Communication is vitally important in so much we do as clinicians.  Without good communication we can’t hope to get a decent history, properly examine our patient, explain what we think is going on or ensure appropriate management. People with learning disabilities, autism and other additional needs often have difficulties with communication.  Adults and children (from 4 years old) with learning disabilities are three times more likely to die from something which should be amenable to treatment, compared to those without a learning disability. Of course there are many reasons for this, including comorbidities, recognition of illness, access to healthcare and so on, but communication challenges have a huge role to play.  It’s not just a challenge for the patient though, but also a challenge which we, as clinicians, must do our best to overcome.  We think nothing of getting an interpreter to help us communicate with people who speak a different language to us.  Shouldn’t we be thinking about communication with people with additional needs in the same way?