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Conversation Analysis (CA) uses recordings of everyday encounters to understand the challenges practitioners face.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Following specialist guidance on systematically reviewing CA research, we reviewed 65 CA research articles examining staff communication in healthcare, education, social care and the police.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified five themes in the synthesis. Two were categories of interactional practices (\n                      <jats:italic>Questions and Answers; Decision\u2010Making<\/jats:italic>\n                      ), one examined non\u2010verbal communication (\n                      <jats:italic>Embodied and Non\u2010Verbal Communication<\/jats:italic>\n                      ) and two considered contributions of other material and human agents (\n                      <jats:italic>Communication Aids and Supports; Involvement of Companions<\/jats:italic>\n                      ). In each theme, we saw examples of competency\u2010enhancing and competency\u2010inhibiting practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Practitioners face interactional dilemmas: (1) Orienting to the Person's Self\u2010determination versus Getting the Job Done; (2) Adapting Communication versus Downplaying Difference. Future research should build on this review to develop and evaluate communication training for staff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jar.70239","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:34:16Z","timestamp":1780050856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Communicative Dilemmas for Practitioners in Service Encounters With People With Intellectual Disabilities: Insights From a Systematic Review of Conversation Analytic Research"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-6968","authenticated-orcid":false,"given":"Deborah","family":"Chinn","sequence":"first","affiliation":[{"name":"Faculty of Nursing, Midwifery and Palliative Care King's College London  London 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