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PubMed1993

Is the money following the clients with learning disabilities?

For the past decade patients with learning disabilities living in long stay mental handicap hospitals have been resettled in the community. Local authorities have also taken on the care of new patients who would once have been long stay residents. The imperfect data that are available suggest that in England about half the residents in mental handicap hospitals in 1981 are now the responsibility of local authorities; the figures for Wales and Northern Ireland are 38% and 33%. Data on revenue suggest that the savings to the health service are much less--perhaps 9% in Northern Ireland and 3.6% in England, although there have also been capital gains through the sale of hospitals. Existing methods of transferring money from health to local authorities--joint finance and "dowries" for individual patients--do not seem adequately to have compensated local authorities. Moreover, as patients still to be transferred are more severely disabled local authorities will require larger sums--about 26 000 pounds per patient per year plus 39 200 pounds in capital. If the government chooses not to transfer these resources from health authorities it will be switching funds away from learning disabled people to other care groups.

Community Mental Health Services↗

PubMed2002

Annie's story: the use of oral history to explore the lived experience of a learning disability nurse in the 20th century.

In the field of learning disabilities, oral history has exclusively focussed on the lives of people who were detained in large institutions and hospitals for the mentally deficient or handicapped. Such work has been invaluable in providing unique and authentic insights into the lives of people with learning disabilities during the last century. It has also helped us better understand the impact of social policy and legislative change, such as the introduction to the Mental Deficiency Act 1913. However, little is known about what life was like as a nurse working the field of learning disabilities in the last century. The chief aim of this paper is to present analysed data obtained by using the oral history approach to support and/or challenge our current knowledge of learning disability during this time. As such, it presents a unique contribution to our knowledge of the history of learning disability nursing in the UK.

History, 20th Century↗

PubMed1998

Self-injury and violence in people with severe learning disabilities.

BACKGROUND: Psychiatry in severe and profound learning disability is essentially behavioural psychiatry. Some clinical and research observations of disorders of behaviour in this group are summarised in this study. METHOD: After inspection of the literature, I postulated a clinical syndrome of violence and self-injury in the severely learning disabled. A check-list of behavioural symptoms was developed and used in a community survey. RESULTS: Behaviour, assessed by the check-list, supported the existence of organic behaviour disorder, as did small-scale psychophysiological testing. CONCLUSIONS: Self-injury is strongly associated with violence, and with severe and profound learning disability. Pathophysiology of violence and self-injury may include high levels of psychophysiological arousal demonstrated by unstable EEGs. Reduction of arousal by antipsychotic medication is associated with clinical improvement in violent and self-injurious behaviours.

Diagnosis, Differential↗

PubMed1980

Relating infant temperament to learning disabilities.

The role of infant temperament in the development of learning disabilities was at issue. As infants, boys with severe learning disabilities were found to be (1) lower in activity level, (2) more irregular, (3) less approaching, and (4) more negative in mood than "normal" boys. Discussion centered around conceptualizing learning disabilities as the outcome of a developmental process. Thus patterns of early parent-infant interaction are established, based in part upon the infant's temperament, that may evolve into a learning disability.

Child↗

PubMed1995

The Multidimensional Perfectionism Scale: correlations with depression in college students with learning disabilities.

Interpretations of depression in children and adolescents with learning disabilities have tended to be neuropsychological or motivational. Some research has related various cognitive-behavioral constructs with depression and other problematic outcomes for this population. Research with nonlearning-disabled college students has provided correlations for scores on the Self-oriented and the two social scales of the Multidimensional Perfectionism Scale with those on depression. No such work has been done with college students having learning disabilities. Measures for multidimensional perfectionism, anxiety, and depression were administered to 110 learning-disabled undergraduate men and women. Analysis showed that scores on only one of the social scales of perfectionism were positively correlated with depression scores, and this relation was weaker than previously found for nonlearning-disabled students. Findings are discussed in terms of previous research and a motivational interpretation of depression in learning-disabled collage students.

Adolescent↗

PubMed1995

An overview of learning disabilities: psychoeducational perspectives.

