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PubMed2000

Rational dosages of nutrients have a prolonged effect on learning disabilities.

CONTEXT: Reports that administration of nutrients has increased the academic performance of learning-disabled children exist in the literature. OBJECTIVE: To document the effects of nutrients on learning-disabled children in a controlled study. DESIGN: A randomized, double-blind, placebo-controlled crossover trial, which followed 1 year of open-label nutrients. Children who improved in the open-label trial were eligible to enter the controlled phase of the study. SETTING: Subjects were enrolled from the general community through advertisements. PATIENTS OR OTHER PARTICIPANTS: Twenty children met the criteria for being learning disabled. INTERVENTION: Each child was tried out on some (but not necessarily all) of the B vitamins and minerals used in this study. These were administered semi-blinded for the first year; double-blinded in crossover rotations during the second year; and open-label in the ensuing years. MAIN OUTCOME MEASURES: At various time points, school-certified psychologists administered psychoeducational tests. School report cards were evaluated at baseline and for all subsequent periods. RESULTS: Twenty learning-disabled children entered the study, but 1 dropped out because of nausea. The remaining 19 children showed significant academic and behavioral improvements within a few weeks or months of open-label treatment with nutrient supplements. Some children gained 3 to 5 years in reading comprehension within the first year of treatment; and all children in special education classes became mainstreamed, and their grades rose significantly. Twelve of the children completed the 1-year double-blind phase, after which approximately half of the children chose to remain on the nutrients for at least 2 additional years. For those who discontinued, it took at least 1 year to begin to see the first indications of decline in academic performance, and another year for their grades to drop significantly. In contrast, for children who remained on nutrients, the gains continued the upward trend; at the end of year 4, the difference in scores between the 2 groups had reached statistical significance (P < .01). CONCLUSION: The overall results of this study tentatively support the concept that learning disabilities may in some cases be a nutrient-responsive disorder.

Adolescent↗
PubMed1989

On learning ... more or less: a knowledge x process x context view of learning disabilities.

The authors review the last decade of their research on learning disabilities and conclude that knowledge x process x context is the most useful way to think about children's cognitive difficulties. According to this framework, learning disabilities is seen as a result of the interplay between a poorly elaborated knowledge base (especially in language-related domains), the biologically determined efficiencies of various microlevel processes such as encoding, and the physical and social meaning attached to performance (i.e, the context). It is suggested that this framework helps explain instances of asymmetry wherein children with learning disabilities deploy a cognitive process more or less efficiently, depending on the material and task demands. It also raises several interesting questions about the presumed "specificity" of the impairment underlying learning disablement and the possibility that these children may not differ qualitatively from nonimpaired peers, only quantitatively.

Adolescent↗
PubMedDate not supplied

Meeting the needs of people with learning disabilities in acute care.

This article describes the work of the Birmingham Acute Hospital Liaison Project, which seeks to support people with learning disabilities in acute care. Following the community care reforms, more and more people with learning disabilities are accessing mainstream primary and secondary healthcare services in community settings staffed by generic rather than specialist learning disability staff. Unfortunately, research suggests that some people with learning disabilities receive poor quality care and that available services are not always responsive to their needs. As a result, the Acute Hospital Liaison Project has a dual role: supporting people with learning disabilities as they enter hospital; and working with ward staff to equip them with the skills and confidence they need to work more effectively with people with learning disabilities.

Community Mental Health Services↗
PubMed2003

An evaluation of community learning disability nurse teams in two London boroughs.

One of the tasks for all the recently established local learning disability partnership boards is to review the role of specialist learning disability services by autumn 2003. This article presents a summary of a recent operational and strategic evaluation of community learning disability nurse teams working in two boroughs, managed by social services. Overall, local caseloads suggest that there are not enough nurses in the two boroughs. Furthermore, there is no spare capacity to address the Government's directive that specialist staff become health facilitators, and give more time to helping primary and secondary care develop the capacity of their services for people with learning disabilities (Department of Health, 2001). Locally, these findings challenge the partnership boards and social services to adequately resource specialist services, meet Government targets and address nationally acknowledged, disproportionately high, unmet health needs in the learning disability population.

