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PubMed1983

Neuroimmaturity of learning-disabled children: a controlled study.

A 46-component neurological exam was administered to 119 learning-disabled children and to 152 control children, and a Neuroimmaturity Index (NI) was constructed. The results were compared by age and sex. Neuroimmaturity decreased significantly with age, and after controlling for age and sex there were statistically significant differences in NI between the learning-disabled and control children. Male children from both groups, controlling for age, tended to have a higher NI than females. Patterns of disability were related to communication skills; older learning-disabled males had difficulty writing and spelling, whereas younger female learning-disabled children had difficulty with spoken language.

Adolescent↗
PubMed1978

Abstract reasoning in a specific group of perceptually impaired children: namely, the learning-disabled.

The present study was designed to investigate whether learning-disabled children differ from normal achievers in terms of logical thought and wheter they exhibit décalages intheir acquisition of Piagetian concepts. The Ss comprised 35 learning-disabled boys attending full-time remedial schools and 35 matched normal achievers. The group mean was 9 years 1 month and the mean IQ was 109. S s were tested on a measure of visual perception and on 11 Piagetian tasks measuring conservation of quantitiy and number, seriation, and classification. Results indicated a significant difference between the groups in terms of perception but not in terms of logical thought. The rank order of the 11 Piagetain tasks was significantly correlated for the two groups (r = .89). It was concluded that the perceptual problems of the learning-disabled reside at a functional rather than at an organizational level, thus effecting only specific congnitive activities.

Child↗
PubMed1989

The relationship between learning disability and delinquency: a review and reappraisal.

Data are presented on the prevalence of learning disabilities among populations of delinquents. Current hypotheses proposed to explain the relatively high prevalence rate are examined in the context of the research literature pertaining to the psychosocial characteristics of youngsters with learning disabilities and the research literature pertaining to delinquency. A multifactorial explanation is offered, according to which the probability of a youngster with a learning disability becoming delinquent is seen as a consequence of the interaction between specific elements of learning disabilities and specific psychosocial correlates of delinquency.

Causality↗
PubMed1993

The performance of children with language-learning disabilities on two types of cognitive tasks.

The performance of children with language-learning disabilities on two types of cognitive tasks was compared to that of two groups without language-learning disabilities, one matched for mental age and the other for language (vocabulary) age. The first task, Concept Formation, measured one's ability to identify and state the rule for a concept about a set of colored geometric figures when shown instances and noninstances of the concept. The second task, Analysis Synthesis, required the identification and use of a solution key to solve an incomplete logic puzzle. Both tasks involved increases in complexity as additional items were administered. Results indicate that the children with language-learning disabilities performed at a level commensurate with the language-matched group on the Concept Formation task, and at a level commensurate with the mental-age matched group on the Analysis-Synthesis task. The implications of these findings for the nature of language-learning disabilities are discussed.

Adolescent↗
PubMed2004

Learning disabilities: a survey of community nurses for people with prevalence of challenging behaviour and contact demands.

BACKGROUND: There is scant knowledge on the contacts community nurses for people with learning disabilities have with clients who display challenging behaviours, or the numbers of such people on these nurses' caseloads. This study was undertaken in a UK region with a population of 1.68 million people. In this region it is estimated that there are 8500 people with learning disabilities who are in contact with services, this includes around 500 people remaining in hospitals awaiting resettlement. AIMS AND OBJECTIVES: The research aims were to identify the overall caseload sizes of the nurses, the prevalence of people with learning disabilities who have challenging behaviours on the nurses' caseloads and what contact demands these people required. An additional aim was to discover courses or training that helped the nurses to fulfill their roles. DESIGN AND METHODS: A postal survey was undertaken of the total population of community nurses for people with learning disabilities in the region. The method of data collection was a self-completion questionnaire. RESULTS: The study found that people with challenging behaviours accounted for over a quarter of the combined caseloads, and these clients required the most frequent visits from the nurses. There was a wide range in the number of clients on the caseloads of each nurse but overall these were higher than in other parts of the UK. CONCLUSIONS: It is concluded that community nurses for people with learning disabilities have large caseloads and people with learning disabilities who have challenging behaviours, who account for over one-quarter of the clients they visit, require much more frequent contact visits than other clients. The combination of high numbers of clients (or low numbers of these nurses) may impact on how such nurses are able to perform their role and functions. RELEVANCE TO CLINICAL PRACTICE: An increase in the numbers of community nurses for people with learning disabilities and skill development in caring for people with challenging behaviours is recommended. If this is not performed the clinical effectiveness of this group of nurses with respect to their work with people who challenge services may be unduly hampered.