In general, people with learning disabilities are a heterogeneous population that require a multidisciplinary evaluation and careful, well-planned intervention. Despite this heterogeneity, patterns of problems often co-occur. Therefore, diagnosticians and educators should look beyond single areas of achievement such as reading or arithmetic. In addition, problems in one area of learning typically have secondary impacts on higher levels of learning. That is, comprehension problems typically interfere with expression. Every effort should be made to examine patterns of problems and to avoid fragmentation of services so that each area of underachievement is not treated separately. Although learning disabilities usually interfere with school performance, they are not simply academic handicaps. They interfere with certain social activities as well as occupational pursuits. In many instances, they impact on mental health and self-esteem. Therefore, students need multiple services. And, as emphasized throughout this journal issue, learning disabled individuals may have comorbid conditions such as attention deficit disorder, depression, and neurologic problems. Furthermore, the problems may change over time. Children may first be identified because of language comprehension problems but later have reading or mathematics difficulty. With intervention, oral expressive problems may be alleviated but may be manifested later in written language.

Child↗

PubMed1998

'Pfropfschizophrenie' revisited. Schizophrenia in people with mild learning disability.

BACKGROUND: It is reported that people with mild learning disability have a higher point prevalence of schizophrenia than the normal population, the reasons for which are unclear. METHOD: Thirty-nine subjects with mild learning disability and schizophrenia, 34 control subjects with schizophrenia and 28 control subjects with mild learning disability were seen. Interviews with relatives and carers were also conducted. Assessments were made of clinical variables, psychopathology, neurological 'soft' signs, IQ, memory and family history. Blood was taken for karyotypic analysis from comorbid subjects. RESULTS: The comorbid group had more negative symptoms, episodic memory deficits, soft neurological signs, epilepsy and receive more community supports than control subjects with schizophrenia. Comorbid subjects had a tendency to belong to multiply affected families and show high rates of chromosomal variants on routine karyotypic testing. CONCLUSIONS: Future work on the generality of schizophrenia should include people with premorbid learning disability, as a discrete subtype from whom valuable genetic aetiological clues may be obtained.

Adult↗

PubMedDate not supplied

Mainstream Experiences for Learning Disabled students (Project MELD): preliminary report.

Mainstream Experiences for the Learning Disabled (MELD) was developed to accommodate students with learning disabilities in the mainstream. This article reports the progress of 13 students at the end of 1 year of planning and 1 year of implementing the MELD model in one urban elementary school. Observational and school adjustment data from the implementation year suggest that although the MELD model was not fully incorporated into the mainstream classes, students with learning disabilities adjusted well to a less individualized and more demanding mainstream program. They came to school regularly, did not present serious behavior problems, and spent as much of reading class and more of math class on task as they had in special education. These students in the mainstream were assigned more opportunities to work with text materials rather than workbooks in reading and spent significantly more reading time in teacher-directed lessions. Nevertheless, the students made no significant progress in reading or math and earned lower grades during the implementation year. The authors suggest that students with learning disabilities will not succeed in the mainstream if teachers continue "business as usual" in mainstream classes.

Achievement↗

PubMed1994

When academic assistance is not enough: addressing the mental health issues of adolescents and adults with learning disabilities.

This article focuses on an answer to a critical question for adolescents and adults with learning disabilities: How can professionals assist students with learning disabilities who have psychosocial issues that appear to be affecting their academic progress and life adjustment? Inherent in this inquiry are other, equally important issues, such as: How do learning disabilities service providers know when to involve other service providers? What are the steps in referring a student for further assistance with different mental health issues? When are team interventions necessary? How are team interventions conducted in either secondary or postsecondary settings? How should learning disabilities service providers establish the boundaries of their professional expertise and/or responsibilities to adequately meet the needs of individuals with learning disabilities? This article illustrates answers to these questions by providing examples of interventions and case studies from two federally funded research/demonstration projects at the University of Minnesota: the Learning Disabilities Transition Project and Project Extra. The authors describe theoretical models for mental health services that address the psychosocial issues frequently encountered in academic or vocational settings. Recommendations are also included that discuss how the models can be personalized to fit the reader's home institution or agency.

Adolescent↗

PubMed1982

Learning disabled children's syntactic proficiency on a communicative task.