Community Health Nursing↗
PubMed1978

A musical profile for sample of learning-disabled children and adolescents: a pilot study.

31 learning-disabled children and adolescents completed the Pitch, Loudness, Rhythm, Time, and Tonal Memory subtests of the Seashore Measures of Musical Talents. Results indicated that the Seashore test did not discriminate between subgroups of these learning-disabled children. However, differences were found in percentile equivalents between these learning-disabled and normal individuals. These data should be interpreted with caution due to the small size of this sample and the spread of percentiles presented by Seashore.

Adolescent↗
PubMed1990

The self-perception of a learning disability and its relationship to academic self-concept and self-esteem.

Eighty-seven children with learning disabilities, aged 9 through 11 years 11 months, completed measures of self-esteem, academic self-concept, and self-perception of their learning disability. The Self-Perception of Learning Disability (SPLD) instrument measures the extent to which children with learning disabilities perceive their disability as (a) delimited rather than global, (b) modifiable rather than permanently limiting, and (c) not stigmatizing. It was hypothesized that self-perception of one's learning disability would be related positively to both academic self-concept and self-esteem, and that each of these relationships would remain significant when controlling for sex, ethnicity, age, reading and math achievement, self-contained versus mainstreamed classroom setting, and age at diagnosis. Correlations and multiple regression analyses confirmed these hypotheses. Results were discussed in terms of helping children to develop less negative self-perceptions of their disabilities.

Achievement↗
PubMed2004

Psychiatric implications of language disorders and learning disabilities: risks and management.

This article reviews the relationship between different learning disabilities, language disorders, and the psychiatric disorders that are commonly associated with learning disabilities and language disorder: attention-deficit hyperactivity disorder (ADHD), anxiety disorders, depression, and conduct or antisocial personality disorder. The complex associations between language disorders and specific learning disabilities--dyslexia, nonverbal learning disorder, dyscalculia--and the various psychiatric disorders are discussed. Clinical vignettes are presented to highlight the impact of these disorders on a child's social and psychological development and the importance of early recognition and treatment.

Adaptation, Psychological↗
PubMed1990

Story composition skills of middle-grade students with learning disabilities.

This study examined the story composition abilities of learning disabled (LD) and normally achieving young adolescents as indicated by measures of writing category, cohesion, and fluency. Findings suggest that although adolescents with learning disabilities have a rudimentary knowledge of story form, this knowledge is less well developed than that of their nondisabled peers. Students with learning disabilities also had greater coherence problems in their writing and were less fluent writers. Several important age trends were noted when results of this investigation were compared with outcomes from a similar investigation involving younger students.

Adolescent↗
PubMed1996

Coping with school stress: a comparison of adolescents with and without learning disabilities.

The experience of school-related stress during the transition to junior high school is compared in a sample of 59 students with learning disabilities (27 females, 32 males) and 402 students without learning disabilities (241 females, 161 males). Using a checklist of 11 stressful school events, the authors found that adolescents with learning disabilities were more likely to report that they had failed a class and less likely to report they had been chosen for a school activity than their non-learning disabled peers. However, the two groups of students did not differ in their perceived stressfulness of any of the pertinent school events. Students with learning disabilities reported relying on cognitive avoidance as a coping strategy more heavily than did non-learning disabled students when coping with an academic stress event, and reported that they mobilized fewer peers for social support when dealing with an academic stressor or with an interpersonal problem. The implications of these differences for the students' well-being are discussed. It is also suggested that school policies need to be examined for their impact on the opportunity for students with special needs to form supportive peer relations within the school environment.

Adaptation, Psychological↗
PubMedDate not supplied

Helping young adults understand their learning disabilities.

This study evaluated the effectiveness of an Understanding Learning Disabilities (ULD) course designed to promote self-understanding and self-advocacy skills in young adults with learning disabilities (LD) functioning in the low-average range intellectually. Nineteen first-year students with LD at the Threshold Program at Lesley College received 15 hours of training throughout one semester. Seventeen first-year students with LD at the Para-Educator Center at New York University served as the control group. Both a paper-and-pencil questionnaire and a role-play interview were used as pre- and postassessments. Results of ANOVAs performed on posttest questionnaire and interview scores support the effectiveness of the ULD course in expanding students' knowledge base regarding their learning disabilities and teaching them to apply their self-understanding in a social context. Moreover, students' performance on the questionnaire was an effective predictor of future work adjustment 1 year later. Significant correlates of ULD performance include IQ, academic achievement, and vocational functioning.