Adaptation, Psychological↗
PubMed2000

Genetics advances and learning disability.

BACKGROUND: Medicine is rapidly becoming molecular medicine, and little escapes the grasp of modern genetics. Most disorders associated with learning disability have at least a genetic component influencing their expression; in many disorders, disturbances of genetic mechanisms play a pivotal role. AIMS: Dynamic mutations, imprinting mechanisms and gene-dosage effects are explained with reference to genetic disorders that lead to learning disability. METHOD: A review of recent important studies in the genetics of learning disability. RESULTS: A host of new genetic connections to conditions associated with learning disability have been made. CONCLUSIONS: A basic understanding of these genetic connections is important for all learning disability psychiatrists if they are to follow the rapid changes--already beginning to influence our practice--that hold immense promise for the future.

Angelman Syndrome↗
PubMed2000

Reducing antipsychotic medication in people with a learning disability.

BACKGROUND: The use of antipsychotic drugs in people with learning disabilities is currently receiving intensified scrutiny and attempts are being made to reduce it. AIMS: A randomised controlled trial was designed to investigate factors influencing antipsychotic drug reduction among people with learning disabilities prescribed such medication for behavioural problems. METHOD: Thirty-six participants randomly allocated to the experimental group underwent four, monthly 25% drug reduction stages. There were no planned drug changes for the control group (n = 20). RESULTS: Twelve participants (33%) completed full withdrawal; a further seven (19%) achieved and maintained at least a 50% reduction. Drug reduction was associated with increased dyskinesia and higher activity engagement but not increased maladaptive behaviour. Some setting characteristics were associated with drug reinstatement. CONCLUSIONS: A substantial proportion of people with learning disability prescribed antipsychotic medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.

Adult↗
PubMed2005

[New trends in the evaluation of mathematics learning disabilities. The role of metacognition].

INTRODUCTION: The current trends in the evaluation of mathematics learning disabilities (MLD), based on cognitive and empirical models, are oriented towards combining procedures involving the criteria and the evaluation of cognitive and metacognitive processes, associated to performance in mathematical tasks. AIMS: The objective of this study is to analyse the metacognitive skills of prediction and evaluation in performing maths tasks and to compare metacognitive performance among pupils with MLD and younger pupils without MLD, who have the same level of mathematical performance. Likewise, we analyse these pupils' desire to learn. Subjects and methods. We compare a total of 44 pupils from the second cycle of primary education (8-10 years old) with and without mathematics learning disabilities. RESULTS: Significant differences are observed between pupils with and without mathematics learning disabilities in their capacity to predict and assess all of the tasks evaluated. As regards their 'desire to learn', no significant differences were found between pupils with and without MLD, which indicated that those with MLD assess their chances of successfully performing maths tasks in the same way as those without MLD. Finally, the findings reveal a similar metacognitive profile in pupils with MLD and the younger pupils with no mathematics learning disabilities. CONCLUSIONS: In future studies we consider it important to analyse the influence of the socio-affective belief system in the use of metacognitive skills.

Learning Disabilities↗
PubMed1993

Working memory in learning disability subgroups.