Previous studies have generally examined learning disabled children's syntactic ability either on structured tasks or by analyzing oral language samples collected under conditions not typical of natural communicative settings. Thus, these studies are of limited value in exploring the impact of learning disabled children's deficits in linguistic structure on their use of language in social contexts. The purpose of this study was to investigate learning disabled children's syntactic proficiency during a task requiring them to convey information to a listener. Subjects were selected on the bases of teacher ratings, reading achievement scores, and Peabody Picture Vocabulary Test IQ scores within the normal range; those children identified as learning disabled received low ratings and demonstrated underachievement (below 40th percentile for their grade) in reading. Oral language samples were collected by having learning disabled and normally achieving children in grades two, four, six, and eight participate in a referential communication task in which they described abstract shapes to an experimenter. The length and syntactic complexity of the children's descriptions were assessed. Learning disabled children in all grades were found to produce shorter mean t-units and shorter mean main clauses than nondisabled children even on this relatively simple communicative task. Although learning disabled children's linguistic problems have previously been characterized as subtle, these findings suggest that their productive language deficits may be significant enough to interfere with even the informal and elliptical conversations characteristic of communication among peers and family members.

Adolescent↗

PubMedDate not supplied

Treating obesity in people with learning disabilities.

Obesity in people with learning disabilities should not be dismissed as untreatable. Such people have the same right to a healthy weight as the rest of the population. Equally, they should have the right to remain overweight if they so choose, provided their choice is an informed one. This paper reviews the reasons people with learning disabilities may become obese, addresses how this problem may be tackled and highlights some of the ethical issues involved in weight reduction for this client group.

Education of Persons with Intellectual Disabilitie↗

PubMed2006

Episodic psychiatric disorders in teenagers with learning disabilities with and without autism.

BACKGROUND: Mental health problems in people with learning disabilities and autism are poorly understood. AIMS: To investigate the prevalence of episodic psychiatric disorders in a sample of teenagers with learning disabilities with and without autism. METHOD: Teenagers with learning disabilities living in one geographical area were identified. Those with autism were matched to those without. A semi-structured investigator-based interview linked to Research Diagnostic Criteria was used to assess prevalence and type of episodic disorders. RESULTS: Significantly more individuals with autism had a lifetime episodic disorder, most commonly major depression. Two individuals with autism had bipolar affective disorder. Other episodic disorders with mood components and behaviour change were also evident, as were unclassifiable disorders characterised by complex psychiatric symptoms, chronicity and general deterioration. Antipsychotics and stimulants were most frequently prescribed; the former associated with episodic disorder, the latter with autism. CONCLUSIONS: Teenagers with learning disabilities and autism have higher rates of episodic psychiatric disorders than those with learning disabilities alone.

Adolescent↗

PubMedDate not supplied

Interprofessional practice and learning disability nursing.

Several decades of policy and service change in the field of learning disability have set in place new service boundaries in health and social care, leading to different working relationships for professionals based on interprofessional and interagency collaboration. However, economic pressures may result in agencies offering resource-led rather than needs-led services, resulting in fragmented services and tensions between professional groups faced with tough choices in order to meet the long-term needs of people with learning disabilities. One of the key roles of the registered learning disability nurse (RLDN) is that of facilitator in meeting the healthcare needs of people with learning disabilities, which involves interprofessional working across these new health and social care boundaries. The aim of this article is to present the findings from a small scale research study that was undertaken to explore the views of the RLDN group in relation to interprofessional practice in the long-term support of people with learning disabilities. Set within a grounded theory methodology, this article focuses on one element of the research study, which was a descriptive analysis of individual practitioners' experiences. In documenting the practitioners' accounts, the research begins to identify a series of key roles and significant practice knowledge held by those employed in learning disability nursing positions.

Attitude of Health Personnel↗

PubMed1985

Ocular anomalies: a comparison of learning disabled and nonlearning disabled elementary school children.

This study compared descriptive data, obtained via retinal reflex photography, concerning ocular anomalies of 439 learning disabled elementary school children, 1657 kindergarten and Grade 1 nonlearning disabled children, and 724 nonlearning disabled children in Grades 2 to 6. Ocular factors included refractive and nonametropic errors as well as severity of the problem. The learning disabled sample had a significantly higher incidence of refractive error than the normal samples in Kindergarten and Grade 1 but lower incidence than the normal sample in Grades 2 to 6. The learning disabled group had a significantly higher incidence of myopia in one or both eyes than did the kindergarten and first grade normal group. No such difference for myopia existed between the learning disabled and the normal sample in Grades 2 to 6. Incidence of hyperopia in both eyes was significantly lower in the learning disabled than in the kindergarten-first grade sample; however, hyperopia in one eye only was greater for the learning disabled than for the older normals. Significant differences between the younger and older normals existed for all types of refractive error except hyperopia in only one eye. Severity of the problem differed significantly between the learning disabled and the kindergarten-first grade sample in the classes of severe and minimal, not at all when comparing learning disabled and older normals, and in all classes when comparing younger and older normals. The learning disabled also had a significantly higher incidence of nonametropic anomalies than did the normal group. Implications relating refractive error and near environment were discussed.

