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36 learning disabled high school subjects rated themselves lower on academic, psychomotor, and verbal performance on a social comparisons task than a control group of 53 nonexceptional peers. Learning disabled students tended to see themselves as less able in most areas involving school achievement but not in areas involving extracurricular activities.
The aim of research is to compare behavior and emotional problems of children with learning disabilities to problems of children without learning disabilities. Parents of 67 children with learning disabilities and of 60 children without learning disabilities were asked to fill in Child Behavior Checklist (CBCL 4/18; Achenbach, 1991). Children with learning disabilities had significantly more internal (somatic complaints, isolation, anxiety/depression) and external problems (aggression and delinquency) as well as attention and social problems. The research showed that children with learning disabilities are at greater risk for psychosocial adjustment difficulties. Limitations of the study are discussed.
The lives of learning disabled children and their parents are beset by bewildering paradoxes and misunderstandings, especially as they try to cope with educational systems. Social work professionals, as counselors and advocates, are shown to have the skills needed for early remedial intervention for the learning disabled.
A dilemma exists regarding the interpretation of learning disabilities. A self-organizing systems (SOS) paradigm suggests widespread, diffuse outcomes, whereas a specific learning disability concept suggests more localized dysfunction. There may be very good reason to doubt the veridicality of the concept of a specific learning disability, not because the construct of learning disabilities itself is a frivolous concept, as some have held, but because the biological or neurological events that underlie a learning disability do not remain focal and constrained only to specific dysfunction. It is important to know whether an identified learning disability remains contained or whether processing disorders might be found in other areas. The assessment profiles of school-age children identified with nonverbal learning disabilities (NLD), assumed to have primarily right-hemispheric brain dysfunctions, and children with language-based learning disabilities (LLD), assumed to have primarily left-hemispheric brain dysfunctions, were examined to explore learning disabilities using an SOS paradigm. The pilot study reported here is used as an exemplar of how a self-organizing systems paradigm is conceptualized. Although a more comprehensive study is needed to confirm the data, this exemplar suggests that overflow into areas not typically associated with each disability subtype may occur. Concerns regarding ways of determining discrepancy for diagnostic purposes are noted, and remediation strategies designed for specific disabilities are questioned.
9 white male learning disabled adolescents were administered the Profile of Nonverbal Sensitivity to assess their sensitivity to nonverbal communication. Analysis indicated these adolescents were poorer at decoding nonverbal cues than the nondisabled standardization sample. They also had difficulties in interpreting nonverbal messages, regardless of the mode in which they were presented. The relationship of learning disabled adolescents' sensitivity to nonverbal communication and social skills should be studied.
BACKGROUND: Tourette Syndrome (TS) is a neurodevelopmental disorder of childhood. Learning disabilities are frequently comorbid with TS. Using the largest sample of TS patients ever reported, we sought to identify differences between subjects with TS only and subjects with TS and a comorbid learning disability. METHODS: We used the Tourette Syndrome International Consortium database (TIC) to compare subjects with comorbid Tourette Syndrome and learning disabilities (TS + LD) to subjects who did not have a comorbid learning disability (TS-LD). The TIC database contained 5,500 subjects. We had usable data on 5,450 subjects. RESULTS: We found 1,235 subjects with TS + LD. Significant differences between the TS + LD group and the TS-LD group were found for gender (.001), age onset (.030), age first seen (.001), age at diagnosis (.001), prenatal problems (.001), sibling or other family member with tics (.024), two or more affected family members (.009), and severe tics (.046). We used logistic modeling to identify the optimal prediction model of group membership. This resulted in a five variable model with the epidemiologic performance characteristics of accuracy 65.2% (model correctly classified 4,406 of 5,450 subjects), sensitivity 66.1%, and specificity 62.2%. CONCLUSION: Subjects with TS have high prevalence rates of comorbid learning disabilities. We identified phenotype differences between the TS-LD group compared to TS + LD group. In the evaluation of subjects with TS, the presence of a learning disability should always be a consideration. ADHD may be an important comorbid condition in the diagnosis of LD or may also be a potential confounder. Further research on etiology, course and response to intervention for subjects with TS only and TS with learning disabilities is needed.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.