The purpose of this study was to investigate (a) the degree to which working memory differences between learning-disabled and nondisabled children reflect a specific or generalized deficit, and (b) whether limitations in the enhancement of learning-disabled student's working memory performance are attributable to process or storage functions. To this end, performances of reading-disabled, math-disabled, chronological age (CA)-matched, and achievement-matched children were compared on verbal and visual-spatial working memory measures under initial, gain, and maintenance conditions. The results indicated that: (a) learning-disabled subtypes were not differentiated by their performance on verbal and visual-spatial working memory measures; and (b) learning-disabled children's working memory performance was inferior to CA-matched and superior to achievement-matched counterparts across initial, gain, and maintenance conditions. The results suggest that learning-disabled children suffer generalized working memory deficits, possibly due to storage constraints in the executive system.

Attention↗
PubMedDate not supplied

Improving primary health care for people with learning disabilities.

'Signposts for Success' (Department of Health (DoH), 1998a) states that specialist learning disability services (SpLDS) must promote liaisons with, and offer specialist advice to, primary healthcare teams (PHCTs). With the advent primary care groups (DoH, 1998b), genuine collaboration and partnership-forging is necessary and timely to prevent people with learning disabilities being excluded from healthcare services. The project described in the article had three broad aims: first, to establish a practice register of people with learning disabilities in all practices involved in the project; second, to enable practice nurses (PNs), with support, to carry out a systematic health check within the practice of people with learning disabilities; and third, to enable the project nurse to act as a crucial link between SpLDS and the PHCT. The health checks highlighted unmet health and social needs, which were then met through appropriate referral and intervention, mainly to specialist services. Follow ups were conducted to measure any health gain as a result of the applied Interventions. Evidence of health gain was revealed, pointing to the clinical effectiveness of performing such checks within the PHCTs.

Community Health Nursing↗
PubMedDate not supplied

Staff perceptions of community learning disability nurses' role.

AIM: This study examines the views of health and social care staff in relation to their perception of the role of community learning disability nurses. METHOD: A total of 40 staff completed a questionnaire to identify the role and rate the effectiveness of community learning disability nurses. Inter-rater reliability was assessed and themes were identified. FINDINGS: Staff see community learning disability nurses as having service development, liaison and consultancy roles. However, respondents also continued to emphasise nurses' direct clinical role, with over 40 per cent identifying assessment and treatment. The perceived effectiveness of the community learning disability nurse was 4.09, SD = 0.71, indicating that staff generally perceived the service to be effective. CONCLUSION: Community learning disability nurses are viewed by their multidisciplinary colleagues as having a broad and varied role, which is consistent with the role, identified by nurses themselves. They may need to consider how to further develop their services in relation to clients' physical health. Overall, all participants rated the nursing service as effective.

Attitude of Health Personnel↗
PubMed1983

Digit repetition in learning-disabled children.

Investigated digit repetition performance in learning-disabled children in an effort to assess its clinical and theoretical significance. Clinically, learning-disabled children were found to demonstrate a higher than expected incidence of large verbal-performance discrepancies, although mean overall digit repetition performance did not differ appreciably from that expected on the basis of intelligence (N = 100). Children with large discrepancies did not differ from those with no such discrepancies when compared on a variety of psychometric and neurobehavioral factors. Theoretically, a hemispheric specialization model and a neuropsychological function model have been proposed to underlie performance on the two somewhat different digit repetition tasks (forward and backward repetition). Some support was found for the neuropsychological function model, with significant correlations obtained between digits forward and a measure of language function and between digits backward and a test of visual constructional ability. Stronger evidence that could have been provided by a double dissociation of correlational findings was limited by a smaller, but significant, correlation between digits forward and Bender Gestalt errors. However, the results are consistent with previous research in suggesting that digit repetition can be an avenue to the study of brain-behavior relationships.

Child↗
PubMed2003

The developmental course of processing speed in children with and without learning disabilities.

