Nottinghamshire SLT’s ID & MH @Notts_ID_MH_SLT
NHS Speech & Language Therapy service supporting communication/ Dysphagia for those with Intellectual & Developmental Disabilities and/or Mental Health Needs. #Nottinghamshire Joined May 2020-
Tweets153
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Followers263
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Following88
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Likes254
We're shining a light on Lucie Aldrich, Speech and Language Therapist. She's made an outstanding difference in the lives of patients & colleagues. Her dedication to listening to others & her constant drive for service improvement reflect her deep commitment to enhancing care."
Swallowing Awareness Day highlights how speech and language therapists assist individuals with eating and swallowing challenges (#dysphagia). Eating, drinking & swallowing is usually effortless, but can present difficulties for some people #swallowaware2025 #dysphagia #slpeeps
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Thank you to everyone who attended our #AHPsDay celebration event today - so much to be proud of amongst our #AHPCommunity @NottsHealthcare . Thank you to all of our #AHPs and #AHPsupportWorkers across the Trust for the impact you have for our patients 🙌🏼 #inspirational
In today’s #AHPAppreciationAwards: ⭐️ The SLT Community AMH Team won the Social Injustice & Tackling Health Inequalities award! ⭐️ The Assistant SLT’s were nominated for team of the year! ⭐️ Members of our amazing CIDT were nominated for Quality & Improvement! @AHPsNottsHC
We had a great day today celebrating #AHPday2024! Thank you for having us!
We had a great day today celebrating #AHPday2024! Thank you for having us!
Huge thanks to my brilliant PhD supervisors @JudyClegg2 @SSpencerSALT and to everyone who contributed to the research project addressing paid carer communication partner intervention in ALD services. @AHPsNottsHC @dellamoney @HeidiHKeeling @SLTHuddsUni
Huge thanks to my brilliant PhD supervisors @JudyClegg2 @SSpencerSALT and to everyone who contributed to the research project addressing paid carer communication partner intervention in ALD services. @AHPsNottsHC @dellamoney @HeidiHKeeling @SLTHuddsUni
A sister in our A&E has spearheaded the launch of a network of learning disability champions to support patients. Rachelle McCarthy said: “I have a son with a learning disability and so I consider how he and his peers could struggle in a healthcare setting in a few years, if…
Well done Vicky! Such a well deserved nomination and🤞🏼 for the main event. #NottshcOSCARS
Well done Vicky! Such a well deserved nomination and🤞🏼 for the main event. #NottshcOSCARS
Vicky, Clinical Director IDD Services demonstrates leadership as a Speech & Language Therapist & as the 1st non-medical CD of Intellectual Disability & Developmental Disability svcs. Vicky champions the rights of people with IDD & autism across health & social care #NottshcOSCARS
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Happy #LearningDisabilityWeek and see below some examples of visual information created to support patients in general hospital 👇🏻🗣️ #MySLTday
Happy #LearningDisabilityWeek and see below some examples of visual information created to support patients in general hospital 👇🏻🗣️ #MySLTday
Proud of our colleagues shortlisted in the @LDAwards2024. This is for outstanding support for a patient with autism. Also the development of an easy read sex & relationships booklet to use with patients with an intellectual & developmental disability. orlo.uk/GVZdO
Typo or not, the job is a great opportunity to do some quality work with young learners who have a learning disability or who are autistic. It is all practical and hands on at @LandmarksSc
Typo or not, the job is a great opportunity to do some quality work with young learners who have a learning disability or who are autistic. It is all practical and hands on at @LandmarksSc
Thank you @HeidiHKeeling and all my colleagues at @Notts_ID_MH_SLT for being such an amazing supportive team. Going to miss working alongside you all!
People living with dementia often experience speech, language, communication, eating, drinking & swallowing difficulties so it's crucial they're able to access speech & language therapy to help reduce the impact of these difficulties #DementiaActionWeek

Nottinghamshire Healt... @NottsHealthcare
11K Followers 2K Following We're Nottinghamshire Healthcare, a major provider of intellectual disability, mental health, community health, forensic & offender healthcare services.
