In this study, we are interested in assessing whether it is feasible for clinicians to deliver an adapted version of aDIALOG+ to service users with mild or moderate learning disability who have behaviours that challenge (such as self-injurious behaviour, physical or verbal aggression, anger / frustration outbursts, or damage to property). 

Our aim is to establish whether it is possible to recruit clinicians and service users into the study. We will also examine the number of sessions of aDIALOG+ that are delivered over 6 months, the quality of the sessions, and the experiences and views of clinicians, service users and participant carers (if applicable) about the intervention, what worked well and what needs to be improved.

Additionally, we will look at whether there are any potential benefits of the intervention by looking at changes in outcome measures such as behaviour, community participation, quality of life and service use.

What will happen?

For service users that agree to take part and provide consent, their clinician will administer the aDIALOG+ intervention using the app during a face-to-face session at least once a month over 6 months. The intervention will take about 30 minutes but it might take less time or more time depending on the needs of the person. Participant carers (if applicable) may be asked to support the service user to their appointments with the clinician and may be asked to help with implementing some of the actions. 

Service users will complete questionnaires at baseline and at 6 months, and clinicians and participant carers (if applicable) will also be asked to complete some questionnaires about themselves and the service user. After the 6-month period, some service users, clinicians and participant carers (if applicable) will be asked to share their views on the experience of using aDIALOG+ through participating in a focus group or interview, which will last about 30-45 minutes. We will obtain feedback on what aspects of the intervention (including the DIALOG scale, app, training and manual) worked well or did not work well, and suggestions for improvement. The interviews will be audio-recorded and analysed so that we can determine which aspects of the intervention need further modifications, which will inform changes to the intervention.

Who can take part?

Service users will be eligible to take part if they are aged 18 or over, have mild or moderate learning disability based on service records / clinical notes, have a current history of behaviour that challenges (at least one incident of of self-injurious behaviour, physical or verbal aggression, anger / frustration outbursts, or damage to property in the last 3 months), are living in any setting including the family home and supported living/ residential home, and can provide informed verbal or written consent.

Clinicians will be eligible to take part if they are aged 18 or over, are currently working within a community learning disability service, intensive support team or in a local authority or social care organisation for people with learning disability, are from any profession (e.g. psychology, nursing, speech and language therapy, psychiatry, social work) with a minimum of six months experience working with people with learning disability, and consent to participate. 

Participant carers will be eligible to take part if they are aged 18 or over, are paid or unpaid (e.g. family carer); if a paid carer, they will need to have worked with the person for at least six months and should know the person well and support the person on a regular basis, and consent to participate.

When is it running?

The clinical services feasibility study started in May 2026 and is expected to run for 12 months.