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PubMed1981

A learning disability screening program in a public school.

The outline of screening program for learning disabilities in a public school is presented in this paper. The screening program consisted of four standardized measures (Information Subtest of the WPPSI, SEARCH, Evanston Early Identification Scale, Bender-Gestalt) and six of the clinical observations suggested by Ayres. Forty-three kindergarten and first graders (25 males, 18 females) were tested and each child was categorized as low, moderate, or high risk for learning disabilities on each of the measures. Approximately 10 percent of the children were identified as at high risk for learning disabilities, but the children did not perform at the same risk level on all measures. A factor analysis of the four measures and six observations revealed that three factors prevailed in this screening program; cognitive abilities, fine motor control, and reflex integration. This analysis also indicated the importance of assessing neurophysiological immaturity in a screening program. The implications of the categories used are discussed.

Aptitude Tests↗
PubMedDate not supplied

Health facilitation in learning disability: a new specialist role.

This article attempts to examine the important role of the health facilitator in learning disability and recommends that the specialist community learning disability nurse already has the appropriate skills and knowledge to carry out competently the role across the acute, primary and secondary care sectors. A model for community specialist learning disability practice already exists (Bollard and Jukes, 1999) but for health facilitation to have an impact a model of leadership and charge is recommended to be aligned to a model for practice. A CALECT model (a mnemonic which represents essential core roles and skills of a health facilitator) is proposed as a complementary vehicle to make facilitation work.

Health Services Accessibility↗
PubMed2005

Women with learning disability and uptake of screening: audit of screening uptake before and after one to one counselling.

BACKGROUND: This study investigates the breast and cervical screening status of women with moderate to severe learning disability and whether uptake could be improved by one to one counselling. METHODS: An audit of screening uptake of women in contact with the National Health Service (NHS) learning disability service within the eligible age groups for breast and cervical screening before and after one to one counselling by a learning disability team nurse. RESULTS: Of the eligible 48 women, 37 (77 per cent) had undergone breast screening indicating that uptake was excellent and comparable to the average national and local uptake. As for cervical screening, of the 160 women who were identified as eligible and were contactable, only 26 (16 per cent) were having regular smear tests. At the end of the project, which involved one to one counselling by the nurses to encourage uptake, nine additional women underwent smear tests bringing the uptake rate to 22 per cent. For the remaining 96 women (60 per cent) the reasons at the time for non-uptake were recognized as appropriate. CONCLUSIONS: Although the uptake of breast screening was found to be good, cervical screening uptake for women with learning disability was low and remained low after a supportive intervention designed to increase uptake. The greater acceptability of breast screening in women with moderate to severe learning disability compared to cervical screening has been confirmed.

Adult↗
PubMed1986

Factor structure of the WISC-R and ITPA for learning-disabled, emotionally disturbed, and control children.

There has been considerable interest in determining possible learning differences in specific populations of children. Stewart (1977) factor analyzed the WISC and ITPA for learning-disabled and mentally retarded samples and compared the results to a control group. He concluded that while the factors were quite similar, evidence suggested different learning processes in the groups studied. The present study (N = 301) enlarged and modified Stewart's study; it replaced the WISC with the WISC-R and the mentally retarded group with an emotionally disturbed sample. Three factors that emerged for all groups (linguistic, memory, and visual-motor) were similar to Stewart's findings. Additional factors highlighted motor skills and a separation in auditory and visual tasks for the learning-disabled group, an expressive factor for the emotionally disturbed, and a conceptual factor for the emotionally disturbed and control groups that was not found for the learning-disabled sample. Results suggested the need for individualized instruction.

Child↗
PubMed2002

Validity of the diagnosis of personality disorder in adults with learning disability and severe behavioural problems. Preliminary study.

BACKGROUND: Personality disorder in people with learning disability has received little research attention, with only a handful of cross-sectional surveys of prevalence available. As yet, there have been no studies to include an examination of validity. AIMS: To investigate the prevalence of personality disorder in adults with learning disability who are in specialist challenging behaviour in-patient services and to examine the validity of the diagnosis of personality disorder in this group in terms of its association with abusive experience in early life. METHOD: The Standardised Assessment of Personality (SAP) was used to diagnose personality disorder in 36 individuals with mild/moderate learning disability. Case notes were reviewed for details of clinical diagnosis and early psychosocial history. RESULTS: Thirty-nine per cent of the sample met the criteria for severe personality disorder. This diagnosis showed a significant association with early traumatic experience. CONCLUSIONS: Severe personality disorder is a common diagnosis in this group. There is preliminary evidence that the diagnosis is associated with abuse in childhood.

