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Vision problems can interfere with the process of learning. However, vision problems are not the cause of learning disabilities. If a child or adolescent is diagnosed as having a learning disability, refraction and eye muscle function must be assessed. If no disorders are found or, if found and corrected, the treatment of choice for the learning disability is special education.
Seven fables were read to 14 average learners and 14 children with learning disabilities, all of whom ranged in age from 10 to 13 years. They were presented with four possible moral choices: one correct, one related, and two incorrect. They were instructed to select the correct moral choice and were asked to explain their choice. The average learners' ability to select the correct moral was significantly better than that of the children with learning disabilities. In addition, even when they chose correct morals, the children with learning disabilities were less capable of explaining their choice.
BACKGROUND: There have been few epidemiological studies of the disabling and poorly understood disorder self-injurious behaviour among adults with learning disabilities. METHOD: Interviews were undertaken with the carers of adults known to the Leicestershire Learning Disabilities Register (n = 2277). The Disability Assessment Schedule was used and information was also collected on demographic characteristics, developmental and physical status. RESULTS: Self-injurious behaviour was present in 17.4% of the population. In 1.7% self-injurious behaviour occurred frequently and was severe. There was no gender difference between those with and without self-injurious behaviour. Both the chronological age and developmental quotient of individuals with self-injurious behaviour were lower than those of individuals without self-injurious behaviour. Autistic symptoms were more common among those with self-injurious behaviour. The association of self-injurious behaviour with a wide range of other maladaptive behaviours was highly significant. Logistic regression analysis retained age, developmental quotient, hearing status, immobility and number of autistic symptoms as explanatory variables for self-injurious behaviour. CONCLUSIONS: Self-injurious behaviour is a prevalent and disabling disorder among adults with learning disabilities.
Community care requires us to pay closer attention to the social and health needs of people with learning disabilities. However, much of the care is focused on people with moderate to profound learning disabilities. Perhaps the needs of those with milder disabilities could be neglected and so individuals could lose out on the support they need. This care study describes the care delivered to a woman who has mild learning disabilities. The aim is to raise people's awareness of the needs of people with mild learning disabilities so they may be met in the future.
BACKGROUND: The management of sex offenders is a major public concern. Behavioural and pharmacological interventions have been used for many years and more recently cognitive behavioural based interventions have become popular around the world. Programmes designed for the general population have been modified for those sex offenders with learning disability, to address their cognitive deficits. The efficacy of these modified programmes is unclear. OBJECTIVES: To determine the efficacy of interventions with learning disabled sex offenders. SEARCH STRATEGY: The reviewers searched electronically EMBASE, PsycINFO, Medline, Cinahl, Cochrane Library, SPECTR, National Clearinghouse on Child Abuse and Neglect Information and National Criminal Justice Reference Service and Biological Abstracts. SELECTION CRITERIA: All randomised controlled trials comparing an intervention for learning disabled sex offenders to any other, or no intervention. DATA COLLECTION AND ANALYSIS: Data were independently extracted. MAIN RESULTS: No randomised controlled trial was identified. REVIEWER'S CONCLUSIONS: Using the methods described the reviewers found no randomised controlled trial evidence to guide the use of interventions for learning disabled sex offenders. Until the urgent need for randomised controlled trials is met, clinical practice will continue to be guided by either extrapolation of evidence from randomised controlled trials involving sex offenders without learning disability or non-randomised trial evidence of interventions for the learning disabled sex offender.
The motor proficiency of 55 learning disabled and 55 nondisabled students was compared on a comprehensive battery of motor-skills tests. Learning disabled students performed significantly lower than nondisabled students on measures of fine motor skills and on measures of gross motor skills. Their greatest deficiencies were on tasks requiring body equilibrium, controlled fine visual-motor movements, and bilateral coordination of movements involving different parts of the body. All of these areas include complex motor patterns that require the integration of visual and kinesthetic senses with motor responses. Implications of these findings for the development of motor training programs and for future research are discussed.