Rampton Hospital SLT ... @RamptonSlt
838 Followers 470 Following SLT inpatient services for the National High Secure Women's, Deaf and Learning Disability Care Streams and Mental Health and Personality Disorder Care Streams
della money @dellamoney
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jobrackley💜 @jobrackley
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Kim Ferrari @KimFerrari_SLT
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suzanne avington @avington_suzann
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RCSLT 💙 @RCSLT
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National High Secure ... @high_secure_ld
385 Followers 286 Following National High Secure Learning Disability Service, Rampton Hospital @nottshealthcare
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303 Followers 440 Following We're aintree autism, follow to see our developing autism service within the National High Secure Learning Disability Service @high_secure_ld @nottshealthcare
Rob Furby RN (He/Him)... @robfub
2K Followers 4K Following Husband | Singer | ICU Nurse | ACP | Proud Matron @nuhcriticalcare + @CCOTNUH | Doctoral researcher - EOLC in SMI @keeleuniversity 🏳️🌈 🏳️⚧️ #busy
Katie Hallam @KatieHallam_SLT
326 Followers 540 Following Speech and Language Therapist developing community CAMHS SLT services across Nottinghamshire #DevLangDis #SLCN #SLT #MentalHealth #Neurodivergentaffirming
Yolanda Martin @yolandamNHS
1K Followers 2K Following Passionate about the NHS. Proud to be Associate Director of Communications and Engagement at @NottsHealthcare 💙🌈 Tweeting in a personal capacity
Adult Speech and Lang... @NottsHCAdultSLT
2K Followers 565 Following 🗣Adult Speech & Language Therapy service @NottsHealthcare Providing SLT services (communication & swallowing) to the Nottinghamshire County community.
Eve @EveG_SLT
439 Followers 355 Following Speech and Language Therapist working in Mental Health and Learning Disabilities 🗨️ 📖 Winter lover 🏂 ⛷️
Sally Morgan @sallymorganslt
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Danielle @Danielle_Haddon
447 Followers 501 Following Clinical Lead Speech and Language Therapist passionate about #CAMHS #SLCN #DevLangDis #Youthjustice #Austim #neurodiversity #Forensics #EDI
Rebecca Allwood @allwood_rebecca
169 Followers 249 Following Speech and Language Therapist in Nottinghamshire. Interests include healthcare of older people, frailty, dementia, workforce and leadership. All views my own.
Jordan Duke @JordanDukeNHS
764 Followers 1K Following Comms Specialist & Staff Governor @nottshealthcare, passionate about design/brand identity. Dad to a husky 🐶 @PanthersIHC fan! 🏳️🌈
TalkingMats @TalkingMats
20K Followers 16K Following Talking Mats is a visual communication framework that enables you to listen more, have better conversations and turn the views expressed into actions.
Gemma Douthwaite @GDouthwaite_SLT
146 Followers 162 Following Clinical Lead Speech and Language Therapist working in a neurodevelopmental service. Nottinghamshire (all views my own)
Speech Apraxia UK @Speechapraxia
55 Followers 1K Following Speech Apraxia UK is the only organisation dedicated to supporting individuals with childhood apraxia of speech, acquired apraxia of speech, primary progressive
Gareth Edwards @Ivesey2
966 Followers 3K Following Dad to two great boys, Head of History, Former Raising Standards Lead, ECT Mentor, Progress Leader, Head of Year, MCCT.
Komal Shires @ShiresKomal
14 Followers 132 Following
Abbie Hurst💫 @abbieSLT
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Chrissy Harvey @harvey_chr41311
0 Followers 2 Following
Cassie @cassiespate1990
34 Followers 257 Following
Shartsi K Musherure @SMusherure
59K Followers 64K Following Member of Parliament, Mawogola North, Ssembabule District, Uganda. V/Chair. East African Affairs Committee. Retweets are not endorsements.
Sophie Owen @SophieJ_Owen
147 Followers 889 Following SaLT, Teacher. All about inclusive communication and love the countryside! 🌿
Emily 🏵️ @EmilyL_SLT2b
44 Followers 131 Following
Tracy Johnson (she/he... @Shooting_SLT
80 Followers 249 Following Speech & Language Therapist. I love tea, animals, tattoos, piercings, target shooting and motorbikes.