Adolescent↗
PubMed1992

Symmetry in building block design for learning disabled and nonlearning disabled boys.

This study examined perceptual differences in symmetry with and without a model between 21 learning disabled boys with reading deficits and 28 learning disabled boys with deficits in mathematics. 55 nonlearning disabled boys served as controls. All boys were in Grades 3, 4, or 5. Without a model, all learning disabled boys built significantly more asymmetrical building block designs than nonlearning disabled boys. However, with a model, all learning disabled boys could imitate the model, but it took them longer to complete the task successfully. All boys appeared to have difficulty in modeling asymmetrical tasks, taking more time for task completion after seeing an asymmetrical model. This study suggests modeling perceptual tasks might be an effective teaching strategy for such children.

Attention↗
PubMed1991

Allocation of study time and recall by learning disabled and nondisabled children of different ages.

Study time and recall by learning-disabled and nondisabled children of five different ages were examined in a task requiring recall of digits that were presented at the child's own rate. Recall increased with age and was significantly higher by nondisabled than disabled children, particularly at older ages. As additional digits of each sequence were presented, study time by 8-year-old disabled and nondisabled groups were relatively constant, increased in older disabled and nondisabled children, but increased more in older nondisabled children than older learning disabled children. Instructions in hierarchical grouping of digits increased recall by all groups to a similar degree, but the increase by younger children and learning disabled children was associated with longer study times. The results suggest that allocation of study time and recall are developmentally delayed in learning disabled children.

Achievement↗
PubMedDate not supplied

Dichotic consonant-vowel (CV) testing in the diagnosis of learning disabilities in children.

The performance of normal and learning-disabled children on a dichotic listening task using 30 paired consonant-vowel (CV) syllables was investigated in a series of studies. The effects of gender, developmental level, and prestimulus cuing on assessed auditory asymmetries were examined. In addition to providing normative data, the results of these studies are discussed as they relate to theoretical notions of cerebral asymmetries in normal and learning-disabled children and as they pertain to clinical diagnosis of childhood learning disabilities.

Age Factors↗
PubMed2002

Topiramate in patients with learning disability and refractory epilepsy.

PURPOSE: Management of seizures in learning disabled people is challenging. This prospective study explored the efficacy and tolerability of adjunctive topiramate (TPM) in patients with learning disability and refractory epilepsy attending a single centre. METHODS: Sixty-four patients (36 men, 28 women, aged 16-65 years) were begun on adjunctive TPM after a 3-month prospective baseline on unchanged medication. Efficacy end points were reached when a consistent response was achieved over a 6-month period at optimal TPM dosing. These were seizure freedom or > or =50% seizure reduction (responder). Appetite, behaviour, alertness, and sleep were assessed by caregivers throughout the study. RESULTS: Sixteen (25%) patients became seizure free with adjunctive TPM. There were 29 (45%) responders. A further 10 (16%) patients experiencing a more modest improvement in seizure control continued on treatment at the behest of their family and/or caregivers. TPM was discontinued in the remaining nine (14%) patients, mainly because of side effects. Final TPM doses and plasma concentrations varied widely among the efficacy outcome groups. Many patients responding well to adjunctive TPM did so on < or =200 mg daily. Mean carer scores did not worsen with TPM therapy. CONCLUSIONS: TPM was effective as add-on therapy in learning-disabled people with difficult-to-control epilepsy. Seizure freedom is a realistic goal in this population.

Adolescent↗
PubMed1994

A framework for commissioning services for people with learning disabilities.