Child↗

PubMedDate not supplied

Toward a scientific pedagogy of learning disabilities: a sameness in the message.

The development of a scientific pedagogy of learning disabilities as called for by Kirk and Bateman (1962) requires the rendering of a science of learning disabilities and a pedagogy derived from that science. But such a pedagogy is necessarily incomplete if it fails to recognize that the structure of the curriculum significantly shapes the act of teaching students identified as learning disabled. The current thinking about curricula is that the universe of information that a curriculum program comprises need only be organized around subject area topics (e.g., mathematics, reading, language arts, science, social studies) and hierarchically arranged in a scope and sequence that has as its main characteristic the general ordering of skills from simple to complex. For all practical purposes, information is viewed as raw material (Kaufman et al., 1990) that can be nominally organized and readily packaged. The information is then consumed as curriculum that requires little or no transformation of its form or structure. The articles in this series of the Journal of Learning Disabilities provide examples of how transforming information by identifying and developing curricula around structural samenesses can lead to a pedagogy that is efficient and effective. The development of a scientific pedagogy of learning disabilities requires that the field acknowledge the importance of curriculum structure and the complexity of information. The field must also examine the intricacies of designing curricula with the same kind of commitment and passion it has demonstrated in the last 30 years in investigating the etiology and organic basis of learning disabilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Achievement↗

PubMedDate not supplied

Instructional design in mathematics for students with learning disabilities.

The low achievement level of students with learning disabilities has multiple causes. One is the mismatch between the students' learning characteristics and the design of instructional materials and practices. Design principles better suited to the characteristics of students with learning disabilities are described and illustrated for five areas: (a) big ideas; (b) conspicuous strategies; (c) efficient use of time; (d) clear, explicit instruction on strategies; and (e) appropriate practice and review. Wider application of these design principles, in instructional material and in actual teaching, could contribute to far higher achievement levels in mathematics for students with learning disabilities.

Achievement↗

PubMed1997

Instrument for locating students with suspected learning disabilities: a quantitative approach.

The instrument to locate students with learning disabilities was developed to create equality and uniformity, so that such difficulties could be spotted independently of socialization factors, teachers and parents to whom the student had been exposed. The instrument was developed on the basis of research that defines the reading rate of students with reading disabilities in words per minute, the minimum number of errors for locating writing disabilities, and the number of answers and lines a student uses to reconstruct the content of a passage adapted to his or her age level. The research carried out in order to construct the instrument is the first to attempt to quantify disability, and on this basis to construct an instrument to locate students with disabilities in reading, writing and visual recall. The procedure can be carried out for a whole class in a single lesson period. One indirect conclusion from the research is that disability indicators remain with the learning disabled regardless of time since diagnosis or remedial help. Other implications related to combining the quantity component in diagnoses of degrees of difference in the disability identified, and in extra examination time for the learning disabled. The instrument should solve the problem of locating students with difficulty reading, writing or in visual recall, due to disability. Students thus identified will be directed to individual diagnosis to find out whether their difficulties are primary or secondary (e.g. a new immigrant who still has trouble with Hebrew). A personal corrective programme can then be constructed.

Achievement↗

PubMed1996

Learning disability in children with postmeningitic cochlear implants.

OBJECTIVE: To determine the effects of learning disability on measures of auditory perception, receptive language development, and sequential organization in children with postmeningitic cochlear implants. DESIGN: Retrospective study. Follow-up ranged from 12 months to 7 years. SETTING: Tertiary care center. PATIENTS: Ten pediatric patients with cochlear implants, 5 with documented learning disability. MAIN OUTCOME MEASURE: Pediatric cochlear implant test battery performance. RESULTS: Children with learning disability showed slower progress, more inconsistencies, and lower test scores than their partners without learning disability. CONCLUSION: Learning disability is not a contraindication to cochlear implantation, but preoperative counseling must be available to families and support personnel about preoperative achievements and expectation for these children.

Child↗