Adult↗
PubMed2004

[Comparing students in inclusive education to those in special schools: the view of parents of children with learning disabilities].

The paper presents the results of a survey of 755 parents of learning disabled children with certified special needs who either attended classes within regular education or special schools. All parents were involved in the decision on the school placement of their children. The experiences of 547 parents of learning disabled students in inclusive classes were contrasted with those of 207 parents of children in special schools. Besides a rather high satisfaction with previous school experiences of their children a number of differences between the two groups of parents could be observed. Parents of students in special schools viewed their children as rather little challenged by their educational requirements whereas those in inclusive education found their children to be overtaxed. The social development of the students in inclusive education was judged as more positive and, generally, a higher rate of parents of learning disabled students in inclusive classes were satisfied with their choice of the educational setting. Although the requirements for parental support concerning studying were higher in inclusive classes this cannot solely explain the differences of experiences with school. In a second step, satisfied parents were compared to dissatisfied parents. It could be found that the group of dissatisfied parents had to make their choice on the educational setting of their children under less favourable conditions and many could not accept that their child had been classified as having special needs. This applied to parents of students in inclusive education as well as to parents of children in special schools. Additionally, parents of students with German as a second language reported to be discontented more frequently. No significant discrepancies could be found between different grades or federal states with different quotas of inclusive education.

Attitude↗
PubMed2000

Women with learning disabilities: risk behaviours and experiences of the cervical smear test.

This paper reports the findings of a study on the views and experiences of women with learning disabilities regarding the cervical smear test. The experience and opinions of the carers were also taken into account. The study was carried out between 1997 and 1999 in Cambridgeshire. The factors that influenced whether women with a learning disability had a smear test included: sexual activity; number of sexual partners; pregnancy; and a past history of smoking. Women with a learning disability who had a cervical smear test most often experienced pain and difficulty with the procedure. Factors that enable women with a learning disability to undergo a cervical smear test, according to their experiences, will be discussed in this paper. These include: the importance of prolonged preparation; issues surrounding communication; the giving of information; and support from the carers. The implications of these findings for collaborative working between learning disability nurses and primary healthcare professionals in clinical practice are highlighted.

Adult↗
PubMed1996

Vocational rehabilitation and special education: partners in transition for individuals with learning disabilities.

A full range of transition services are now available to eligible individuals with learning disabilities through vocational rehabilitation agencies in each state. However, the differences in professional jargon and the academic focus of special education versus the employment outcome emphasis of vocational rehabilitation (VR) have created roadblocks to collaboration between these two agencies. This article describes the purpose of vocational rehabilitation and the service delivery process for individuals with learning disabilities in transition from school to work or postsecondary education settings. Suggestions are also made to prepare families and students with learning disabilities, VR counselors, and special educators to become effective partners in the transition process.

Disability Evaluation↗
PubMed2006

The face you recognize may not be the one you saw: memory conjunction errors in individuals with or without learning disability.

Memory conjunction errors, that is, when a combination of two previously presented stimuli is erroneously recognized as previously having been seen, were investigated in a face recognition task with drawings and photographs in 23 individuals with learning disability, and 18 chronologically age-matched controls without learning disability. Compared to the controls, individuals with learning disability committed significantly more conjunction errors, feature errors (one old and one new component), but had lower correct recognition, when the results were adjusted for different guessing levels. A dual-processing approach gained more support than a binding approach. However, neither of the approaches could explain all of the results. The results of the learning disability group were only partly related to non-verbal intelligence.

Adult↗
PubMed2006

The evolving role of community nurses for people with learning disabilities: changes over an 11-year period.

