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Introduction
Life expectancy of people with learning disabilities is significantly lower than the general population by up to 26 years, with the leading causes of death being circulatory diseases, respiratory diseases and cancer (Public Health England, 2016). There is a higher prevalence of mental health issues in people with learning disabilities with 30–50% of adults presenting with one form of mental health difficulties (Dairo et al., 2016). People who experience mental health difficulties alongside a learning disability may receive psychotropic medications with potential metabolic side effects; and also be at a greater risk of an unhealthy lifestyle, which may lead to obesity, diabetes, hyperlipidaemia and, therefore, significantly poorer physical health and higher mortality (Pearce, 2017).
With overwhelming evidence for the role of physical activity in improving physical and mental health, multiple studies over the years have identified a lack of sufficient physical activity in both people with mental health difficulties and people with learning disabilities. In addition, physical activity may have a role to play in better symptom management as well as improving health-related quality of life and social inclusion in this group (Hallawell et al., 2012; White et al., 2017; Toscano et al., 2018).
Lack of sufficient levels of physical activity in people with learning disabilities is widely recognised as a priority (Davies, 2013; Public Health England, 2016; Dairo et al., 2016). However, it is important to increase the frequency and intensity of physical activities appropriate to the individual’s current health condition and their abilities. This requires assessing the current level of physical activities (Public Health England, 2018). This is where using standard, reliable and structured scales come to play an important role.
The current approach to assessing levels of physical activity in general population is primarily based on self-administered questionnaires which are designed and validated for people without learning disabilities. People with learning disabilities may frequently present with significant challenges in communication, regardless of their level of learning disability (Goldbart et al., 2010; Mencap, 2019). As such, an unadapted self-administered verbally communicated questionnaire can prove difficult and unreliable in this group. There is evidence for the effectiveness of picture and symbol-based communication in people with learning disabilities, for both the receptive and expressive exchange of information (Ganz et...