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PubMed2003

Learning disabilities and the menopause.

How menopause affects women with learning disabilities is a neglected area of research. Women with learning disabilities experience the same physiological effects of the menopause as others, including hot flushes and night sweats, but difficulties in understanding and communication mean that additional supports are often required. They are less likely to report the psychological difficulties or symptoms associated with menopause than women in the general population. Menopause is usually earlier in women with learning disability and earlier still for those with Down's syndrome. Debate about hormone replacement therapy often ignores the needs of women with learning disabilities who, as a result, are very often excluded from the decision-making process. Physical problems among women with learning disabilities and other aspects of ageing warrant particular focus.

Persons with Disabilities↗

PubMedDate not supplied

Equity and access to health care for women with learning disabilities.

The increased expectation for women with learning disabilities to become more autonomous and independent is generally a positive and dynamic force. However, care must be taken to ensure that, within this environment, women with learning disabilities are not isolated or lack support as this increases their vulnerability. These issues exist for all women within our society, but women with learning disabilities are more vulnerable because of their lack of voice both individually and politically. Within this new culture of independence and rights for women with learning disabilities, nurses must ensure that they address their own accountability and responsibility.

Female↗

PubMed1997

A sense of loss: working with loss and people who have a learning disability.

For many years people with learning disabilities have had forgotten bereavements, forgotten grief and have often become forgotten people when it comes to meaningful support over the death of a loved one. This Learning Unit aims to explore some of the issues involved in the sensitive area of bereavement, loss and learning disabilities and to examine critically the role of the learning disability nurse in supporting this client group.

Persons with Disabilities↗

PubMed1991

Pragmatic language skills of students with language and/or learning disabilities: a quantitative synthesis.

A meta-analytic review of 33 studies investigating the pragmatic language skills of 3- to 12-year-old students with language disorders, language-learning disabilities, or learning disabilities as compared with the pragmatic language skills of nondisabled peers was conducted. The students with language and/or learning disabilities demonstrated consistent and pervasive pragmatic deficits in conversation compared to non-disordered peers (mean effect size = -0.52; SE = 0.06) across settings, conversational partners, age groups, and types of pragmatic skills measured. The pragmatic differences between the students with language or learning disabilities and control groups could not be accounted for by differences in study methodology or design. Furthermore, these pragmatic deficits appeared to be more attributable to underlying language deficits than to insufficient social knowledge. These findings are consistent with the perspective that students with learning disabilities can also be described as language disordered, and that children with language disorders experience a continuum of language failure that may be manifested in different ways as they progress through school.

Child↗

PubMed1983

Physiological correlates of conduct problems and anxiety in hyperactive and learning-disabled children.

Thirty-six learning disabled children (21 of whom were also classified as hyperactive) were subgrouped according to teacher ratings of tension-anxiety and conduct problems and then compared on measures of tonic and phasic autonomic arousal. The results indicated that children rated high on the conduct problem dimension evidenced smaller amplitude specific skin conductance responses, and that anxiety appeared to exert a moderating effect on physiological responses. When the hyperactive sample was considered separately, lower skin conductance levels were observed in children rated high on conduct problems than in hyperactive children rated low in conduct problems. These findings support the notion that hyperactive and learning-disabled children are heterogeneous at a physiological level and suggest that physiological differences previously attributed to hyperactivity may actually be correlates of the conduct problem dimension.

Anxiety↗

PubMed2004

Antipsychotic medication versus placebo for people with both schizophrenia and learning disability.