BACKGROUND: This paper describes primary care consultation rates in a sample of people with learning disability. The study was carried out as part of a wider survey of primary care for this population group in response to concerns over quality of care and debate between general practitioners (GPs) and the local health authority over the need for additional remuneration for caring for people with learning disability. Estimates of consultation rates in the literature to date are conflicting and we sought to provide local data on the number and type of contacts with the primary care teams to inform this debate. METHOD: A primary care case note review was carried out of 112 people with learning disability aged over 18, identified from an administrative sample of 967 people known to health and social services. Contact rates (with practice nurses or GPs) were calculated and indirectly standardized for age using data from the fourth National Morbidity Survey in General Practice (MSGP4). RESULTS: Standardized consultation ratio in men was 156 (95 per cent confidence interval (CI) 142-172), in women was 111 (95 per cent CI 102-121) and for both sexes was 127 (95 per cent CI 120-135). Average contact rate was 4.6 per person per year. Eighty per cent of contacts were with GPs. Eighteen per cent (95 per cent CI 11-25 per cent) of subjects consulted, on average, more than once every two months. Limited information on underlying cause of learning disability and severity was available. Consultation rates were independent of age and sex, and were not increased in people with Down's syndrome or epilepsy compared with the rest of the sample population. Consultation rates were highest in people living in staffed group homes (p = 0.01). The presence of special arrangements between practices and residential facilities did not appear to increase service contact, but this finding is prone to measurement bias. CONCLUSIONS: Contrary to the findings of previous studies, people with learning disability consult primary care teams more frequently than the general population. However, this should not be taken as supporting calls for additional resources without addressing the effectiveness and appropriateness of health care offered.
This review addresses recent research on social and nonverbal learning disabilities. Involvement of right hemispheric dysfunction in these disabilities has been hypothesized, as studies with adults have suggested that documented right hemisphere damage may lead to deficits in social skills, prosody, spatial orientation, problem solving, and recognition of nonverbal cues. Studies of children purported to evidence nonverbal learning disabilities are reviewed and compared with the results from studies of adults with right hemisphere damage. Specific subtypes of nonverbal learning disabilities are reviewed, including the nonverbal perceptual-organization-output subtype, Asperger's Syndrome, Developmental Gerstmann Syndrome, left hemisyndrome, right hemisphere syndrome, and right parietal lobe syndrome. Finally, implications and future research needs are addressed. The need for a diagnostic nosology and improved and validated intervention techniques is stressed as is early identification of these types of specific nonverbal learning disabilities.
Communication effectiveness of 15 learning-disabled and 15 control adolescent boys was compared, employing a referential task entailing repeated communication failure. The task required one to four verbal descriptions of eight abstract drawings to a pseudoconfederate listener. Transcribed descriptions were presented to two groups of 10 judges for matching to the proper drawing. One group of judges was provided with each description as an independent item while the second group was presented descriptions as part of a sequential set. Both subject groups achieved higher effectiveness when the judges received the descriptions as ordered sets. The learning-disabled boys provided less effective messages than their nondisabled peers. Egocentricity in the learning-disabled adolescents' descriptions was identified.
Epilepsy is a common problem of adults with learning disabilities. Despite the high prevalence there have been few studies of the epilepsy suffered by adults with learning disabilities. The findings of a Leicestershire study are that multiple seizure types are a common presentation, and that for many (75%) the seizures remain refractory to treatment. Those who suffer tonic-clonic seizures are most likely to achieve remission, whereas for those with simple or complex partial seizures the prognosis is poor. For a significant proportion, status epilepticus, emergency admission to hospital and injuries occur on a regular basis.
Neuropsychological deficits in Tourette's syndrome (TS) may be associated with learning disabilities. We examined the neuropsychological performance of 70 children with TS between the ages 6 and 18 years who were classified into four groups based on their pattern of performance on the Wide Range Achievement Test-Revised. The groups included three learning disability subtypes and a nonlearning disabled comparison group. The groups differed significantly on several measures in a comprehensive neuropsychological test battery. The pattern of differences was not entirely consistent with previous research, however, suggesting that neuropsychological correlates of learning disabilities may be influenced by the specific pathophysiology associated with TS. Thus, previous research on the neuropsychology of learning disability subtypes might not be generalizable to children with discrete neuropsychiatric disorders such as TS.
The frequency of the developmental dysfunction and specific learning disabilities were assessed in the retrospective study in the group of 56 school-aged twins. The relationships between genetic, perinatal and social factors and learning disability were also determined. It was found that 12.5% of twins had learning disabilities. The most common neurodevelopmental dysfunction were language disorders, poor graphomotor fluency and poor fine motor dexterity. It was also found that educational difficulty were associated with prematurity, low Apgar scores, neonatal complications and familial predisposition.