AIMS AND OBJECTIVES: To provide an overview of the changes in the caseload and working practices of community nurses for people with learning disabilities (CNLDs) over an 11-year period within one region of the UK. BACKGROUND: Recent reviews of government policy within the UK and internationally have highlighted the need to promote inclusion and health facilitation for people with learning disabilities (intellectual disabilities). The CNLDs have been highlighted as having an integral role in achieving these objectives. However, little is known about the current role of community nurses and how this has evolved over the past decade. DESIGNS AND METHODS: A survey design was used in which the total population of CNLDs within one region of the UK were asked to complete a postal questionnaire. RESULTS: Forty community nurses in Northern Ireland completed questionnaires. This provided information about 1559 people with learning disabilities on their current caseloads. Results showed less involvement with children, more focus on adults with physical and mental health needs and nurses often appeared to have a monitoring rather than an active clinical role. Data also identified an increasing caseload size and a pattern of referral largely from within learning disability services. CONCLUSIONS: The role of CNLDs has altered in Northern Ireland over the past 11 years with some evidence of a reorientation towards a more health-oriented focus. Further consideration needs to be given to how well this will meet the changing needs of people with learning disabilities and their families in light of the increasing emphasis on the provision of inclusive services. RELEVANCE TO CLINICAL PRACTICE: Community nurses need to review their current role, caseload management and links to primary and acute care if the policy objectives of inclusive services and health facilitation are to be achieved. It will also be necessary to revise their education preparation in light of the changing role of CNLDs.

Adult↗
PubMed1988

Group psychotherapy and the learning disabled adolescent.

This paper describes the special benefits provided by group psychotherapy for adolescents with learning disabilities. Group psychotherapy is a form of treatment with distinct advantages for assisting learning disabled adolescents whose perceptual problems and subsequent inability to correctly perceive social cues have led to difficulties in interpersonal relationships and to antisocial behavior. A brief description of short-term psychotherapy groups and specific information about how the group was conducted is furnished. The rationale outlined regarding the utility of group psychotherapy with learning disabled adolescents is illustrated by two clinical case vignettes which depict how the group process facilitated positive changes in the interpersonal skills of these youngsters in a relatively brief period of time.

Adolescent↗
PubMed1992

Psychophysiological treatment for learning disabilities: controlled research and evidence.

Research data are presented on the effects of a psychophysiological treatment method for learning disabilities. A total of 238 subjects with learning disabilities were selected based on their school records. Of these, 105 received the full treatment which consisted of the manipulation and maintenance of bilateral electrodermal activity between 6.5-8.5 mu mhos simultaneously combined with increasingly complex perceptual tasks (Mangina, 1981a, b, c; Mangina and Beuzeron-Mangina, 1988). Another 133 subjects with learning disabilities were assigned into four different conditions: (a) classmate controls; (b) only attachment of electrodes; (c) only optimal activation; (d) only perceptual stimulation. Evidence for the effectiveness of the treatment method was found based on different experimental conditions which are presented in this paper. ANOVA and multiple comparison tests indicate that beneficial effects were only obtained by the administration of the full treatment method and were significant at all three time intervals investigated (P less than 0.001). The evidence supports that the treatment method has induced a 'synergistic simultaneity' which is required by the brain both in terms of its bilaterally 'optimal' physiological activation and the appropriate quality of incoming stimulation in order to produce a beneficial neural integration.

Acoustic Stimulation↗
PubMed1989

Relationship between social perception and peer status in children with learning disabilities.

This study was undertaken to examine the social perceptual skill deficit theory in explaining the low peer acceptance of children with learning disabilities. The quality of tests measuring social perception was also examined. Thirty 9- to 12-year-old children with learning disabilities and a matched control group were given two measures of social perception: a laboratory task and a behavior rating scale. The behavior rating scale was completed by the children's teachers. In addition, the Peer Acceptance Scale (Bruininks, Rynders, & Gross, 1974) was administered to assess peer status. Results showed that the children with learning disabilities differed significantly from their nondisabled peers on each of the three measures-the children with learning disabilities obtained lower social perception and peer acceptance scores. However, the relationships between sociometric status and social perception varied as a function of task. A small but significant correlation wa found between the behavior rating scale and peer status. The laboratory task was not correlated with either the behavior rating scale or peer status. Results are discussed in terms of the psychometric properties of laboratory versus naturalistic measures of social perception and the importance of establishing the external validity of social skill measures by correlating them with outcome measures such as peer status.

Child↗
PubMed1985

A critical look at vestibular dysfunction in learning-disabled children.