Seyma Calisgan @seyma_calisgan
139 Followers 832 Following Physiotherapist. PhD researcher in Speech and Language therapy
Esme Palmer @esme_palmer2
37 Followers 140 Following Speech and Language Therapist working in Mental Health and Secure Services 🗣💬🧠👩🎓
Daisy Humphries @SLT_Daisy
17 Followers 25 Following Children's Speech and Language Therapist @DCHStrust
Amy Swan @AmySwanSLT
26 Followers 43 Following Speech & Language Therapist working across Intellectual Disability and Mental Health services 🧠👩🏼⚕️
Biozoon UK @BiozoonUK
2K Followers 3K Following Innovative products designed for those suffering from dysphagia
Annie Hurren @DrAnneHurren
1K Followers 2K Following Speech & Language Therapist, Senior Lecturer @leedsbeckett university Research - laryngectomy, voice, head & neck cancer. Views my own.
Helena Satonick @HelSatonickCPSP
13 Followers 200 Following Speech pathologist working in NDIS | Neurodiverse affirming | Interest in disability justice and youth forensic mental health.
Notts Healthcare NHS ... @NottsHCPeople
1K Followers 613 Following Make A Difference with @NottsHealthcare. Find out about all the latest opportunities available for your career here. Managed by The Communications Team.
NUH SDEC AHPs @NUHSDECAHPS
62 Followers 190 Following We are the NUH SDEC AHPs consisting of Speech and language therapy, OT, Physio and Dietetics
ICATT North and South @ICATT_NottsHC
15 Followers 31 Following Intensive Community Assessment and Treatment Team (ICATT) based in Nottingham to support patients with a learning disability in the community.
East Midlands (Trent)... @emtacen
32 Followers 87 Following Clinical Excellence Network for SLTs with an interest in ALD and working in the East Midlands region. Organising study days, webinars & sharing good practice
The Big Picture Graph... @TheBigPictureGF
35 Followers 62 Following As Graphic Recorders, we create a colourful and meaningful visual display using words and images that the people can relate to.
Nicole @nicolescreaton
148 Followers 255 Following Speech and Languge Therapist, working with adults with acquired communication and swallowing difficulties|Stroke|Long Term Conditions|All views are my own
Lauren Booth @LaurenBoothSLT
210 Followers 306 Following Neuro Speech and Language Therapist 🧠 w/ interests in AOS and AAC 🗣️ All opinions are my own.
Natalie Ballett @NatalieBallett
163 Followers 419 Following #HelloMyNameis Natalie 👋🏻 Highly Specialist SLT for SBUHB ALD team 🗣 Interests in PBS , AAC and teaching self-advocacy skills . All views my own 🤓
LauraSLT14 @SLTLauraB
93 Followers 158 Following Highly Specialist Speech and Language Therapist 🗣️ working in mental health
MHSOPNottsHC @MHSOPNottsHC
861 Followers 468 Following We deliver Mental Health Services for Older People across Nottinghamshire in community and inpatient settings. We are part of @Nottshealthcare
Hannah’MiniSaLT’ @HMiniSaLT
1K Followers 952 Following ☕️ Mum and NQP Speech and Language Therapist in a private education setting supporting Autistic Children. 🗣️
reanne /rɪæn/ @speechiere
225 Followers 214 Following she/her. speech and language therapist 🗣️👄🧠 interested in #mentalhealth #dysphagia #stroke all opinions are of my own
Satewuth @satewuth20680
16 Followers 1K Following
Fee @Fee_Socialwork
1K Followers 2K Following Mum| Social Worker| Adult Social Care| Co-creator @swbohemians | Passionate about social justice | Living with PTSD & Anxiety | views are my own.
Cheryl /tʃeɹʊl/ @CherylR_SALT
646 Followers 2K Following Newly Qualified Speech and Language Therapist
Sara Dowling @79sjd
89 Followers 219 Following RNLD working in Community IDD services, Nottinghamshire NHS Trust. Dance Mum to two 💃 💃 Completed MA in Autism studies Tizard.
Huma SLT @humajabeenx
432 Followers 233 Following Clinical Specialist Speech and Language Therapist working alongside #autistic adults and learning disabilities in a specialist college setting.
Rehan Nasir @helloistutter
628 Followers 2K Following Stuttering for over 30 years. Blogging for over seven about it. I want to write to help the young me out there. Pitt grad. Mechanical engineer.
Ruth Radford @ruthradford_slt
95 Followers 178 Following Speech and Language Therapist working within secure accommodation for children and young people
Paul Mukherjee @mukherpaul
9 Followers 28 Following Mature student, Apprentice learning disabilities nurse. Ex support worker with a bee in his bonnet. Hopeful and curious, never without a flask of tea.