This study contrasted the development of processing speed in children with and without learning disabilities. We examined whether the same global mechanism presumed to be responsible for the normal developmental improvement in processing speed might also be associated with the processing speed deficiencies observed in children with learning impairments. One hundred and twenty-two children with learning disabilities in reading and/or math and 206 non-disabled community controls participated. There were no differences in relation of age to the development of processing speed for children with and without learning disabilities. We interpreted these results as suggesting that the underlying etiologies for the normal developmental change in processing speed and for the relative deficiencies in processing speed seen among children with learning disabilities were different.

Adult↗
PubMed1991

Science instruction at the secondary level: implications for students with learning disabilities.

Designing appropriate content area instruction for secondary students with learning disabilities is a challenging endeavor. Even if these students are mainstreamed into algebra, history, or science classes, special educators are likely to expect only a minimal grasp of the material. To go beyond this, to teach higher order thinking through these subjects, would be regarded by most practitioners as too labor-intensive. The authors of this article argue that, through a comprehensive revision of traditional materials, secondary students with learning disabilities can learn content area subjects--earth science and introductory chemistry, particularly--in an integrated manner. These students can achieve a firm understanding of the subject, as well as learn how to solve complex, domain-specific problems. For this kind of integrated instruction to be feasible, the curriculum must be designed and field-tested by professional curriculum developers.

Adolescent↗
PubMed2003

An exploratory study on needs of parents of adults with a severe learning disability in a residential setting.

Parents are the key figures in the lifelong rehabilitation of adult children with a learning disability, including those who have a severe learning disability (i.e., having an IQ level between 20-25 and 35-40) (Hong Kong Rehabilitation Programme Plan, 1999). To provide specialized care, parents have to cope with a great deal of parenting demands. The purpose of this study was to explore parental needs in caring for adult children with a severe learning disability in residential setting. Focus group research design was adopted. Twenty-five parents of adults with a severe learning disability from a hospital in Hong Kong were invited to participate in five focus group interviews. The data were analysed by content analysis. Inter-coder reliability was established with inter-coder agreement of 0.8. Six broad categories of parental needs were revealed. Findings of the study may assist nurses to plan appropriate care for both the parents and the residents.

Adult↗
PubMed1987

Measuring the effects of failure with learning disabled children.

The effects of failure on performance for children diagnosed as learning disabled (reading) and normal children were compared with a simple clinical measure. As hypothesized, learning disabled children stressed with failure scored significantly (p less than .05) poorer than stressed normals on a reading posttest. Learning disabled children were seen to have developed a learned helplessness response mode and experienced greater difficulty in recovering from failure than normal cohorts. The results were interpreted as lending support to the use of a clinical measure in assessing the role played by failure in children's learning disorders.

Child↗
PubMed2003

Limited efficacy of gabapentin in severe therapy-resistant epilepsies of learning-disabled patients.

Knowledge on the effects of gabapentin (GBP) in learning disabled patients is limited. The objective of this study was to assess antiepileptic efficacy and tolerability of GBP in routine therapy. A retrospective open observational study design was applied. Twenty-nine consecutive residential patients with simple and/or complex partial seizures with or without secondary generalization and with different degrees of learning disability were included. All patients had severe therapy-resistant epilepsy. GBP was administered as add-on therapy. Dosages were progressively increased up to 1600-2400 mg/day (in a number of cases up to 4800 mg/day), in accordance with clinical requirements. The seizure frequency was recorded and compared between a baseline and a treatment period (after 3 months of titration) of 3 months duration each. Only three patients (10.3%) had a reduction of their seizure frequency by 50% or more. No patient became seizure-free. Unwanted side effects, mostly mild and dose-dependent, occurred in 37.9% of all patients. Somnolence and ataxia were the most frequently observed unwanted effects. In two cases hyperphagia/weight increase, and in two other cases edema occurred.We conclude the efficacy of GBP in learning disabled patients with highly therapy-resistant partial seizures is limited.

Acetates↗