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Through conversations with members of a parent-run support organization, mixed concerns were identified about the accessibility of general National Health Service (NHS) services for children with disabilities. A questionnaire, aimed at uncovering the main issues related to general health services for children with disabilities was designed with representatives from the parent-run support organization. The questionnaire was administered as part of a semi-structured interview with 25 parents of children with disabilities (mainly learning disabilities). Eight themes were reported 'preparation', 'flexibility', 'parking', 'physical space', 'waiting areas and consultation rooms', 'health professionals' understanding and knowledge of disabilities, particularly around communication', 'on the wards' and 'overseeing care'. Themes are presented with parents' useful comments and suggestions. As the themes are wide ranging it is suggested that the research be repeated, focusing in on particular areas of general NHS services.

Accessible summary• This report describes how abdominal massage was provided to five children, to see if it would help with their constipation. • Children and adults with learning disabilities often have long-term constipation that is treated with laxatives. • The abdominal massage was not effective for all the children.• However the parents enjoyed doing the massage and all thought that it was a helpful and enjoyable experience for them and their children. SummaryChronic constipation is a common problem in people with learning disabilities. Treatment often involves dietary changes or long-term laxative use. The aim of this study was to examine the effectiveness of abdominal massage. The participants were five children with profound learning disabilities and additional physical difficulties. Their long-standing idiopathic constipation was managed by laxatives. Intervention lasted up to 35 weeks, during which participants received 20 min of massage at least twice daily. Parents were asked to maintain stable use of laxatives during the intervention phase, although some chose to withdraw laxatives during abdominal massage intervention. Abdominal massage appeared to result in stools of a more 'normal' consistency in some cases. However, no significant differences were found in stool frequency. Parents reported that abdominal massage was a positive experience. In addition, they believed that massage was an effective treatment for constipation. As a result, laxative use was reduced in some cases, apparently with no ill-effects. These subjective beliefs were not, however, generally borne out by the objective results.

Befriending (BF) has received attention as a beneficial part of mental health care. For example, when compared with cognitive-behavioural therapy (CBT) for schizophrenia, BF was found to be as effective as CBT in terms of initial symptom improvement (Sensky et al., 2000). Why was the BF apparently so effective? Was the BF really a discrete and powerful intervention? Or was it simply an unrecognized aspect of regular CBT? We addressed these questions by first observing BF's convergence with "social support" (a plausibly discrete treatment) and, second, by examining its divergence from CBT, drawing on archival data. For the convergence prediction we correlated the speech content of therapists' in 10 BF sessions from the Sensky et al. study with previously published social support data from stylists working with people with severe mental health problems in a psychiatric hospital (Milne and Netherwood, 1997). For the second prediction the same 10 BF sessions were compared with a sample of 10 CBT sessions, also from the Sensky et al. study. The results indicated that BF was indeed significantly correlated (converged) with social support (r = 0.7; p < .05), and also that it did differ (diverged) significantly from CBT (p < .05). As a treatment fidelity check, therefore, these findings indicate tentatively that the two treatments in the Sensky et al. (2000) study were appropriately implemented. As an analysis of effective interventions for schizophrenia, it cautiously suggests that "social support" merits serious attention, and is perhaps no mere placebo.

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