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PubMedDate not supplied

Caring for people with learning disability using care management.

Current Government health policy is moving towards the delivery of services for clients with a learning disability through mainstream primary care services. At present there are difficulties in providing health services that meet the needs of clients. These include lack of resources (financial, physical and human), time and expertise. Yet clients with learning disabilities often have some of the most complex physical and mental health needs and they have a right to expect access to services that are responsive and sensitive to their requirements. In light of the current policy and stated difficulties, all service providers and stakeholders need to work together to review how services are provided and to negotiate shared resources. This article suggests adopting a care management approach, where clients are supported by different providers with a lead practitioner taking responsibility for assessment, planning and review in partnership with the client and his/her carers.

Case Management↗
PubMedDate not supplied

Learning disabilities and mental ill health: care plans.

Comprehensive multidisciplinary assessment and treatment are particularly important for clients who present with learning disabilities and mental health problems (O'Hara and Sperlinger, 1997). This should not be restricted to professionals who work in services for people with learning disabilities and should include a wider network of professionals from statutory services and the independent sector. This arrangement can be complex as different agencies and even different departments of the same agency may differ fundamentally in their philosophy, vision and understanding of their own and other's roles and responsibilities. It is vital that these differences are recognised and dealt with so that they do not become a barrier to accessing best practice. Only in this way can the person benefit fully and have their needs met.

Adult↗
PubMed1985

Effect of instruction for creativity on learning disabled students' drawings.

50 pupils from self-contained classrooms for learning disabled students in Grades 5 and 6 were subjects. The Torrance Tests of Creative Thinking were used as pretests and posttests to measure the effect of instruction for creativity on drawings by these subjects. For 14 wk. the Purdue Creative Thinking Program was used to stimulate the learning disabled group. These children made significantly higher scores than a control group on the figural subtests of drawing of the Torrance Tests of Creative Thinking.

Art↗
PubMed1985

Language and visuospatial abilities in learning-disabled, brain-damaged, and nondisabled young adults.

This study confirmed the construct validity of dysphasic errors but not of Block Design or dyscopia for 88 male and 22 female young adults, aged 17 to 29 yr. Right-hand sensorimotor deficits correlated with dysphasic errors but not with Block Design. Brain-damaged and learning-disabled with Halstead Impairment Index (HII) greater than or equal to 0.4 differed from nondisabled on both dysphasic errors and Block Design. Learning-disabled with HII less than 0.4 differed from nondisabled only for dysphasic errors. As a group, young learning-disabled adults had impaired language abilities. Learning-disabled with HII greater than or equal to 0.4 and brain-damaged had generalized neuropsychological deficits characterized by less adequate language and visuospatial abilities.

Adult↗
PubMed2006

Joint inspection of services for people with learning disabilities in Scotland: compliance or commitment?

PURPOSE: The article describes the development of a practical model of joint, integrated inspection of managed care services for people with learning disabilities in Scotland. The model will give a reliable measure of the impact services are making to people's lives and the quality of service that individuals are actually receiving. CONTEXT OF CASE: At present health, social services and education services for people with learning disabilities in Scotland are inspected separately, by up to nine different agencies. The first joint, integrated inspections of all services for people with learning disabilities in Scotland will take place in 2006. This is the first inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. DATA SOURCES: Quality Outcome Indicators were developed in 21 different areas, or domains. Evidence based best practice, and evaluative data from previous inspections were the primary sources of data. CASE DESCRIPTION: This paper reviews the background and rationale for the integrated, joint inspection process. Strengths and constraints of this approach to inspection are discussed, including the crucial importance of commitment from services and from inspectors, rather than mere compliance with demands. Some guidance on how to fully involve staff, carers and services users in the inspection process is given. CONCLUSIONS AND DISCUSSION: The model will produce data to inform decision-making for managers in integrated services and give services users clear information about how well local needs are being met, what areas need development, and what capacity the organisations have to improve. The model of inspection may be of interest to practitioners in a national and international context. The model will be evaluated, following the first joint inspection.

Journal Article↗
PubMed1984

The Slosson Intelligence Test and young learning-disabled children: a comparative study.

Evaluated 26 children independently diagnosed as learning disabled in a counterbalanced design with the deviation IQ form of the Slosson Intelligence Test and the Wechsler Intelligence Scale for Children-Revised (WISC-R). Moderate to good correlations were obtained between the Slosson and the WISC-R Full Scale (r = .91), Verbal (r = .94) and Performance (r = .60) IQ scores. The Slosson correctly predicted functioning level to within 10 IQ points of WISC-R Full Scale scores for 88% of the Ss. These data suggest that the recent revision of the Slosson has corrected the tendency of earlier versions of this instrument to inflate the estimated IQs of young learning-disabled children.

Child↗
PubMed1978

Body movement and inattention in learning-disabled and normal children.

Four experiments were conducted to test various aspects of an optimal level of arousal model of hyperactivity in learning-disabled children. Vigilance performance and level of body movement were measured while learning-disabled and control children performed in an auditory vigilance task. The results suggested that body movement increased throughout the vigilance task, increased rates of external stimulation result in decreased level of body movement, and learning-disabled children differed from controls in showing higher levels of body movement and poorer vigilance performance. The results were discussed in terms of changes in arousal level and compensatory stimulus-seeking behavior.

