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PubMed1996

Prevalence and cluster typology of maladaptive behaviors in a geographically defined population of adults with learning disabilities.

BACKGROUND: Maladaptive behaviours are frequently present in individuals with learning disabilities; however, their prevalence varies between studies and the aetiology, classification and most appropriate management of such behaviors remain unclear. The aims of the study were twofold: firstly to determine the prevalence of maladaptive behaviours, and secondly to develop a classification typology. METHOD: A population of 2202 adults with learning disabilities was surveyed to determine the prevalence of maladaptive behaviours. These were subjected on the basis of 13 behavioural characteristics to cluster analysis. The clusters were further examined in respect of secondary variables. RESULTS: Over 60% of individuals demonstrated the presence of at least one maladaptive behaviour and in 40% this problem was of either severe degree or frequent occurrence. Men were more likely to demonstrate physical aggression, property destruction, tantrums and verbal abuse than women. Although some severe maladaptive behaviours diminished with age, many persisted through all age groups. Six behavioural clusters were devised which demonstrated face validity and which differed in respect of demographic and developmental variables, and the prevalence of maladaptive habits and autistic symptoms. CONCLUSIONS: These findings demonstrate a high prevalence of maladaptive behaviours and 'objectionable habits' among people with learning disabilities. A classification of behavioural symptoms may be possible on the basis of symptom clusters.

Adolescent↗
PubMed1983

Neuropsychological assessment of learning disabilities: a discriminant analysis.

The neuropsychological test scores of 23 learning disabled children were compared with those of a matched population of normal children in the 9-1 to 13-1 age range. All children were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R), a dichotic listening task involving both free and directed recall conditions, a handedness inventory, the Tactile Performance Test and the Category Test from the Halstead-Reitan Neuropsychological Test Battery. A multivariate analysis of variance resulted in a significant separation between groups (p less than .001) using these procedures. A stepwise discriminant function analysis revealed that both of the directed dichotic tasks contributed the most of all 13 measures to the significant group separation. In addition, other cognitive tasks found to discriminate normal from learning disabled children include general verbal processes, concept formation, and tactile memory. These findings suggest that the directed dichotic listening procedure and the WISC-R Verbal IQ measure are reasonably valuable clinical tools in the classification of learning disabilities.

Adolescent↗
PubMed1998

Violence faced by staff in a learning disability service.

This study explores the issue of violence experienced by staff in the learning disability service of an NHS Trust. Based on the literature review a questionnaire survey was sent to all staff employed in the Trust's learning disability service (n = 295). The questionnaire sought: background details of respondents; numerical incidences and types of violence experienced over the previous 12 months; reporting mechanisms; reactions to and impact of violence on individuals and their work; support received. Vignettes provide a rich picture of the types of violent incidences and their impact. The findings show that 81% of staff in the learning disability service had experienced violence in the previous 12 months. Many had numerous experiences of violence. New and inexperienced staff are particularly vulnerable. Training and support systems are, on the whole, limited. Support received from colleagues is generally regarded as more helpful than that of line management. To explore good practice elsewhere, semi-structured interviews were held with individuals working with potentially violent clients in organizations other than the learning disability service. Suggestions are offered for putting in place human resource strategies to reduce the incidences of violence and provide appropriate post-incident support for staff on a continuing basis.

Adult↗
PubMed1977

Teenage status of hyperactive and nonhyperactive learning disabled boys.

Three groups of learning disabled boys--hyperactives, normoactives, and hypoactives--were studied in grade school, reevaluated at fourteen. At follow-up, all three groups remained at disadvantage to controls on academic and cognitive measures and on complex reaction time. Half the hyperactives had experienced major conflicts with authority, and over a third of hypoactives exhibited psychologically disturbing behaviors. Mental health of normoactives appeared comparable to controls.

Achievement↗
PubMedDate not supplied

Profiles of college students demonstrating learning disabilities with and without giftedness.