BACKGROUND: Antipsychotic medication is the standard treatment for people with learning disability and schizophrenia. OBJECTIVES: To determine the effects of any antipsychotic medication compared with placebo for treating people with a dual diagnosis of learning disability and schizophrenia. SEARCH STRATEGY: For this update we searched the Cochrane Schizophrenia Group's Register of trials (July 2004), relevant reference lists and sought unpublished data from pharmaceutical companies. SELECTION CRITERIA: We included all randomised clinical trials of longer than one month's duration, involving people with both schizophrenia and learning disability (a measured IQ of 70 or less) that evaluated antipsychotic medication versus placebo. DATA COLLECTION AND ANALYSIS: We reliably selected and assessed studies for methodological quality. Two reviewers, working independently, extracted data. We would have analysed dichotomous data on an intention-to-treat basis and presented continuous data with 65% completion rate. For dichotomous outcomes, our intention was to estimate a fixed effect relative risk (RR) with the 95% confidence interval (CI) together with the number needed to treat/harm (NNT/H). MAIN RESULTS: We found only one relevant randomised trial using our search method and this had to be excluded. This study included four people with a dual diagnosis of schizophrenia and learning disability, but results were only available for two of the participants. It was unclear as to which groups the other two people were allocated. In order to display the data, we would have had to have made too many assumptions about these two people and any results would be uninformative and potentially misleading. REVIEWERS' CONCLUSIONS: Using the methods described we found no randomised controlled trial evidence to guide the use of antipsychotic medication for people with both learning disability and schizophrenia. Until the urgent need for randomised controlled trials is met, clinical practice will continue to be guided by extrapolation of evidence from randomised controlled trials involving people with schizophrenia, but without learning disability, and non-randomised trials of those with learning disability and schizophrenia.

Adult↗

PubMed1999

Order of selection in vocational rehabilitation: implications for the transition from school to adult outcomes for youths with learning disabilities.

Interagency cooperation between special education and vocational rehabilitation (VR) is central to ensuring the continuity of services to young adults with disabilities who are in transition from school to adult living. However, the interface between special education and VR may be complicated by order of selection, an equally binding mandate in federal VR policy to provide priority services to individuals with the most severe disabilities. Because students with learning disabilities are typically perceived as having mild rather than severe disabilities, these youths are most at risk for falling through the cracks in the service landscape once they leave the school setting in states where the VR agency is implementing an order of selection procedure. This article identifies and discusses common impediments to collaborative transition planning for students with learning disabilities that may be intensified when the state VR agency is operating under an order of selection plan. Recommendations are provided to facilitate greater interagency cooperation among schools and VR agencies so that transition planning and implementation for students with learning disabilities is not subverted as a result of the order of selection mandate.

Journal Article↗

PubMedDate not supplied

Use of psychotropic medication in people with a learning disability.

The use of psychotropic medication for people with a learning disability is a controversial issue that has received much attention. This article explores some of the issues for learning disability nurses surrounding the use of psychotropic medication. There are concerns regarding the side-effects that antipsychotic medication can produce. Evidence suggests that some healthcare professionals, including learning disability nurses, need to keep themselves regularly updated on issues surrounding the use of these drugs such as efficacy, side-effects and interactions. Learning disability nurses need a clear understanding of the reasons behind the prescription of such powerful medication especially when it is used in the management of challenging behaviour. There are indications that learning disability nurses would support alternative approaches to medication such as the use of behavioural interventions. More healthcare professionals, direct carers and clients should be encouraged to become part of the multidisciplinary drug-review process.

Drug Interactions↗

PubMed1986

Cognitive and learning profiles of delinquent and learning-disabled adolescents.

The association between juvenile delinquency and learning disabilities has been a focus of considerable discussion and controversy. Nevertheless, only a limited number of investigators have directly contrasted these two populations. In those studies which have examined the link between antisocial behavior and school problems, research methodology has varied, resulting in conflicting evidence and limited consensus. The present study was designed to address this issue by comparing the cognitive and learning profiles of delinquents and learning-disabled adolescents. Specifically, 53 delinquents, 26 learning-disabled adolescents, and 50 average achievers were evaluated with newly developed educational and cognitive inventories. These assessment techniques were used to analyze several functional areas including processing efficiency, problem solving, and response style. Application of discriminant analysis to the cognitive and educational profiles of these adolescents suggested the existence of various subtypes of delinquency. Learning disabilities characterized one of these subgroups. It was concluded that more specific descriptions of the learning profiles of adolescent delinquents holds promise for rehabilitation and, perhaps, prevention of juvenile delinquency.

