When it comes to supporting people with a learning disability to engage in activities of daily living and creating a space to help improve their health and wellbeing, a learning disability service in Camden is making positive moves. Naomi Burke explains.
Whether you’re young, old, or somewhere in between, you will most likely enjoy the DreamWorks film Madagascar, which features the song ‘I Like to Move it Move it’; watch the film, listen to the music, dance to the track!
This is not, however, a film review. Instead, I’d like to introduce you to a health initiative led by a working group of multidisciplinary professionals at the Camden Learning Disability Service that I was part of, and which was named after the song.
What’s this health initiative about?
The initiative approaches the issue of obesity for individuals with learning disabilities in a new, fun and affordable way, with far-reaching results. It has been described as genuinely life-changing for people, in a very real way.
It meets the core role of occupational therapy by supporting people with a learning disability to engage in activities of daily living, creating a space to help improve people’s health and wellbeing.
But its impact goes beyond that. On a personal and professional level, it has also helped me to meet a number of professional standards, by allowing me to work collaboratively, create personalised intervention plans and recommendations, and to keep accurate records of interventions.
How did it come about?
Individuals with learning disabilities often have to deal with poor physical and mental health issues, premature deaths and barriers to accessing health and social care (NHS England 2022). More often than not, learning disability is not the cause for these issues.
Compared with the general population, the issue of obesity is more prevalent among the learning disability community, particularly among women and those women living in community settings (LeDeR Programme 2019).
Obesity is defined as having a BMI of 30 or more, while being overweight is associated with people who have a BMI of over 25.
Generally, being overweight raises the risk of serious health problems, including diabetes, heart failure, stroke and overall quality of life (LeDeR Programme 2019; PHE 2020). However, many individuals with learning disabilities rely on others for their dietary intake and/or access to engagement in physical activities (LeDeR) Programme 2019).
People with a learning disability may also have mobility difficulties, which play a part in being able to engage in certain exercises. Additionally, they may have mental health or behavioural issues and have challenging finances (Halland House 2023).
As an occupational therapist I’m particularly interested in how people can optimally engage in activities of daily living. While activity doesn’t necessarily equate to exercise, most activities do nevertheless involve physical movements, therefore it is important for individuals to be supported in being able to do this (RCOT 2019).
Moreover, we know that engaging in regular activities of everyday life also helps individuals improve their wellbeing; people gain a sense of belonging and purpose, self-esteem and social connectedness, which in turn relieves stress and boredom, while improving concentration and memory (RCOT 2019).
With all of this in mind, I was delighted to join a multidisciplinary team to try and address some of these issues.
Setting up and inviting participants
Our health initiative’s title – ‘I Like to Move it Move it’ – says it all. It has rhythm, it has music, it has fun, it’s positive, it’s forward looking – it moves!
With our offices conveniently based above a Better Leisure Centre, we were able to rent gym-studio space for one morning a week for a period of eight weeks. Two designated gym instructors led a free, accessible, tailor-made exercise programme, for around 20 individuals with a learning disability. Some attended with their support-workers, but all received the support of our multidisciplinary team of a health facilitator, OTs, physiotherapists, nurses, speech and language assistant and health support workers.
We started by thinking about who would benefit most from these sessions. Our main focus was on people with a mild learning disability who are living with obesity or at risk of it. At the same time, we wanted to keep things flexible and welcoming, so we didn’t restrict participation only to those who fit that description.
We took steps, through leaflets, letters and word-of-mouth, to make sure that people with a learning disability, along with their support workers and families, really understood what the programme was about. We wanted them to feel clear on the goals, comfortable asking questions, and confident about what to expect and how to prepare.
For example, we created ‘easy-read’ resources explaining the programme and what people should wear and bring to the sessions. We also invited those our team already works with, who later signed up, to meet up before the start of the exercise sessions.
Staff were then able to learn more about the participants’ interests, including in music and exercise, to help everyone get to know one another and, going forward, to enable the instructors to incorporate these interests into the sessions.
