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Employees who are mentally retarded or learning-disabled are not troubled when there is a good job match and appropriate management. The article covers the nature of these disorders and various issues that concern business and industry in arranging appropriate employment for such individuals.
This article addresses the issues surrounding the role of learning disability nurses and their relationship with primary healthcare colleagues. It highlights opportunities in general practice for the learning disability nurse who has become a key player in shaping services for this client group as services swing towards primary healthcare. The NHS Executive document NHS Priorities and Planning Guidance 1997-98 is explored and the opportunities that this gives the community learning disability nurse are discussed. The article stresses the need for learning disability nurses to obtain quality research-based evidence on effective caring interventions. The importance of clinical audit and outcome measurements from interventions are highlighted. Finally, the importance of good communication and being able to respond to this client group's needs is emphasized.
The Coopersmith Self Esteem Inventory (CSEI) was administered to 23 Ss diagnosed to have learning disabilities, and normally achieving seventh graders (N = 70) to investigate: a) whether differences exist between the self-esteem of the adolescent with learning disabilities and the normally achieving adolescent, b) the dimensions of self concept in which these differences occur, and c) the relationship between self concept and the number of years in the special classroom for the adolescent with learning disabilities. The data were fitted to a 2 X 2 (ability X school) fixed effects non-orthogonal multivariate analysis of variance model. A significant difference (p less than .05) in "social self-peer" self concept favoring the "normally" achieving S's was found. A trend was evidenced for more negative "general self" and "school-academic" self concepts for the learning disabilities sample. Number of years in the special class did not appear associated with self concept as measured by the CSEI.
This article gives an overview of the draft of the London Learning Disability Plan developed by the Department of Health, Social Services Inspectorate and the National Health Service Executive. The London Plan is founded on a social model of disability in which there is not only a strong focus on health and social care, but also an integration with housing, education, employment, leisure and other relevant organizations. It advocates integrated commissioning and delivery of specialist learning disability services that will require both health services and nurses to change existing structures and interventions. New forms of workforce development will emerge and clarification will be required about the future role of learning disability nurses within London. Information specific to the Plan is gathered from the Department of Health's learning disabilities Web site. The Plan is laid out in four booklets, one of which (Booklet 2: 'Services to Improve People's Lives') was not available at the time of writing. The article thus contains information and proposals that may be altered by subsequent publication.
Examined the research on WISC-R profile analysis germane to the differential diagnosis of learning disabled children in relation to several methodological problems that concern score use and interpretation. The evidence based on Bannatyne's (1974) recategorization of the subtests indicates a Spatial greater than Conceptual greater than Sequencing pattern of performance for learning disabled children. The application of this evidence of group characteristics to the individual child is problematic. The trend is not consistent. In addition, the interpretation of the individual profile is complicated by the unreliability of a few of the subtests, the unreliability of subtest difference scores, the unreliability of Bannatyne category difference scores, and the invalidity of the difference scores for discriminating between learning disabled and other children. It was recommended that clinicians not use the WISC-R profile to diagnose specific learning disabilities. Instead, the analysis may have greater utility in the prevention and remediation of learning problems, especially at the preschool level.
OBJECTIVES: People with learning disabilities are more prone to a wide range of additional physical and mental health problems than the general population. Our aim was to map the issues and review the evidence on access to health care for these patients. The review sought to identify theory, evidence and gaps in knowledge relating to the help-seeking behaviour of people with learning disabilities and their carers, barriers and problems they experience accessing the full range of health services, and practical and effective interventions aiming to improve access to health care. METHODS: A three-strand approach was adopted, involving searches of electronic databases, a consultation exercise and a mail shot to researchers and learning disability health professionals. Evidence relevant to our model of 'access' was evaluated for scientific rigour and selected papers synthesized. RESULTS: Overall, a lack of rigorous research in this area was noted and significant gaps in the evidence base were apparent. Evidence was identified on the difficulties in identifying health needs among people with learning disabilities and the potentially empowering or obstructive influence of third parties on access to health care. Barriers to access identified within health services included problems with communication, inadequate facilities, rigid procedures and lack of appropriate interpersonal skills among mainstream health care professionals in caring for these patients. A number of innovations designed to improve access were identified, including a communication aid, a prompt card to support general practitioners, health check programmes and walk-in clinics. CONCLUSION: There are important gaps in the knowledge base on access to health care for this group. While these need to be addressed, developing strategies to overcome identified barriers should be a priority, along with fuller evaluation of existing innovations.