Arousal↗
PubMedDate not supplied

Dilemmas in assessing the health status of children with learning disabilities.

There has been little research directed at the evaluation of the general health status of children in mainstream settings with learning disabilities. The purpose of this study was to describe the effectiveness of a teacher-referral instrument in comparing the health status of children with learning disabilities and nondisabled children. Health records were reviewed to validate the findings of the teacher assessments. Students with learning disabilities were found to have increased frequency of health problems on the teacher-referral instrument. The health records did not serve to validate the teacher assessments, however, as a result of missing information and format inconsistencies. Policy implications are identified and discussed.

Child↗
PubMedDate not supplied

What follow-up studies say about postschool life for young men and women with learning disabilities: a critical look at the literature.

Follow-up studies examining the outcomes for children and youth with learning disabilities who attended special education have appeared in the literature for decades. As American society becomes more technologically advanced and competitive, postsecondary school opportunities and subsequent employment choices that are meaningful and provide a livable wage teeter out of the reach of young people with learning disabilities. Follow-up study investigators seek to understand how to better prepare youth to meet these challenges by studying their long-term outcomes. The authors review data from 13 frequently referenced follow-up studies regarding postschool outcomes, postsecondary education, and employment, with attention to gender differences, for youth with learning disabilities who were served by and graduated from special education programs nationwide. They take a critical look at contradictions in the findings and discuss five methodological issues that seem to influence the conduct and interpretation of follow-up studies: aggregating data across disability categories; combining data on graduates who have been out of school for unequal periods of time; ignoring the issues of missing data, participant attrition, and incomplete data sets; combining data from different informants; and using nonequivalent databases to make comparisons to a population with no disabilities. The authors provide recommendations for conducting follow-up research on the long-term quality of life of children and youth with disabilities and their families.

Adult↗
PubMed1994

Prevalence and predictors of substance use: a comparison between adolescents with and without learning disabilities.

A considerable body of literature has accumulated that examines patterns of substance use and abuse among adolescents attending general education classes. However, much less information exists on the prevalence and predictors of substance use among adolescents with learning disabilities. One purpose of this study was to determine the comparative prevalence of tobacco, alcohol, and marijuana use among a sample of 123 students with learning disabilities (91 male and 32 female, mean age = 14.37 years) and 138 nondisabled students (77 male and 61 female, mean age = 13.71 years). A second purpose was to determine whether two psychosocial variables (self-esteem and type of behavior problem) or severity of drinking problem best predicted use of tobacco and marijuana. Students were administered the Self-Esteem Inventory (SEI)-School form (Coopersmith, 1987) and the Adolescent Drinking Index (ADI) (Harrell & Wirtz, 1989); their teachers completed the Revised Behavior Problem Checklist (RBPC) (Quay & Peterson, 1987). Tobacco and marijuana use were proportionally higher for adolescents with learning disabilities; no differences emerged for alcohol use between groups. A discriminant function analysis revealed that scores on the SEI and subscale scores of the RBPC did not reliably predict tobacco or marijuana use for either group. ADI scores were reliable predictors of marijuana use for students with learning disabilities and tobacco use for both groups.

Adolescent↗
PubMedDate not supplied

Is the sexuality of people with a learning disability being denied?

This article explores how the nursing profession has become more liberal in its attitudes towards sexuality as a consequence of and a response to HIV/AIDS. This liberal attitude has, however, failed to be generalized towards people with a learning disability. The continued use of labelling terms for people with a learning disability serves as an excuse to either justify the control of people's sexuality and fertility, or a rationale to argue that people with a learning disability do not have a sexual identity. Developments in the self-advocacy and advocacy movement provide opportunities for people with a learning disability to have a say in the development of sexuality policies to guide the practice and philosophy within an organization.

Attitude of Health Personnel↗
PubMedDate not supplied

Coming to terms with the "otherwise qualified" student with a learning disability.

Section 504 of the Rehabilitation Act of 1973 ensures all "otherwise qualified" individuals with handicaps the right to higher education. Federal regulations implementing the broad principles of Section 504 address only obliquely the interpretation of the construct "otherwise qualified." The determination of the qualified individual with a handicap in higher education entails unique consideration when applied to students with learning disabilities. In a setting traditionally based on academic merit and competition, the student with a learning disability requires accommodation of the learning process. Postsecondary institutions are faced with the task of determining the qualified student while maintaining academic standards. To clarify this process, existing tenets of the construct "otherwise qualified" were examined. Issues in implementing the law with students with learning disabilities were discussed, and current practice in addressing the issues was evaluated in light of legal principles. Guidelines were proposed for implementing the construct "otherwise qualified" with students with learning disabilities in higher education.

Persons with Disabilities↗
PubMed1990

Concerns of families of children with learning disabilities.