The purpose of this study was to analyze the assessment profiles of two groups of adults with learning disabilities. The first group comprised 48 adults (34 men and 14 women) demonstrating giftedness and a learning disability profile (G/LD). The second group of 46 adults (31 men and 15 women) demonstrated a learning disabled profile without giftedness (NG/LD). Both groups of participants were either attending or planning to attend college and sought testing at a university-affiliated learning disabilities center. Participants' mean age was 20 years, and all were White and from middle to upper-middle class backgrounds. Findings indicate that, as a group, the adults demonstrating a G/LD profile tended to be identified later and have more discrepancy among cognitive assessment profile scores than the NG/LD group. Cognitive subtest scores showed significant differences between the groups, but also several areas of weakness evident in both groups regardless of the presence of giftedness. These findings emphasize the importance of identifying the presence of learning disabilities among gifted populations.

Achievement↗
PubMed1987

Effects of viewing aggressive cartoons on the behavior of learning disabled children.

Forty-six learning disabled children (M = 7.6 years) were exposed to six aggressive and six control cartoons in school. Treatment effects were assessed using direct observations of five categories of social behavior. There were no main effects for condition, and neither initial aggressiveness nor gender interacted significantly with condition for any of the behaviors. There was a significant interaction of condition with IQ: the low IQ group became significantly more physically aggressive following control compared with aggressive cartoons. The results from the present study are compared with the findings from other field experiments, and their clinical relevance is discussed.

Aggression↗
PubMed2004

"I'm not the only one!" group therapy with older children and adolescents who have learning disabilities.

Children and adolescents with learning disabilities (LD) are vulnerable to psychosocial difficulties. Both the detrimental impact of LD on social adjustment and the significance of peer relations for developmental needs make group therapy a natural intervention. Despite modifications that are required due to their cognitive deficits, many students with LD fit the criteria and can benefit from group psychotherapy. In this paper, a model of group therapy for older children and adolescents with LD is presented. The approach is informed by a combination of self psychology, mutual aid, and interpersonal group therapy. The leaders use special techniques to accommodate the LD and to foster the group process. Examples are presented to illustrate the approach.

Adolescent↗
PubMed2003

Integration of heard and seen speech: a factor in learning disabilities in children.

Normal-learning children (NL) and children with learning disabilities (LD) reported their perceptions of unisensory (auditory or visual), concordant audiovisual (e.g. visual /apa/ and auditory /apa/) and conflicting (e.g. visual /aka/ and auditory /apa/) speech stimuli in quiet and noise (0 dB and -12 dB signal-to-noise ratio, SNR). In normal populations, watching such conflicting combinations typically changes auditory percepts ('McGurk effect'). NL and LD children identified unisensory auditory and congruent audiovisual stimuli similarly in all conditions. Despite being less accurate identifying unisensory visual stimuli, LD children were more likely than NL children to report hearing only the visual component of incongruent audiovisual stimuli at -12 dB SNR. Furthermore, LD children with brainstem timing deficits demonstrated a distinctive pattern of audiovisual perception. The results suggest that the perception of simultaneous auditory and visual speech differs between NL and LD children, perhaps reflecting variations in neural processing underlying multisensory integration.

Adolescent↗
PubMedDate not supplied

The effectiveness of a multisensory alphabetic phonetic approach with college students who are learning disabled.

College students diagnosed as learning disabled were studied to determine whether they would make more progress in a summer program if taught by an adaptation of the Orton-Gillingham (O-G) approach. Progress of those exposed to this approach was compared to progress of those exposed to (a) a nonphonetic approach or (b) no educational activity. Pre- and posttest results are reported for the Wide Range Achievement Test-Revised and Woodcock Reading Mastery Tests. The subjects were 30 college students aged 17 to 24, who were diagnosed as LD. They were divided into groups of 10 and exposed to the indicated educational intervention. The O-G group was found to achieve statistically significant improvement in reading when compared to the group using the nonphonetic approach or no educational activity. No statistically significant difference was noted between the latter two groups. This study indicates that a modified O-G approach is useful in the teaching of reading to college students who are LD.

Achievement↗
PubMedDate not supplied

Access to secondary care for people with learning disabilities.