I’ve noticed positive improvements in their confidence, motivation and their generally more positive outlook since starting as part of the group.”
Group activities such as this one can be used to provide opportunities for social interaction and the majority of participants told us they’d never been to an exercise class before.
Before the eight-week trial began, we asked participants, along with their carers, support workers, and healthcare staff, to share their views in a questionnaire. Hearing directly from them about behaviours and healthcare needs gave us the insight we needed to shape a programme that truly fit the people taking part.
Typical session structure
Having weekly weigh-ins, in a confidential setting, and writing this down for each individual in a logbook helped people to monitor their respective progress, while staff made a weekly telephone call to participants and their family or carers to enable better attendance.
Each session was different; we alternated dance, boxing, cycling, functional bar and chair exercises, splitting off occasionally into smaller groups to allow for an even more personalised approach.
At the end of each session, prior to us recording notes for each participant, people gathered to reflect on the session and to take part in some learning on healthy eating. They each also made a personal commitment for the following week, to try and consider healthy lifestyle changes.
Challenges and feedback
Of course, we faced challenges along the way. Sometimes it was about finding the right level for the exercises, and other times it was about supporting people through social or emotional difficulties and keeping everyone engaged.
By holding regular staff meetings, and talking directly with participants, we were able to spot these issues early on and make adjustments as necessary.
Drawing on Kaplan’s work (1988), I was reminded that activities can be adapted in many ways: by adjusting their complexity, introducing something more or less familiar, or shifting how predictable they are.
This gave me a framework for giving feedback after the session, and suggesting ways to adapt the programme. For example, instead of moving on quickly to harder exercises, I recommended repeating and simplifying some of the moves, so they were more manageable and inclusive.
Every single participant voted that they wanted the ‘I Like to Move It Move It’ health initiative to carry on – and we share that hope that it will indeed continue, provided that the required funding is available and that we continue to learn and make improvements.
We also plan to look at arranging for participants to get together with staff support to attend sessions relating to healthy lifestyle issues.
The feedback we received about how the health initiative affected the participants was overwhelmingly positive – it was truly humbling to hear.
I want to end by quoting one of the psychologists who was working with a participant, who told us: ‘I’ve noticed positive improvements in their confidence, motivation and their generally more positive outlook since starting as part of the group. They are both happy with the progress made, in terms of weight and fitness, and proud of themselves for attending and staying engaged.
‘Given their background of repeated disengagements from activities, this is a huge step. Their healthcare support team has been very explicit that the positive and consistent support they are receiving from the facilitators is what’s made them feel comfortable to continue attending. Overall, a very positive impact on them.’
And so, with that, let all of us move it, move it!
Halland House (2023) The role of exercise for people with learning disabilities. Available at
https://bit.ly/47loFbJ [accessed 2 September 2025].
Kaplan K (1988) Directive group therapy: innovative mental health treatment. Thorofare, NJ: Slack Inc.
Learning Disabilities Mortality Review (LeDeR) Programme (2019) Learning Disabilities Mortality Review (LeDeR) Programme Fact Sheet 28. Available at https://bit.ly/46DWbYT [accessed 2 September 2025].
RCOT (2019) Living well in care homes. Available at
https://bit.ly/422KAko [accessed 2 September 2025].
NHS England (2022) Learning from lives and deaths – people with a learning disability and autistic people (LeDeR). Available at
https://bit.ly/45L5gQd [accessed 2 September 2025].
Public Health England (2020) Obesity and weight management for people with learning disabilities: guidance. Available at https://bit.ly/4lUry6Q [accessed 2 September 2025].
Words NAOMI BURKE, Occupational Therapist, formerly working within Camden Learning Disability Service, as part of Band 5 rotations with the Whittington NHS Trust. Naomi has recently started a new position as a Band 6 Occupational Therapist in the Harringay Learning Disability Partnership Team