Charlotte Brinkler @CharlotteB_SLT
31 Followers 64 Following Speech and Language Therapist working in the North Manchester Community Learning Disability Team
Grace Hatton @graceHatton6
546 Followers 1K Following Associate Director Physical Health, Advanced Clinical Practice (ACP) Lead & NMP Lead, Notts Healthcare NHS FT. MSc Advanced Clinical Practice. All views my own.
Joanne Beaman @Jobey_RNLD
124 Followers 331 Following Specialist Learning Disability Community Nurse at Notts Healthcare. FNF alumni. All views are my own.
Neuro Enthusiast @neuro_enthusias
840 Followers 4K Following
Chloe McManus-Thomson... @ChloeMcT_SLT
100 Followers 351 Following 🏳️🌈 Speech & Language Therapist working as Dysphagia Lead @LPTnhs across the Directorate of Mental Health inc HD services 💬Own views. She/her
Isobel Lees @IsobelLeesSLT
379 Followers 314 Following Speech and Language Therapist in acute Stroke
Leesa @leesas38
3 Followers 623 Following
Hannah Seaton-Faulkne... @HSeatonFaulkner
673 Followers 2K Following Speech&Language therapist Dysphagia🍕 Communication🗣 Altered Airways🫁 Neuro Rehab🧠 Palliative care🕊 MentalCapacity🧐 I❤️🐕⛱️🚶♀️➡️ All views my own
Nottinghamshire Healt... @NottsHealthcare
11K Followers 2K Following We're Nottinghamshire Healthcare, a major provider of intellectual disability, mental health, community health, forensic & offender healthcare services.
Rampton Hospital SLT ... @RamptonSlt
838 Followers 470 Following SLT inpatient services for the National High Secure Women's, Deaf and Learning Disability Care Streams and Mental Health and Personality Disorder Care Streams
della money @dellamoney
2K Followers 382 Following Associate Director for Allied Health Professionals in Nottinghamshire. Speech and Language Therapist. All views my own.
jobrackley💜 @jobrackley
2K Followers 555 Following HOPEs consultant, HOPEs lead, SLT, views my own talking about communication, mental health, reducing restrictive practice
suzanne avington @avington_suzann
864 Followers 931 Following Associate Director for AHPs @Nottshealthcare. Physiotherapist. Proud mother of daughters and Cooper dog too!
RCSLT 💙 @RCSLT
30K Followers 592 Following The Royal College of Speech and Language Therapists is the professional body for speech and language therapists and support workers.
National High Secure ... @high_secure_ld
385 Followers 286 Following National High Secure Learning Disability Service, Rampton Hospital @nottshealthcare
Aintree Autism @AintreeAutism
303 Followers 440 Following We're aintree autism, follow to see our developing autism service within the National High Secure Learning Disability Service @high_secure_ld @nottshealthcare
Katie Hallam @KatieHallam_SLT
326 Followers 540 Following Speech and Language Therapist developing community CAMHS SLT services across Nottinghamshire #DevLangDis #SLCN #SLT #MentalHealth #Neurodivergentaffirming
NottshcAHPs @AHPsNottsHC
955 Followers 85 Following Account of the Chief Allied Health Professional @NottsHealthcare. Contact: @avington_suzann
Adult Speech and Lang... @NottsHCAdultSLT
2K Followers 565 Following 🗣Adult Speech & Language Therapy service @NottsHealthcare Providing SLT services (communication & swallowing) to the Nottinghamshire County community.
Danielle @Danielle_Haddon
447 Followers 501 Following Clinical Lead Speech and Language Therapist passionate about #CAMHS #SLCN #DevLangDis #Youthjustice #Austim #neurodiversity #Forensics #EDI
QI Nottinghamshire He... @QI_NottsHC
2K Followers 890 Following Hi 👋 We are the Quality Improvement team at @Nottshealthcare NHS Foundation Trust | #LetsTalkQI
Jordan Duke @JordanDukeNHS
764 Followers 1K Following Comms Specialist & Staff Governor @nottshealthcare, passionate about design/brand identity. Dad to a husky 🐶 @PanthersIHC fan! 🏳️🌈
TalkingMats @TalkingMats
20K Followers 16K Following Talking Mats is a visual communication framework that enables you to listen more, have better conversations and turn the views expressed into actions.
