Expressive touch in health and social care: A review of touch guidance to explore the extent to which social and communication needs of adults with learning disabilities are considered

Abstract

Background

People with a learning disability can present with complex physical and social needs, and sometimes rely on touch for communication. Historically, touch-related staff guidance has been described as risk-averse, lacking an evidence base, control-orientated and potentially harmful. This project reviews local touch-related guidance from adult learning disability services, exploring the extent to which they consider the social and communication needs of service users.

Methods

Five touch-related guidance documents were analysed using a summative content analysis. Counts of relevant search terms were analysed quantitatively. Extracts containing the search terms were then analysed qualitatively, to explore their context.

Findings

Considerable variation was noted between the guidance documents. All the documents discuss communication within the context of touch, although to varying extents. The analysis highlighted a focus on safety and risk within most documents, however, some documents also demonstrated encouragement of positive risk management and the safe use of touch.

Conclusions

While this study has identified several positive aspects of the guidance documents, these helpful recommendations and arguments appear inconsistently within individual documents. Services should work towards developing guidance that consistently considers practical steps to reduce risk and facilitate the safe and effective use of expressive touch cross-service. Further research into current practice relating to expressive touch is indicated.