Achievement↗

PubMed2005

The effectiveness of psychotherapeutic interventions for people with learning disabilities: a critical overview.

Historically, people with learning disabilities have had little or no access to psychotherapeutic interventions, although there are signs that, over the past decade, this situation has seen some gradual improvement. This paper provides an overview of the evidence for the effectiveness of psychodynamic, cognitive-behavioural and cognitive therapies in this client group. The available data support the position that all three approaches can be effective in people with mild learning disabilities and in a proportion of people with more severe conditions. However, the literature reporting outcomes of psychotherapeutic interventions in people with learning disabilities is extremely limited, and there is a conspicuous and unjustified poverty of randomized controlled trials. There is also very little evidence regarding either the importance of specific components of therapeutic packages, or the optimal manner of delivering these interventions to people with learning disabilities.

Cognitive Behavioral Therapy↗

PubMedDate not supplied

Issues in the definition and diagnosis of learning disabilities: a perspective on Guckenberger v. Boston University.

This article reviews issues related to the definition of learning disabilities in the context of the Guckenberger v. Boston University case. Four major questions are addressed: (a) Who is learning disabled? (b) How should learning disabilities be assessed? (c) Who is qualified to make a decision about whether or not an individual has a learning disability? and (d) What accommodations should be provided by a postsecondary institution and how should they be selected? Although these are complicated and difficult questions, it is possible to develop a simple, reasonable classification system for learning disabilities, and to conduct assessments based on a coherent and relevant set of achievement tests in which individuals who score below a cutoff are considered learning disabled. Scores on IQ tests are irrelevant and not useful and may even be discriminatory. The issues of decision making regarding learning disabilities and appropriate accommodations remain significant dilemmas for the field; resolution of these issues seems virtually impossible without agreement on appropriate procedures for the definition, identification, and assessment of learning disabilities.

Adult↗

PubMed1996

Initiation of cigarette smoking among children with and without learning disabilities.

The goals of this study were to determine if: (1) children with learning disabilities should be included in school-based smoking prevention programs and (2) existing prevention curricula are appropriate for children with learning disabilities. Initiation of cigarette smoking and several correlates of smoking, including personal attribute, peer influence, and parent influence variables, were measured in a sample of 1470 3rd and 5th grade children. The rates of smoking initiation were 17% and 15% for children with and without learning disabilities, respectively. In addition, several of the known correlates of smoking among youth, including low self-control, negative orientation toward school, and peer smoking, were also significantly associated with smoking by children with learning disabilities. Children with learning disabilities are as much in need of smoking prevention programs as children without learning disabilities. Although current smoking prevention curricula address issues relevant to children with learning disabilities, additional research is needed to identify the special needs of these children and to determine the type of smoking prevention program most likely to be effective with them.

Age Factors↗

PubMed1979

Nystagmus and ocular fixation difficulties in learning-disabled children.

The visual fixation ability of learning-disabled children was evaluated after sensory integrative therapy had been administered for short or long periods of time. Children with hyporesponsive postrotary nystagmus displayed reduced oculomotor control skills, but the deficit was apparent only in those who had been in therapy for a shorter interval. These results present further support for the hypothesis that the learning disabled can be differentiated according to their nystagmus characteristics. In addition, very tentative evidence suggested that sensory integrative therapy may have been successful in ameliorating the fixation deficiency; however, further research into this possibility is needed. The data also indicate that oculomotor control dysfunction may be a mediating mechanism for at least part of the learning disabilities experienced by some learning-disabled children.

Child↗

PubMedDate not supplied

The effects of extended time on algebra test scores for college students with and without learning disabilities.

The purpose of this study was to assess the effects of extended time on the algebra test performance of community college students with and without learning disabilities. Forty-four students with learning disabilities and 44 students without learning disabilities attending five California community colleges participated in the study. The students each took an algebra test under timed conditions and a comparable test under extended-time conditions. The main results were that the students with learning disabilities scored significantly lower than the students without learning disabilities under timed conditions, the scores of the students with learning disabilities increased significantly with extended time, and the scores of the students with learning disabilities under extended-time conditions did not differ significantly from the timed or extended-time scores of the students without learning disabilities.