Gemma Douthwaite @GDouthwaite_SLT
146 Followers 162 Following Clinical Lead Speech and Language Therapist working in a neurodevelopmental service. Nottinghamshire (all views my own)
Giving Voice @GivingVoiceUK
15K Followers 592 Following @RCSLTpolicy (mainly @PeterDJust & @elissacregan) covering how SLT transforms lives, charity partners' work & people's stories. #GVTwitterTakeover host.
Jenny Bailey @JennyBailey__
508 Followers 567 Following Occupational Therapist, Head of Allied Health Professionals, Mental Health Care Group @Nottshealthcare
Sally Knapp @sallyknapp16
305 Followers 465 Following Lead AHP Practice Learning + Education Facilitator @NottsHealthcare; Notts ICS AHP Faculty Co-Chair; Speech and Language therapist;all views my own
SFH Adult Speech and ... @sfh_slt
568 Followers 481 Following Departmental twitter account for SFH Adult SLT. Helping people with communication and swallowing difficulties. Passionate about making a difference.
Sara Dowling @79sjd
89 Followers 219 Following RNLD working in Community IDD services, Nottinghamshire NHS Trust. Dance Mum to two 💃 💃 Completed MA in Autism studies Tizard.
Abi Lane @AbiLaneSLT
307 Followers 320 Following 🗣Specialist Speech & Language Therapist | @NottsHealthcare & @LingsBar | Primary Ovarian Failure / Premature Menopause awareness advocate 🫶🏼
Learning Disability P... @NottsPCLN
86 Followers 34 Following A team of Learning Disability Nurses providing liaison, education and working with individuals with a learning disability around accessing Primary Care services
Annie Hurren @DrAnneHurren
1K Followers 2K Following Speech & Language Therapist, Senior Lecturer @leedsbeckett university Research - laryngectomy, voice, head & neck cancer. Views my own.
Notts Healthcare NHS ... @NottsHCPeople
1K Followers 613 Following Make A Difference with @NottsHealthcare. Find out about all the latest opportunities available for your career here. Managed by The Communications Team.
AHPs4Notts @AHPs4Notts
404 Followers 288 Following
SNA @SouthNottsAcdmy
1K Followers 55 Following South Nottinghamshire Academy is for students aged 11 – 18 serving the communities of Cotgrave, Radcliffe on Trent and Shelford in South Nottinghamshire
Dr Chitra Acharya @chitraacharya
1K Followers 2K Following #ComputerScientist 👩💻 Reconfig Manager 🧩 Volunteer Staff Dance Facilitator 💃🏾 #NHSVolunteerResponder 🦺 #NHSAppAmbassador 📲 #PeerLeader #BreastmilkDonor
Marie Anne @mazsmith1674
470 Followers 499 Following Mother to 2 amazing children! Head of Nursing at Nottinghamshire Healthcare NHS Foundation Trust. RNLD - passionate about Learning Disability Nursing
Hannah Cooper🗣 @HannahCooperslt
403 Followers 739 Following NQP SLT working with adults in the acute setting @DBH_NHSFT • Interests in dysphagia, head and neck, and voice.
ICATT North and South @ICATT_NottsHC
15 Followers 31 Following Intensive Community Assessment and Treatment Team (ICATT) based in Nottingham to support patients with a learning disability in the community.
Fiona Hamilton @Fiona_Hamilton7
22 Followers 51 Following What can you do today to make a difference?
Lauren Bell @LaurenBellSLT
76 Followers 224 Following SLT very proud to work in CAMHS ID. Passionate about all things mental health, ID, CYP & supporting SLTs & all those we work with. All views my own.
Lauren Booth @LaurenBoothSLT
210 Followers 306 Following Neuro Speech and Language Therapist 🧠 w/ interests in AOS and AAC 🗣️ All opinions are my own.
