good to have some information to take away and refer to.

Social media such as Facebook and Twitter can be a good way of sharing your message. Some people with a learning disability use Facebook. Lots of supporting organisations and carers use Facebook and Twitter. You can share links, videos, easy-read documents, use pictures and infographics.

Pros:

• Good tool to help share your message–especially with groups
• Quick and cheap way of sharing information.

Cons:

• Lots of people with a learning disability are not on social media
• Limited space for information
• Information can be taken out of context
• There can be misunderstandings and disagreements on social media.

Some people require tailored communication methods, if their communication requirements are more complex. These are called augmented and alternative communication (AAC). The Royal College of Speech and Language Therapists have resources which can help.

Pros:

• Useful for working one to one with people who would not understand other communication methods.

Cons:

• If you’re not used to these different communication methods, you will need support to use them.

Making accessible information takes time. For published documents, you should aim to publish it at the same time as your ‘standard’ document. If your easy-read is for a meeting, make sure it is given to participants in good time to help them prepare. This should be at least two weeks before the meeting (unless agreed with participants).

It depends what format you choose and the provider you use as to how long production will take. A long document with bespoke images could take up to six weeks for the supplier to produce. Part of this is having enough time to test the information and make changes if needed.

There are guides on easy-read which have been co-produced with people who have a learning disability, from which these guidelines have been produced with gratitude (Appendix). Many of these principles can also be applied to producing the other types of accessible formats outlined above.

The first steps to producing accessible information for people with a learning disability is to clarify and simplify the message-

1. Identify the main messages of interest to people with a learning disability.
2. Remove information that doesn’t help to explain the most important messages.
3. Re-write the main messages in simple English
4. If the standard version is a very long document, consider publishing more than one accessible version with different focuses. Too much information can overwhelm people
5. Remove or explain jargon and acronyms
6. Test the simplified text with people with a learning disability. This could be people who work on your project or ask an external group to do this.

The purpose of easy-read is clarity of information; there should be enough information to empower someone, not too much so that it is confusing. The accessible version should be significantly shorter than the standard document.

For documents that will not be published you can create your own easy-read versions. NHS England often uses Photosymbols to add pictures. Photosymbols is a bank of images which you can insert into the text document to illustrate the simplified text. Check with people with a learning disability that the images support the text.

Do not download photographs from the internet for use in easy-read. These will not have been tested by people with a learning disability and there may be licencing issues.

For documents which will be externally published, you will need to work with an external supplier. Alternatively, you could establish your own coproduction group to work with you to develop the document. It is essential that people with a learning disability are involved in production. There are many different easy-read providers. Each provider produces easy-read differently. Things to consider:

If you have a complicated issue you want to explain you may need bespoke images to explain the text. You also need to consider if you want drawings or photos. Providers specialise in either making easy-read using drawings or photos. Your audience will often have a preference.

There are different ways people with a learning disability can be involved in producing easy-read. Different providers will involve people at different stages in the process.

• Co-producing the whole document
• Testing the text
• Quality checking the final easy-read document.

It is better if people are more involved throughout and paid for their work and expertise, rather than used as volunteers.

Simple English

Here are guidelines to keeping the text for your easy-read information in simple English:

• Make sure that the information appears in a logical order.
• Write as though you are speaking.
• Keep your sentences short and to the point. About 15 words is good.
• Avoid using difficult words, jargon, abbreviations or acronyms if you do not explain them.
• If you need to use technical terms throughout the document include a glossary or ‘list of useful words’ where you explain the meaning of each word, rather than repeatedly explaining the concept. For example, using ‘Personal Independence Payment’ and including a glossary definition such as ‘money that is given to people to pay for things that they need to be able to live independently’.
• Use simple punctuation, for example question marks, exclamation marks, commas and full stops. Avoid using colons, semi colons, dashes and brackets.
• Do not use too many commas. It is often better to split a sentence into two rather than use a comma. If you are using commas because your sentence has a list, it might be better to use bullet points.
• Use active and personal language for example ‘I’, ‘you’ and ‘we’. If you use ‘we’ you should be explicit about who ‘we’ means. For example, “When this document says ‘we’ it means NHS England”. It makes the document direct and easy to understand.
• Avoid using percentages and fractions. Say ‘few’ instead of ‘7%’. Say ‘most people’ rather than ‘3,409 out of 4,001 people’.
• Use numerals instead of words. For example, ‘3’ instead of ‘three’.

In addition to keeping the language in simple English, here are some guidelines on how to make the language and content easy to read:

• Write in facts. Do not write using abstract language like metaphors. Metaphors could be misunderstood by some readers.
• Be simple and direct.
• Have one idea or action per sentence.
• Be consistent with use of language. Keep using the same word throughout the document. For example, if you use the word ‘doctor’ use that word throughout, do not alternate between ‘doctor’ and ‘GP’.
• Making it clear whether the document is just for information, or whether an action is needed.
• A document is not ‘easy-read’ if it is too long. One guideline is that it should be no more than 22 pages although shorter documents are more accessible. One idea is to split larger documents up into smaller chunks.
• For long documents include a contents page.
• Test the language and content with your target audience.

Here are some guidelines on how to make the layout and design of your document accessible:

• Use photos, drawings or symbols to support the text.
• Ensure that the images used match the text.
• It is conventional to have the images on the left.
• Use large print, 14-point minimum. People with a learning disability have a higher incidence of undiagnosed sight problems than the rest of the population.
• Use a clear, uncluttered, ‘sans serif’ font, such as Arial.
• Do not use italics, underlining and CAPITALS as they change the shape of the written word making it harder for some people to read. You could use bold to highlight important words but remember that some people may not notice that text is in bold.
• Start and finish a sentence on the same page.
• Do not split a word across two lines with a hyphen. Start a new line for a new word. To some people a new line might signify a new idea, so it is best if one sentence fits on the same line.
• Print the document on good quality paper so that the images and text on the reverse side do not show through.
• Using colour: black text on white or yellow background is generally best unless a person specifically wants a different colour.
• Don’t squeeze too many words onto a page. Some white space helps readability.

Helpful resources

This is a list of resources which can help you develop easy-read:

• How to make information accessible
• Department of Health. Making written information easier to understand for people with learning disabilities
• European standards for making information easy to read and understand
• Am I making myself clear?
• NHS England The Accessible Information Standard
• People First. Easy-read Standards
• The plain English campaign.

How do you feel about strategic planning? Does it conjure images of endless meetings, unreadable jargon filled documents left on a shelf and never used? Many small organisations operate from project to project and evolve their planning as they go. It can be useful to pause and reflect on what you’ve achieved, and what you would like to do in the future, and why. This is the essence of a strategic plan.

Strategic planning is about making decisions about how you as an organisation define your goals and about how you navigate your organisational path to that destination. It helps you make decisions about what you do and don’t do, and how you do it. It helps you to target your resources more effectively and more sustainably and helps you to know when you’ve achieved your goals and how you exit in the best way for the communities you work with.

At Hub Cymru Africa we can support you with this process through our enhanced development support programme. You can contact us at advice@hubcymruafrica.wales and we can work through this process with you and your partner(s).

You can also use the following resources to find out more about strategic planning and to work through this process, as an organisation and partnership, considering power dynamics and using an anti-racist approach.