The case of a 20-year-old woman with a histrionic personality disorder is described. She claims to have a mild learning disability, and indeed, is receiving special college education for people with learning disabilities and has a specialist learning disability social worker, despite being of above average intelligence. Aetiologically, her persona is viewed as a psychological defence, rather than a deliberate attempt at deception. A process of 'institutionalization' appears to have occurred and compounded the problems with further regression. Psychiatrists and professionals in allied disciplines should not accept that a person has a learning disability purely because that person tells you that he or she has one.
To investigate the development of mediational deficiencies in verbal and nonverbal visual short-term memory of learning-disabled children, the recall task of Atkinson, Hansen, and Bernback was administered to learning-disabled children in two experimental conditions. In Experiment 1 no significant differences on nonverbal short-term memory recall between normal and learning-disabled children were found. Similar recall responses (e.g., middle response bias, primacy effects, and recency effects) were found for both groups. Nonverbal recall was comparable for disabled and normal children as suggested by stimulus content and association scores. Experiment 2 found that while the effects of overt rehearsal on pretrained labels on learning-disabled children's recall was negligible, labels provided superior recall for normal children. Results suggested that learning-disabled children suffer from a verbal mediational deficiency consistent with Flavell's (1970) mediation deficiency hypothesis.
BACKGROUND: Neuroimaging has proven useful in confirming diagnoses of certain neuropsychiatric conditions, but neuroimaging studies in learning disability are at an early stage. METHOD: A review of recent structural neuroimaging research in relation to learning disability was carried out. RESULTS: Brain abnormalities can be detected in cases of idiopathic and non-idiopathic learning disability, but their significance is not clear due to discrepancies in study findings and the small cohorts involved. CONCLUSION: Although the role of structural neuroimaging in the assessment of people with learning disability is not clear, new magnetic resonance imaging technology holds great promise for future research.
The purpose of this study was to examine the effects of extra time on the ability of university students with and without learning disabilities to complete a reading comprehension test under timed and extra-time conditions. The participants were 16 students identified as having learning disabilities and 15 normally achieving students, all attending the University of California. The Nelson-Denny Reading Comprehension and Reading Rate Test was used. Percentile ranks were obtained for reading rates on individuals, and for comprehension scores under timed and extra-time conditions. The major findings of this study were that there is a significant difference between scores obtained by students with learning disabilities and by normally achieving students under timed conditions and that there are no significant differences in test performance between students with learning disabilities and normally achieving university students when students with learning disabilities are provided extra time. Normally achieving students did not perform significantly better with extra time.
An earlier investigation indicated that the education students in this sample gave estimates of the prevalence of learning disabilities that were 4 times greater than those given by experts. In the present study, we identified the sources of information these students used to conceptualize and estimate the prevalence of these disabilities. These 140 first-year education students cited direct contact with persons identified as learning disabled as the primary individual source and personal experience as the primary type of source they used to form conceptions of learning disabilities. These findings raise questions about the effects exposure to possible stereo-types of learning disabilities and their resolution may have on the practices of educators. Faculty must present research to students so stereotypical views of pupils who have difficulty learning in school and the solutions to their problems are questioned.
PURPOSE: Whilst the health benefits associated with regular physical activity are well known, little objective evidence exists regarding the activity profiles of adults with mild and moderate learning disabilities. The aims of the present study were to establish 7 day physical activity profiles for 24 adults with mild and moderate learning disabilities and to compare them with the general population and current Department of Health recommendations for physical activity. METHOD: A descriptive study was used, based on interviews with 24 adults with learning disabilities (mean age 34 years) triangulated by daytime and residential care workers. Participants volunteered from two residential homes and one social education centre (SEC) in a city in the North of England. RESULTS: The physical activity profiles show that the participants led sedentary lifestyles that were more exaggerated than those of the general population. Twenty-two participants (93%) performed significantly less than the minimum daily levels of physical activity recommended by the Department of Health. CONCLUSIONS: Few adults with learning disabilities can choose to walk to work, go for a run or visit the local swimming pool without adequate support. This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care settings to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health. Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity.