Zainab✨ @ZainabSLT
418 Followers 471 Following Speech and language therapist interested in dysphagia, stroke, aphasia + diversity. NIHR ICA Internship Award 2023. Also a painter, baker, and cyclist🚲
Silvia D. Medina (she... @SMedina_SLT
398 Followers 438 Following Speech and Language Therapist working in Community CAMHS across Nottinghamshire, passionate about #YouthJustice #SEMH #SLCN #DevLangDis
Marie McGahey @MarieMcGahey
40 Followers 155 Following
Charlotte Brinkler @CharlotteB_SLT
31 Followers 64 Following Speech and Language Therapist working in the North Manchester Community Learning Disability Team
Rebecca Sams pronoun ... @holmes_holmes
162 Followers 445 Following Community Learning Disability Nurse relationships and sex education for adults with learning disabilities Nottinghamshire healthcare Nhs trust💙🌈
Isobel Lees @IsobelLeesSLT
379 Followers 314 Following Speech and Language Therapist in acute Stroke
NUH Acute SLT @NUHAcuteSLT
622 Followers 436 Following 💬 NUH Speech & Language Therapy for adults, paediatrics & neonates - acute & some outpatient services @nottmhospitals @NUHTherapies. For ENT/HNC @NUHsltENT
Thorneywood Mount Reh... @mount_unit
338 Followers 284 Following Rehabilitation for adults with mental health difficulties. We focus on recovery and developing life skills for living back in the community.
Georgia Dodsworth @georgiadslt2b
48 Followers 117 Following Student Speech & Language Therapist 👩🎓 | Assistant Practitioner at Clayfields House | ASLT for Nottinghamshire’s Community Forensic ID Service
LTHT LD and Autism @getmebetter
2K Followers 2K Following This account is now closed. For clinical queries or advice please call 0113 2066836 or email [email protected]
laura @lucasl1986
27 Followers 153 Following NHS speech & Language therapist ♥️ Mum to 2 children loves holidays and making memories
Emily Turner – etwr... @ETWriteHome
19K Followers 3K Following Storyteller and writer – Prolific public transport rider – Likely over on BlueSky... or if not, on a bus!
FTSpeechie @FtSpeechie
177 Followers 149 Following SLT working with Adult ID and loving it. Mum to two, plus hound, hamsters and whatever else lives here now. Autistic and figuring that out as I go along.
Katie Stocks @KatieStocks14
28 Followers 57 Following Final year student SALT studying at DMU, Leicester.
Lovejoy Gorka @LovejoyGorka
89 Followers 195 Following SLT in autism and ADHD. Muddling through with my own ADHD. Proud to work in the NHS. Scared for our future. all opinions my own.
Tiffany Green (she/he... @TJG247
422 Followers 485 Following Front Door Speech & Language Therapist working with adults with communication & swallowing difficulties in ED, SDEC, GAU & admission units. All own views.
NottsHC Libraries @NottsHClib
774 Followers 965 Following Nottinghamshire Healthcare Knowledge & Library service. Providing evidence searching, training, keeping up to date, electronic resources as well as books.
Carla @CarlaMorrell6
114 Followers 82 Following Highly Specialist Speech & Language Therapist IDD background, currently working in Notts HC Liaison & Diversion supporting vulnerable people throughout the CJS
Acute Learning Disabi... @NUH_Ldlt
557 Followers 399 Following Acute Learning Disability Liaison Team in Nottingham NUH Hospitals 🚦Making healthcare more acessible for people with a learning disability 🗣️
Lois Dugmore @DugmoreLois
425 Followers 970 Following SLT working with adults & YP with intellectual disabilities. AAC advocate. Lover of tableware, animals, cool ‘80’s music & Autumn. All views my own.
Beckie T @BeckieSLT
282 Followers 170 Following 🗣 Adult Mental Health Speech & Language Therapist @nottshealthcare
Nottingham IDD Physio @NottsIDDPhysio
38 Followers 49 Following Notts health care IDD physiotherapy team working to empower adults with learning disabilities
NHS Ability @NHSAbility
10K Followers 1K Following We share accessible health information & co-produced resources for people with a learning disability & autistic people. We don't respond to comments.
Autistica @Autistica
18K Followers 1K Following The UK's leading autism research and campaigning charity. We fund research, shape policy and work with autistic people to make more of a difference.
AliceHowells.SLT @AliceHowellsSLT
399 Followers 633 Following Speech and Language Therapist working in an acute stroke setting 🏥🗣️
Horizon Day Centre @CentreHorizon
116 Followers 100 Following Horizon is a specialist therapeutic service for adults with Intellectual Disabilities who are over 18 years and have ID with complex needs