The purpose of this study was to investigate the vestibular dysfunction hypothesis in learning disabilities. The data indicated that there was no significant difference in vestibular function between normal and learning-disabled children; that there was no significant correlation between vestibular function and academic achievement; and that there was no significant educational relevance in categorizing learning-disabled children according to vestibular dimensions.

Achievement↗
PubMed1996

One and two year outcomes for adults with learning disabilities discharged to the community.

BACKGROUND: Long-stay patients with learning disabilities (n = 214) were assessed in hospital and 12 and 24 months after discharge in order to examine the effects of relocation. METHOD: Each resident acted as his/her own control in a prospective repeated-measures design. Skills and behavioural problems were assessed by keyworkers. Self-perceived quality of life was obtained during interviews with researchers who also completed an environmental checklist of the residents' accommodation. RESULTS: There was little or no change in people's low pre-discharge skill levels. Certain aspects of problem behaviour improved after 12 months, although socially unacceptable behaviour increased slightly. People were less depressed (P < or = 0.01) 12 months after discharge (N = 119) and were more satisfied (P < or = 0.05) with their new 'homes' (n = 108). There were few changes in the pattern of activities or the social networks of people 12 months later. Little or no further change in outcomes was reported 24 months after discharge. CONCLUSIONS: The implementation of the deinstitutionalisation policy in Northern Ireland has been limited by the predominance of residential and nursing homes and the lack of 'ordinary' accommodation. There is a need for purchasers and providers to give more attention to ways in which the principles of normalisation could be incorporated in the process of contracting and delivering services.

Activities of Daily Living↗
PubMed2000

Ageing and learning disability.

BACKGROUND: Ageing is a continuation of the developmental process and is influenced by genetic and other biological factors as well as personal and social circumstances. AIMS: To identify some key biological, psychological and social issues relevant to how ageing might particularly effect people with learning disabilities. METHOD: This selected review considers the extent to which there are similarities and differences relative to people without learning disabilities. RESULTS: There is a convergence, in later life, between people with a learning disability and those without, owing to the reduced life expectancy of people with more severe disabilities. People with Down's syndrome have particular risks of age-related problems relatively early in life. CONCLUSIONS: The improved life expectancy of people with learning disabilities is well established. There is a lack of a concerted response to ensure that the best possible health and social care is provided for people with learning disabilities in later life.

Age Distribution↗
PubMedDate not supplied

The effects of goal setting and self-instruction on learning a reading comprehension strategy: a study of students with learning disabilities.

This study examined the contributions of instruction in goal setting and self-instruction, separately and combined, on the acquisition, maintenance, and generalization of a reading comprehension strategy by fourth-through sixth-grade students with learning disabilities. A previously validated strategy involving the use of story structure to analyze and remember story content was taught to 47 students with learning disabilities using the self-regulated strategy development (SRSD) model. Comparisons were made among students with learning disabilities in four conditions (strategy instruction, strategy instruction plus goal setting, strategy instruction plus self-instruction, and strategy instruction plus goal setting and self-instruction). Result indicated that instruction in the reading strategy produced meaningful, lasting, and generalizable effects on students' story comprehension skills. Furthermore, the comprehension performance of the students with learning disabilities after strategy instruction was indistinguishable from that of a social comparison group of normally achieving students. Explicit instruction in goal setting and self-instruction, however, did not augment the comprehension performance of students with learning disabilities.

Analysis of Variance↗
PubMed1998

Mortality in people with learning disability: risks, causes, and death certification findings in London.

Two thousand people with learning disabilities registered as service users in two London districts were followed up for 8 years to ascertain, in those who died, age and cause of death and significant associations with early death. Respiratory disease was documented as the leading cause of death in 52% of the study population compared with only 15% of males and 17% of females in the whole population. People with learning disabilities have an increased risk of early death. Although the majority of deaths (83%) in the whole population occur in people aged 65 years and over, less than 50% of deaths in the study population were in this age group, and the risk of dying before the age of 50 was 58 times higher than in England and Wales generally. Early death was significantly associated with cerebral palsy, incontinence, problems with mobility, and residence in hospital. Death certificates were not found to be a reliable source of data about factors contributing to cause of death, and learning disabilities were rarely mentioned. The authors recommend an extension to the current format of the Medical Certificate of Death to include recording of chronic disabling conditions.

Adolescent↗