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Introduction: Person-centred approaches and service user involvement are integral to occupational therapy, but evidence is lacking about how occupational therapists working in the field of learning disabilities gather feedback from service users. Method: This research aimed to explore how members of the College of Occupational Therapists Specialist Section — People with Learning Disabilities gathered feedback from their service users. Questionnaires were completed by 70 occupational therapists and 12 of them participated in semi-structured interviews. Findings: The occupational therapists were passionate about service user feedback, but they were likely to use informal methods rather than established methods with a more robust evidence base. Despite research indicating greater potential for bias when asking people with learning disabilities for feedback, almost half the participants did not take measures to reduce this. The interviews suggest that this is due to service pressures, lack of confidence and the complexity of service users' needs. Conclusion: Occupational therapists need to do more to gain feedback from people with learning disabilities. Further research is required to establish the most effective way of doing this.

Over several years, there has been much debate about the best way to manage challenging behaviour. Although national guidance highlights the importance of meaningful occupation, it is unclear to what extent this helps. This systematic review of the literature aimed to answer the question, 'does engagement in meaningful occupation reduce challenging behaviour in people with intellectual disability?' By searching a range of databases, electronic resources and web pages, 13 relevant articles were identified. Additionally, experts in the field were contacted, hand searches were performed and citation searches were carried out. These 13 articles were critically appraised and analysed using narrative synthesis. Although the amount of research identified was limited and the methodological quality was variable, some broad themes arose. A skilled and structured approach for carrying out occupation may be effective in reducing challenging behaviour; however, more robust research is needed before definitive conclusions can be drawn.