The purpose of this report is to share the experiences and concerns of a group of parents of children with learning disabilities. Parents of eight different families were interviewed in depth, and seven themes emerged from the interviews. Parents discussed their involvement in their child's education, and their positive and negative experiences with school personnel as well as with seeking other sources of support. They expressed concerns about the social isolation and future well-being of their children with learning disabilities. They indicated many emotional strains from parenting children with learning disabilities, and that there are both positive and negative effects on the families. Implications for further research and practice are discussed.

Adolescent↗
PubMed1980

Validating optimal response modes of learning disabled children.

To determine optimal and least effective response modes of learning disabled children, the procedure described by Owen, Braggio, and Ellen (1976) and the Illinois Test of Psycholinguistic Abilities were used. On the basis of pretest and posttest comparisons on selected subtests, the performance of these children could be described as individual or multiple combinations of covert-, vocal-, or visual/manual-response modes. This learning style analysis was validated by presenting a paired-associate task to the children using an administration similar to (matched condition) or different from (unmatched condition) the child's optimal response mode. More items were recalled under the matched condition than under the unmatched condition. Also, the children with multiple response modes recalled more items than the learning disabled children with single optimal response modes. These results suggest that disabled children may do poorly on academic tasks because they may not have enough optimal response modes, or are unable to select the most appropriate mode of responding as required by a task. The use of optimal response modes as an aid in the diagnosis and remediation of educational handicaps is discussed.

Child↗
PubMed2003

Autism spectrum disorders in children with active epilepsy and learning disability: comorbidity, pre- and perinatal background, and seizure characteristics.

The aim of this study was to examine the comorbidity pattern, seizure characteristics, and aetiology in a representative group of children with a combination of autism spectrum disorder (ASD), active epilepsy, and learning disability. Ninety children (47 males, 43 females; mean age 11 years 2 months, range 8 to 16 years at the time of psychiatric examination) with active epilepsy and learning disability, identified in a population-based study in Göteborg, Sweden, were subdivided into those with and those without ASD and compared with respect to aetiology, additional neuroimpairments, and seizure characteristics. In addition, the cohorts were examined for trends of prevalence over a period of time. Results indicated that established aetiology was much more often present in the prenatal period than in the peri- or postnatal periods in the ASD group. Cerebral palsy and visual impairment were under-represented in the ASD group. Partial seizures tended to be more common and generalized seizures less common in the ASD group compared with the non-ASD group. Seizure onset was later in the ASD group. Many of the significant differences were accounted for by a large group of psychiatrically unclassifiable participants in the non-ASD group. There was no trend towards an increase of affected children over the 12-year period. There was no increase in the prevalence of active epilepsy and learning disability nor in the rate of autism with active epilepsy and learning disability in children born between 1981 and 1986 compared with those born from 1976 to 1980, indicating no statistical association with the general measles-mumps-rubella vaccination introduced in the early 1980s.

Adolescent↗
PubMed1989

Screening for learning disabilities: a neuropsychological approach.

The ability of the Trail Making Test (TMT) and Tactual Performance Test (TPT) to discriminate between learning-disabled and normal children was examined. Twenty children aged 9 to 14 years who recently had been classified as learning disabled and 20 matched controls were administered individually the TPT, TMT, and two experimental forms of the TMT (parts X and Y). The data from the two groups were analyzed with a discriminant analysis. An overall accuracy rate of 82.5% was obtained when the measures were used to predict the classification status of individual children. A stepwise discriminant analysis procedure revealed an experimental form of the TMT (part X), Tactual Performance Test total time, and Tactual Performance Test localization to be the most sensitive measures. The use of such measures to screen for learning disabilities is discussed.

Achievement↗
PubMed2003

An interview study of people with learning disabilities' experience of, and satisfaction with, group analytic therapy.

A number of clinicians have developed psychodynamic treatments for people with learning disabilities, but there have been few studies assessing the impact of psychodynamic therapy with this population. In particular, there have been no studies in which investigators have asked clients about their experience of psychodynamic treatment. The current study is an attempt to rectify this by exploring people with learning disabilities' experiences of, and satisfaction with, two psychodynamic groups provided by an inner city service. Nine learning-disabled clients, four from a sexual offenders' group and five from a women's group, were interviewed about their experience of psychodynamic group psychotherapy. Their responses were analysed using Interpretive Phenomenological Analysis. Participants suggested that they valued the therapists and the group, and appreciated the opportunity to talk about painful experiences and be included and valued in the group. However, participants also indicated that they found the group emotionally painful, on occasion found it hard to identify with other group members, and were often unaware of any positive change in themselves. These interview findings complement ongoing quantitative attempts to establish the impact of psychodynamic treatment for this population.

Adult↗
PubMed2000

Professional composition of community learning disability teams in Scotland: implications for service provision.

A survey of all trusts in Scotland who provided specialist services to people with learning disabilities was made with a response rate of 100%. An examination was made of the professional composition of the community learning disability teams and the population covered. A disparity was found across Scottish trusts in the professions represented in the community learning disability teams with some professions having no input. Nursing and Clinical Psychology were found to be the two professional groups with largest representation across Scotland and along with Speech and Language Therapy had representation in all of the Teams. A review of some of the factors which have impacted on the role and professional composition of these services is made and the implications discussed.

Community Health Services↗