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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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

Short-term memory and working memory: do both contribute to our understanding of academic achievement in children and adults with learning disabilities?

Seventy-five children and adults with learning disabilities (age range = 5.0 to 42.10 yrs.) and 86 normally achieving children and adults (age range = 5.11 to 58.0 yrs.) were compared on short-term memory (STM) and working memory (WM) tasks to assess the relationship between STM and WM, and to test whether these measures independently relate to achievement. For both ability groups, the factor analyses indicated that STM and WM loaded on different factors, and the regressions and partial correlations showed that these different factors accounted for separate variance in reading comprehension and mathematics. Both STM and WM are important in understanding reading comprehension and mathematics performance in children and adults with learning disabilities; however, WM is more important for children and adults without learning disabilities. In contrast to WM, STM contributed minimal variance to word recognition in both ability groups. Overall, it was concluded that STM and WM do reflect different processes, both of which seem to separate the two ability groups. However, models of memory that view STM and WM as interchangeable, or STM in isolation, do not provide an adequate framework for capturing academic performance in children and adults with learning disabilities.

Achievement↗

[Neurochemical and neurotransmitter studies in patients with learning disabilities].

To clarify the pathophysiology of learning disability (LD), we measured the urinary levels of 3-methoxy-4-hydroxyphenyl glycol (MHPG), and phenylethylamine (PEA) in urine samples collected in a 24 hour period. Findings were compared with those obtained in age-matched controls and diseased controls including patients with attention deficit-hyperactivity disorder (ADHD), infantile autism, and mental retardation. The mean urinary level of MHPG in LD (n = 6) were not significantly different from those in ADHD (n = 16), mental retardation (n = 4), infantile autism (n = 5), and the controls (n = 6), while the mean urinary levels of PEA were significantly lower in LD (n = 6, 91 +/- 17.3 micrograms/mg) and in ADHD (n = 5, 65 +/- 53.6 micrograms/mg) as compared to age-matched controls (n = 3, 340 +/- 264.5 micrograms/mg) ANOVA, (p < 0.05). PEA is considered to play an important role for the pathogenesis of LD and ADHD.

Attention Deficit Disorder with Hyperactivity↗

Integrative strategy instruction: a potential model for teaching content area subjects to adolescents with learning disabilities.

In part because learning strategies are often taught in isolated resource settings outside of the contexts in which students with learning disabilities are expected to apply this knowledge, generalization has been a significant challenge to educators. To address this problem, an instructional model is proposed for integrating cognitive strategy instruction and content area instruction when teaching students in content area classes. Teacher-directed instructional procedures, cooperative learning, and direct explanation and dialectical strategy instruction are integrated into four key instructional processes: orienting, framing, applying, and extending. In this model, teacher-mediated instructional devices and routines used to teach content area subjects serve as a basis for teaching students to self-mediate parallel cognitive strategies and processes. The model is discussed in terms of its theoretical and philosophical orientations as manifested in its knowledge and instructional bases. A scenario is provided that depicts a social studies teacher implementing many of the principles and methods associated with the model.

Adolescent↗

A developmental study of vigilance in learning-disabled and nondisabled children.

To test the proposition that learning-disabled children manifest a sustained attentional deficit, the Continuous Performance Test was administered to learning-disabled and nondisabled children at three age levels. Children were tested on three task lengths (5, 10, and 15 minutes) and two modalities (auditory and visual) in which dependent measures were correct detections and false responses, d' and B values. As expected, learning-disabled children male fewer correct detections and more false responses and were less sensitive (d') to critical stimuli than were nondisabled children at all ages. There was also evidence to indicate that learning-disabled children apply different response criteria across age when compared to nondisabled children. B values varied significantly across age, group, modality, and time on task; d' remained relatively unchanged across time periods. The popular notion that learning-disabled and younger subjects start a vigilance task with the same capacity as nondisabled older children but show a decline in attention as time on task increases was not supported.

Adolescent↗

Speech-recognizing computers: a written-communication tool for students with learning disabilities?

Students with specific learning disabilities (LD) in written composition may experience difficulties that restrict their ability to demonstrate in writing what they know and can communicate orally. Voice-input technology now allows users to speak into a microphone and have their words appear on a computer screen in a word processing format, ready for revision and editing. This exploratory study reports the efforts of one sixth-grade student to learn to use this technology to assist written communication. The findings suggest that the technology holds promise for students with LD when it is refined to allow less difficulty in using it.

Child↗