The needs of people who have global developmental learning disabilities (mental handicap) are complex and lifelong. Unless social and health service commissioners agree a framework for conceptualizing their need, there is a danger that services could become fragmented. This paper uses the World Health Organization's model of disabilities to put in context these needs. Using this model it is logical for health services to focus on (1) ensuring access to the full range of primary and secondary health services, (2) reducing the occurrence and severity of intellectual and associated impairments and (3) ensuring the provision of assessment and treatment of behaviour disorders and associated mental health problems. Some of these inputs are required before birth and in early childhood, but a number of people will require health services throughout life because of the presence of other disabilities or continuing behaviour and/or mental health problems. At school age, the education authority should provide the lead in ensuring the best physical and social learning environment. All children with learning disabilities will be socially disadvantaged in adulthood unless they are provided with opportunities for social integration, continuing education, skills training, employment and normal living facilities which meet their needs. Although there appears a logical shift in agencies' responsibilities as children with intellectual impairment progress through life, there is considerable diversity within this group and care can only be effectively provided on the basis of a sophisticated assessment of individual need and provision of integrated care.

Activities of Daily Living↗
PubMed1982

Right hemisphere involvement in learning disability, attention deficit disorder, and childhood major depressive disorder.

Learning disability, attentional disorder and childhood major depression are frequent diagnoses in children with behavioral disturbances and impaired school performance. All three disorders are associated with right cerebral hemisphere dysfunction. Anatomical disturbance of right hemisphere function results in learning disability and/or attentional disorder. The physiological disturbance of right hemisphere function produced by a major depressive episode results in additional learning disability and/or attentional disorder.

Attention↗
PubMed2004

Developing methods for systematic reviewing in health services delivery and organization: an example from a review of access to health care for people with learning disabilities. Part 1. Identifying the literature.

OBJECTIVES: Our objectives were to identify literature on: (i) theory, evidence and gaps in knowledge relating to the help-seeking behaviour of people with learning disabilities and their carers; (ii) barriers experienced by people with learning disabilities in securing access to the full range of health services; (iii) interventions which improve access to health services by people with learning disabilities. DATA SOURCES: twenty-eight bibliographic databases, research registers, organizational websites or library catalogues; reference lists from identified studies; contact with experts; current awareness and contents alerting services in the area of learning disabilities. REVIEW METHODS: Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to the Guilliford et al. model of access to health care (Gulliford et al. Access to health care. Report of a Scoping Exercise for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). London: NCCSDO, 2001), which was modified to the special needs of people with learning disabilities. Inclusion criteria focused on relevance to the model with initial criteria revised in light of literature identified and comments from a consultation exercise with people with learning disabilities, family and paid carers and experts in the field. Data abstraction was completed independently and selected studies were evaluated for scientific rigour and the results synthesized. RESULTS: In total, 2221 items were identified as potentially relevant and 82 studies fully evaluated. CONCLUSIONS: The process of identifying relevant literature was characterized by a process of clarifying the concept under investigation and sensitive search techniques which led to an initial over-identification of non-relevant records from database searches. Thesaurus terms were of limited value, forcing a reliance on using free-text terms and alternative methods of identifying literature to supplement and improve the recall of the database searches. A key enabler in identifying relevant literature was the depth and breadth of knowledge built up by the reviewers whilst engaged in this process.

Databases, Bibliographic↗
PubMed1998

Learning disabilities with and without attention-deficit hyperactivity disorder: parents' and teachers' perspectives.

Our objective was to delineate the educational and behavioral differences between learning disabled children with and without attention-deficit hyperactivity disorder (ADHD). A restrospective (TROHOC) multimeasure comparative design was employed. Parents' and teachers' questionnaires (ANSER system) pertaining to attention-activity, associated behaviors, and scholastic achievements were compared. Parents' questionnaires failed to distinguish between the two groups. Teachers' questionnaires were significantly more sensitive. Significant correlations between educational achievements and attention-activity and associated behaviors scores among children with learning disabilities were evident, no such correlations were found in the group with learning disability with ADHD. The factor analysis identified different educational and behavioral aggregates with language related difficulties and externalizing behaviors more typically aggregated in the learning disabled group with ADHD and recall deficit and internalizing/neurotic behaviors in the group with learning disability only. ADHD appears to be an associated comorbidity and not necessarily a specific learning deficit. However, children with learning disability with ADHD possibly have a different underlying neurocognitive pattern than their peers with learning disabilities only.

Attention Deficit Disorder with Hyperactivity↗