This research was done to answer whether learning disabled students attend to different word features than nonexceptional and gifted students and whether there is a difference by grade. Word sorts of meaningful and nonsense words were used to estimate differences between 145 first- and fifth-grade learning disabled, nonexceptional, and gifted groups. Analyses indicated that 54 learning disabled students were more likely to provide no response or to give simpler responses than 61 nonexceptional or 30 gifted peers. Older children (n = 78) attended to more and varied word features, were more likely to focus on recognizable meaning, and were more able to use syllables as a tool for sorting than were 67 younger children. Significant differences were noted between grade and exceptionality groups. Implications for practical application and further research are discussed.
This article aims to reflect upon the changes in the learning disability nursing profession over the last 10 years. It highlights the nurses' role in supporting a change of culture within the field of learning disability from one of oppression and restriction of individual rights to one where the principles characterized in the White Paper--civil rights, independence, choice and inclusion--are being increasingly supported by learning disability nurses. It concludes by examining the key issues that face the learning disability profession over the next 10 years.
Although considerable research has been done with biofeedback in adults, little is known of its effect in children of different ages or those with learning disabilities. This study assessed the effects of thermal biofeedback in 60 children (40 boys, 20 girls) aged 7 to 9 yr. (Mage 8-6) half of whom were learning-disabled and half, normal children matched for age, sex, grade, race, socioeconomic status, and IQ. Training consisted on one 15-min. period daily for five days with three trials per period. Children (16 learning-disabled, 16 normals) received consistent reinforcement for digital temperature increases while 28 children (14 learning-disabled, 14 normals) received mixed reinforcement after Day 1, on which all children were consistently reinforced to yield a performance baseline. Feedback was provided by a variable intensity light and toy electric train. Learning was demonstrated only for the consistently reinforced group, which performed almost twice as well as those receiving mixed reinforcement. Learning-disabled children learned thermal control even better than normals, explained in terms of biofeedback reinforcing an internal steady state conducive to learning. Younger children did better than older children, and girls did somewhat better than boys. Post-training improvement in figure-ground discrimination and intersensory-integration was linked with performance and learning, respectively.
This article discusses an area of education for students with learning disabilities that is often neglected. The topic of study skills education, although not new to education in general, has only recently been emphasized in the literature for students with handicaps. An overview of the study skill proficiency (or lack of it) of students with learning disabilities is provided, followed by the presentation of 15 student study skill strategies designed to assist students in their use of various study skills. These strategies may be employed appropriately and effectively with many students with learning disabilities provided that individual needs and abilities are considered. The article concludes with a discussion about the implementation of a study skills program, including guidelines to follow in this process.
BACKGROUND: People with a learning disability are increasingly being encouraged to take a more active role in decisions about their psychological and medical treatment, raising complex questions concerning their ability to consent. This study investigates the capacity of people with a learning disability to consent in the context of three treatment vignettes, and the influence of verbal and memory ability on this capacity. METHODS: Measures of verbal ability, memory ability and ability to consent to treatment (ACQ) were administered to 40 people with a learning disability. The ACQ consisted of three vignettes depicting a restraint, psychiatric or surgical intervention. These were followed by questions addressing people's ability to understand the presenting problem; the nature of the proposed intervention; the alternatives, risks and benefits; their involvement in the decision-making process; and their ability to express a clear decision with a rationale for treatment. RESULTS: Five people (12.5%) could be construed as able to consent to all three vignettes; 26 (65%) could be construed as able to consent to at least one. The questions that were most difficult to answer concerned a participants' rights, options and the impact of their choices. Verbal and memory ability both influenced ability to consent. CONCLUSIONS: This study introduces a measure that may enable clinicians to make more systematic assessments of people's capacity to consent. A number of issues surrounding the complex area of consent to treatment are also raised.
A retrospective cross sectional study of the prevalence of emotional problems among 502 learning disabled children seen in a specialized learning centre was conducted. Learning disabled children, diagnosed by an experienced clinician, were tested for emotional disturbances using the Child Behavior Checklist. The prevalence of behaviour problems among these children was 43%. This was much higher than the ten percent expected when this measure is used in a general population. There was no greater frequency of behaviour problems in children referred by teachers than in those referred by parents. Results of logistic regression analyses reveal that children who were adolescents, from non intact families, or from lower social class backgrounds had an increased odds of having behaviour problems. The implications of these findings are examined, especially in light of possible methodological problems including selection bias, which may account for the association between emotional problems and learning disabilities found in other studies.