Karen has worked with adults with a learning disability, firstly in Esher and then in Kingston and Richmond, since qualifying as a Clinical Psychologist in 1992. She trained at York University and then, for her postgraduate doctoral degree, at Surrey University. When Karen started her career she worked within both community learning disability and specialist day assessment and intervention services for those with more complex health care needs and behavioural challenges. This led, over time, to her specific areas of interest in working with those with autism spectrum conditions and people who present behavioural challenges.