On this downloadable sheet you can fill in someone’s current ‘framework of knowledge’, describing a singular chunk of knowledge in each empty box. You can also describe the chunks of knowledge that need to be added.

Use the tool for:


You could either device your own scenarios, or print out the Training Scenario (based on the examples of Jeremy and Christina link to Examples page). Students can be encouraged to imagine and discuss someone’s current ‘framework of knowledge’ as well as which knowledge chunks should be added, when, how and by whom. This exercise can be particularly useful for helping students to focus on the perspectives and experiences of the person with intellectual disabilities him/herself.

Your practice

By filling out the sheet for someone with intellectual disabilities you support, the bad news situation (and how the person can cope with this) may become clearer. It will be helpful to discuss this with as many people involved in the situation as possible.

Click here for downloadable tool

Click here for Training Scenario

Dr Irene Tuffrey-Wijne is hoping to develop this work further. She welcomes feedback on any training or practice based on the Breaking Bad News guidelines. Please email her with comments or suggestions.

Helping teams in intellectual disability services talk about death and dying

Communicating about illness, death, dying and bereavement is difficult in general, not just in relation to people with intellectual disabilities. Many people working in intellectual disability services have hardly ever talked about death and dying with colleagues, friends and family – let alone with people with intellectual disabilities.

This guidance is designed to help get “death conversations” going. Talking to colleagues and peers first will help staff feel more comfortable in communicating about death and loss with the people they support. The guidance provides ideas for discussion topics in team meetings or staff training events.

Click here for guidance document