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'It's pretty hard with our ones, they can't talk, the more ..:

Bigby, C. ; Clement, T. ; Mansell, J..
Journal of Intellectual Disability Research.  53 (2009)  4 - p. 363-376 , 2009
Link: https://doi.org/10.1111/j.1365-2788.2009.01154.x