A person-centred approach is needed to improve access to secondary health care for people who have learning disabilities. The Department of Health (1995a) drew attention to this issue when it reported that people with learning disabilities sometimes have problems maintaining their health because hospitals fail to work in an interdisciplinary manner with the specialist learning disability services. This article focuses on a case study where the difficulties in operating on a patient with learning disabilities and mental health problems were overcome through a multidisciplinary and patient-centred approach. The case study provides evidence of mainstream health staff and learning disability professionals working together and breaking down barriers to provide a seamless service.

Adult↗
PubMed2004

Neuropsychological characteristics of selective attention in children with nonverbal learning disabilities.

BACKGROUND: Children with nonverbal learning disabilities (NLD) usually manifest defective attention function. This study sought to investigate the neuropsychological characteristics of selective attention, such as attention control, working memory, and attention persistence of the frontal lobe in children with NLD. METHODS: Using the auditory detection test (ADT), Wisconsin card sorting test (WCST), and C-WISC, 27 children with NLD and 33 normal children in the control group were tested, and the results of C-WISC subtests were analyzed with factor analysis. RESULTS: Compared with the control group, the correct response rate in the auditory detection test in the NLD group was much lower (P < 0.01), and the number of incorrect responses was much higher (P < 0.01); NLD children also scored lower in WCST categories achieved (CA) and perseverative errors (PE) (P < 0.05). Factor analysis showed that perceptual organization (PO) related to visual space and freedom from distractibility (FD) relating to attention persistence in the NLD group were obviously lower than in the control group (P < 0.01). CONCLUSIONS: Children with NLD have attention control disorder and working memory disorder mainly in the frontal lobe. We believe that the disorder is particularly prominent in the right frontal lobe.

Attention↗
PubMed2002

Beds, budgets and burdens: learning disability expenditure v. workload across English health authorities. Comparative review.

BACKGROUND: Following the closure of asylums and widespread changes in the population distribution of people with learning disabilities, there has been little investigation of changing expenditure requirements of health authorities in England. AIMS: To compare expenditure on learning disability health services across England with the burden of services regionally, as estimated by numbers of people with learning disabilities. METHOD: A national database was set up using data from the National Audit Commission and the Department of Health. The spend/burden ratio was calculated and correlation tests for likely causes of inequality were applied. RESULTS: There is widespread discrepancy from the median spend/burden ratio of 10,260 UK pounds per person with learning disability. There is a positive correlation between ratios and levels of net exports of people funded by their local authority social services to reside "out of area". Comparative underspending occurs in rural areas. CONCLUSIONS: There are inequalities in levels of spending on learning disability services. Comparison of regions suggests resources may not be allocated fairly. Health authorities should ensure that population increases are mirrored by appropriate adjustments in expenditure.

Budgets↗
PubMed1994

Researching adults with learning disabilities from an adult-development perspective.

As the field of learning disabilities begins to discover the manifold issues of adulthood, there is a need for a framework for studying adults with learning disabilities. Currently, the research on adults focuses primarily on service delivery systems. If a life-span developmental perspective is utilized as a conceptual approach in future research, then the knowledge gained will be more meaningful. Considerations for incorporating such essential concepts as mediating variables, context, and age-span phases into research on adults with learning disabilities are discussed.

Adolescent↗
PubMedDate not supplied

Technology in the assessment of learning disability.