Adolescent↗

PubMedDate not supplied

Value of employment to people with learning disabilities.

A key objective of the Government White Paper 'Valuing People: A New Strategy for Learning Disability for the 21st Century' is to encourage and assist people with learning disabilities to gain employment. This is because very few people with learning disabilities are in paid work and employment is promoted as a means of improving self-esteem, skills and social integration and acceptability. The aim of this article is to highlight some benefits of, and the risks and concerns around, people with learning disabilities undertaking paid work. Learning disability nurses need to be aware of these issues if they are to advise and support clients effectively. If people with learning disabilities are not able or unwilling to enter the world of work then alternative approaches are needed. Leisure has the potential to offer similar benefits as work to people with learning disabilities.

Adult↗

PubMed1997

Identification, accommodation, and success of students with learning disabilities in nursing education programs.

Few studies have addressed the issue of nursing students with learning disabilities, although students with both identified and undiagnosed learning disabilities are pursuing nursing education. Legal mandates concerning these students impact nursing programs and faculty. To reduce the risk of discrimination litigation, nursing education programs need to establish educational strategies to promote these students' success. The purpose of this research was to discover the extent to which Bachelor of Science in Nursing and Associate Degree of Nursing programs in one southeastern state admit, identify, and graduate nursing students with learning disabilities, and to identify accommodations provided by these programs to promote success among this student population. Of the 54 programs surveyed, 45 responded. Almost 50% indicated that their program had admitted nursing students with learning disabilities and one-third reported graduating students with learning disabilities. Enrolled students with undiagnosed learning disabilities were identified during their course of studies by both faculty members and by students themselves. The most frequently reported accommodations for students were counselors, tutors, tape-recorded lectures, and computer access. As the number of students with learning disabilities seeking post-secondary education increases, nursing programs and nurse educators will be involved with greater numbers of students needing educational accommodations.

Education, Nursing, Baccalaureate↗

PubMed1994

Cognitive performance in learning disabled children with and without epilepsy.

Cognitive functioning and educational achievement were examined in learning disabled children with epilepsy (n = 65) and without epilepsy (n = 122) in order to explore whether children with epilepsy show unique types of learning problems, different from those in other learning disabled children. The learning disabled children with epilepsy tended to perform better on tests of verbal intelligence, certain achievement-related abilities and were better in one area of academic achievement, i.e. spelling. Despite their superior performance in these areas, the learning disabled children with epilepsy were slower than those without epilepsy and regular education controls (n = 100) on simple auditory and visual reaction tasks as well as on a multiple decision reaction task and a visual searching task. The results obtained with the school achievement tasks provide no clear evidence for specific types of learning impairment in children with epilepsy. Learning disabled children with epilepsy do not appear to have educational needs different from those of other learning disabled children.

Attention↗

PubMed2000

Reliability and validity of the CANDID--a needs assessment instrument for adults with learning disabilities and mental health problems.

BACKGROUND: People with learning disabilities and mental health problems have complex needs. Care should be provided according to need. AIM: To develop a standardised needs-assessment instrument for adults with learning disabilities and mental health problems. METHOD: The Camberwell Assessment of Need for Adults with Developmental and Intellectual Disabilities (CANDID) was developed by modifying the Camberwell Assessment of Need (CAN). Concurrent validity was tested using the Global Assessment of Functioning (GAF) and the Disability Assessment Schedule (DAS). Test-retest and interrater reliability were investigated using 40 adults with learning disabilities and mental health problems. RESULTS: CANDID scores were significantly correlated with both DAS (P < 0.05) and GAF scores (P < 0.01). Correlation coefficients for interrater reliability were 0.93 (user), 0.90 (career), and 0.97 (staff ratings); for test-retest reliability they were 0.71, 0.69 and 0.86 respectively. Mean interview duration was less than 30 minutes. CONCLUSIONS: The CANDID is a brief, valid and reliable needs assessment instrument for adults with learning disabilities and mental health problems.

Adult↗