Assessing clinicians' consultation with people with profound learning disability: producing a rating scale.

This paper describes the development of a scale for assessing clinicians' communication with people with profound learning disability. Four psychiatrists and four nurses were assessed completing three simple non-invasive clinical procedures--blood pressure, pulse and axillary temperature--with people with profound learning disability. Videotaped assessment of consultations was performed by three experienced speech and language therapists using a previously designed scale for analysing encounters with people with mild learning disability. This led to the production of a new scale specifically for people with profound learning disability. A significant inter-rater reliability was found between the three speech therapists for total scores (rater a-b, corr = 0.654, P = 0.006; rater a-c, corr = 0.795, P = 0.0001: rater b-c, corr = 0.673, P = 0.004). Significant reliability between raters was also found for the subsections of verbal behaviour and non-verbal behaviour.