Recent neuroradiologic and brain imaging technologies, along with methods for displaying electrophysiologic data, have promulgated active exploration in the assessment of learning disability with attempts to improve diagnostic precision and elucidate the neurobiological substrates of learning disorders. The following article reviews these techniques and explores the research that has been conducted in this area over the past two decades. Initial investigations attempted to elucidate irregularities or abnormalities of brain morphology in individuals with learning disability utilizing computerized tomography (CT). The current standard for structural imaging of the brain is magnetic resonance (MR) imaging, which has allowed for greater specificity in identifying brain abnormalities. More recently, functional magnetic resonance imaging (fMRI) has been postulated as holding some promise in distinguishing anatomic/function differences in LD. Electrophysiological (EEG) and metabolic imaging techniques offer methods by which human brain activity can be studied during cognitive processes. Computerized EEG studies including evoked potentials (EP) or event-related potentials (ERP), spectral EEG analysis, and topographic EEG brain mapping have also identified a number of brain irregularities in individuals with learning disabilities, though no consistent exemplars have emerged. Studies with positron emission tomography (PET) and single photon emission computerized tomography (SPECT) have also demonstrated a number of abnormalities and inconsistencies in individuals with learning disabilities, but, again, no systematic research has demonstrated specific diagnostic abnormalities. Though inroads and some consistent patterns have begun to emerge in the assessment of learning disability with the preceding technologies, a number of challenges persist with neuroimaging and neurophysiological and metabolic imaging techniques. To date, no diagnostic conclusions have been drawn utilizing these methods in the assessment of the neurobiologic basis to LD.

Brain↗
PubMed1996

Learning-disabled readers' working memory as a function of processing demands.

The purpose of this study was to investigate whether limitations in the enhancement of learning-disabled readers' working memory performance are attributable to process or storage functions. For Experiment 1, performance of reading-disabled, chronological age-matched, and reading level-matched children was compared on verbal and visual-spatial working memory measures under initial (no probes or cues), gain (cues that bring performance to an asymptotic level), and maintenance conditions (asymptotic conditions without cues). The results indicated that (a) learning-disabled readers' working memory performance was comparable on visual-spatial measures, but inferior to CA-matched children on verbal working memory measures; (b) learning-disabled readers' performance was superior to reading-matched counterparts across working memory conditions; and (c) performance differences remained between learning-disabled and CA-matched children or gain and maintenance conditions, even when initial and processing efficiency (probe) scores were partialed out in the analyses. Experiment 2 included the same conditions as Experiment 1, except that verbal short-term memory scores were also partialed out in the analysis. The results indicated that learning-disabled readers are inferior on both verbal and visual-spatial working memory measures when compared to CA-matched children on high demand conditions (maintenance). Two findings that emerged across experiments were (a) intercorrelations among diverse WM measures increased on demanding conditions and (b) verbal WM was not directly related to reading skill. In sum, the results support the notion that learning-disabled readers' poor working memory performance on demanding conditions reflect constraints in a central executive storage system.

Child↗
PubMed1993

Vertical fixation disparity in learning disabled.

In this correlation study of visual parameters as related to learning disabilities, we considered several deficits: uncorrected refractive error, accommodative infacility, inaccurate pursuits, and vertical fixation disparity. Because vision is the primary sensory input involved in reading, it is nothing new to find a correlation between visual deficits and learning problems; however, vertical fixation disparity, unique in its relation to other sensory systems, deserves a great deal of attention. The high incidence of vertical fixation disparity measured in 5th and 6th graders with learning disabilities suggests that there is a plausible causal relation. Vertical oculomotor imbalance, vestibular problems, and learning disability are discussed.

Accommodation, Ocular↗
PubMed2001

Oral health status and dental service use of adults with learning disabilities living in residential institutions and in the community.

OBJECTIVE: To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services. DESIGN: A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner. SETTING: Residential homes, day centres or community homes of people with learning disabilities in Sheffield. SUBJECTS: A 20% random sample of adults (18-65 years) on the register. RESULTS: A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble. CONCLUSIONS: Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.

Adolescent↗
PubMed1990

Cognitive correlates of social perception in students with learning disabilities.

In investigating possible explanations for social skills deficits in students with learning disabilities, researchers have examined social perception-the interpretation of behavior in order to understand the thoughts and feelings of others. This study specifically examined cognitive correlates of social perception in individuals with learning disabilities. Thirty-two students with learning disabilities in elementary grades were measured on three subtests (Comprehension, Picture Arrangement, and Digit Span) of the Wechsler Intelligence Scale for Children-Revised and on the Profile of Nonverbal Sensitivity. Both Picture Arrangement and Comprehension seemed to have an inherent relation to social perceptual functioning. Implications of these results are discussed.

Child↗