Immediate free recall by learning-disabled and nondisabled children was compared under two incentive conditions. Recall of the first few words of each list by disabled children and younger nondisabled children was lower than that by older nondisabled children, and receiving a monetary reward increased early list item recall by older disabled and nondisabled learners. These findings suggest that elaborative encoding processes, such as rehearsal, are impaired in younger disabled and nondisabled children and that receiving a reward increased elaborative encoding by older children. Similar recall of the last few list items by all groups suggests that attention and immediate memory are comparable in disabled and nondisabled children of different ages. Receiving a reward increased recall of the last few list items by younger disabled and nondisabled children, suggesting that a reward increased attention, immediate memory, or both, in these groups. Because receiving a reward increased recall equally in all groups, lower motivation did not appear to be responsible for the lower recall by younger nondisabled children and learning-disabled children.
The performance of normal children (N = 13) and learning disabled children (N = 26) on an experimental battery of central auditory processing (CAP) tasks was examined. The battery included low-pass filtered speech (LPFS), binaural fusion (BF), time-compressed speech (TC), and dichotic monosyllables (DM) tests. The learning disabled subjects were classified as having normal (LD/N) or significantly impaired (LD/LD) auditory perceptual skills on the basis of a pretest battery of auditory language tests. The normal (N/N) subjects and nonauditory learning disabled (LD/N) subjects tended to perform alike across measures. The auditorily impaired (LD/LD) subjects tended to perform significantly poorer than their normal agemates. The results emphasized the heterogeneity of the learning disabled population. In addition, the results suggested a potentially useful "at risk" criterion when a CAP test battery is used in the assessment of auditory perceptual impairment among children.
The relation of damage to the central nervous system to learning disabilities remains a continuing issue. This study explored how learning disable children fare on the Visual Retention Test. Analysis of correct scores and errors for the 24 children responding to Administration A would ordinarily suggest a primary relationship (t = 2.60, p less than .02; t = 4.01, p less than .001, respectively). However, since extensive medical and case history material yielded no evidence of cerebral injury or disease and since the impact of short-term memory (Administration D) led to no further performance decrement (t less than 1.00), additional research must determine a more precise understanding of perceptual dysfunction and the role of short-term memory in regard to learning disabilities.
It is known that a substantial proportion of people with a learning disability also have associated emotional problems in the form of psychiatric illness and disturbed behaviour. In the UK various health authorities are developing in-patient facilities for assessment and treatment of this group of people by default rather than by planning. We report the prospective findings of psychiatric admissions to a hospital for learning disabled people in the Grampian region of Scotland over a three year period between 1.1.89 to 31.12.91. Nine beds were deemed necessary for a health district with a general population of 500,000. Average bed occupancy was 66.7%. The most common conditions leading up to an admission was disturbed behaviour followed by affective disorder and psychoses. The majority of the admissions were of adults with a mild to moderate degree of learning disability as opposed to severe and profound learning disability. A hard-core group of patients had many re-admissions. Some acute admissions became long-stays (over one year), although average stay of admissions were between four to six weeks.
We compared neurobehavioral profiles of 10 children with neurofibromatosis 1 (NF-1) referred for evaluation of learning disabilities (NF/LD) to those to learning disabled children without known genetic disease (LD), matched for age, sex, and estimated IQ. It was hypothesized that the NF/LD children would exhibit a neurobehavioral profile diagnostic of compromise of frontal/subcortical brain systems while those of the case controls would be heterogeneous. Records from a clinical data base were reviewed retrospectively for the neurological and neuropsychological components of an interdisciplinary learning disabilities evaluation. Neurological abnormalities were more frequent in the NF/LD group, involving gross and fine motor coordination, praxis, and megencephaly. As predicted, clinical neuropsychological diagnostic ratings and composite neurobehavioral observation scores were consistent with compromise of frontal systems in the NF/LD group. An unanticipated finding was that outcomes in the NF/LD group were sex dependent: Megencephaly was observed in females only; and the frontal/subcortical neurobehavioral profile was more consistently observed in females. Females with NF-1 with megencephaly may be at increased risk for a neurobehavioral syndrome contributing to LD that is consistent with compromise of frontal/subcortical brain systems.
Developmental pediatricians are being consulted by medical school promotion committees with regard to the course of action to be taken with learning-disabled medical students experiencing academic difficulties. Faculty attitude, a difficulty understanding the nature of learning disabilities, appears to be a major contributor to poor medical school performance on the part of learning-disabled adults. Utilizing the sequential-simultaneous information processing model as a simplified introduction to learning disability patterns, the authors argue that recommending intensive remediation of rote spelling and writing skills in students engaged in graduate education represents both a waste of time and a further emotional trauma to these young professionals.