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PubMed2000

Moving home: costs associated with different models of accommodation for adults with learning disabilities.

This paper reports on variation in the cost and social outcomes of provision for clients with learning disabilities, resettled across different models of community accommodation; identifying personal and service-related characteristics influential on such variation. The study was conducted to inform the community reprovisioning strategy associated with the phased closure of the Gogarburn and Tornaveen learning disability hospitals in the Lothian region, Scotland. Total mean service costs, quality of life and community integration outcome data were collected and compared. Total mean service costs ranged between pound16 438 and pound74 097 per year (mean pound42 023; SD = pound16 712). Cost estimates varied by age and dependency group, with costs for elderly clients comparatively low. Overall, there was an inverse relationship between total mean costs and size of accommodation. There was no evidence of a direct relationship between costs and changes in social outcomes. Services with the lowest mean costs were, however, associated with the smallest increases in social outcomes. The most expensive services did not realise proportionally greater gains in social outcomes. The paper concludes that clients generally benefited from the transition from hospital to community accommodation. However, some experienced better outcomes than others. In the absence of a clear link between levels and type of resource use and social outcomes, it is difficult to identify which service features are more or less efficacious in achieving positive outcomes. Broader evaluation perspectives, embracing a fuller range of costs and benefits, will be required to unpack exactly what it is about different models of community care provision that leads to positive outcomes, or otherwise, for learning disability clients. A more sound evidence base is required before effective strategies can be designed to ensure that key policy outcomes are realised and social integration truly achieved.

Journal Article↗
PubMed1997

A comparison of older longstay psychiatric and learning disability inpatients using the Health of the Nation Outcome Scales.

OBJECTIVE: With increasing longevity, the number of elderly patients with psychiatric or learning disabilities is likely to increase. The degree of overlap of symptoms and needs of these two groups of patients, which may allow for their care within the same service, was examined. DESIGN: Twenty-six longstay, elderly (> 65 years) psychiatric patients resident in psychogeriatric wards of a psychiatric hospital were compared with 23 longstay, elderly patients and 40 longstay patients aged 50-65 years, both resident in the wards of a specialist hospital for learning disabilities. The instrument used was the Health of the Nation Outcome Scales (HoNOS). RESULT: On the HoNOS, the elderly psychiatric patients scored significantly higher for problems with mood, relationships and occupation/activities. There were no significant differences for any of the scales rated between the 50-65 and > 65 years old patients with learning disabilities. CONCLUSION: The similarities between the three groups of patients would suggest that for some patients the same services may be utilized. This could reduce the cost of the care in the community and entail more economical use of the facilities and staff. The HoNOS proved to be a concise and simple instrument, which could become a useful tool in monitoring the outcome of healthcare in longstay patients.

Aged↗
PubMed1997

Learning disability and epilepsy. 1, towards common outcome measures.

A major component of the population of people who have epilepsy are people with a learning disability. As a group, such individuals often have complex epilepsy which is refractory to treatment. Current available measures to assess the outcomes of therapeutic interventions in epilepsy are based on seizure frequency, seizure severity and quality-of-life measures, but have not been validated in people with a learning disability. Thus, we do not know if such measures of outcome serve the needs of this group. This review examines how able we are to assess the efficacy of our interventions to control epilepsy in people with learning disability. It is suggested that a standard data set is necessary as the basis of the assessment of any therapeutic intervention. Central components of this data set would encompass a definition of important characteristics of an individual, a description of their epilepsy and an assessment of the impact of their condition on both their own and their carer's health. The approach to obtaining this information should employ a methodology which can allow for environmental influences.

Epilepsy↗
PubMed2002

University students with learning disabilities advocating for change.

PURPOSE: In recent decades Western psychology has conceptualized learning disabilities (LD) in terms of deficits and such related 'social emotional issues' as insecurity, low self-esteem and social isolation that can be rehabilitated through combined remedial teaching and psychological intervention. With increasing advocacy and legislation on behalf of people with disabilities in the US, UK and Australia, more resources are being made available to students with LD in institutions of higher education. Due to this increase in the quantity of services, written programmes and accommodations made to their needs, increased numbers of students with LD have been graduating successfully from institutions of higher education. This paper describes an option for treating students with LD that is based on a theoretical perspective that understands these students as an excluded population and emphasizes the importance of their empowerment. METHOD: A project involving social work students with LD at Hebrew University in Jerusalem is presented as a case study. Case-study investigation, one of the common methods of qualitative research, explores social and human problems in their natural context. A 6-year evaluation of this project was conducted based on questionnaires, focus groups, documentation of all activities related to the project, in-depth interviews and outcome measures. RESULTS: The results suggest that the project developed in three stages: raising awareness, building partnerships, and lobbying for rights and services. Outcome measures indicate that the project was successful in lowering dropout rates and improving students' academic achievement. Analysis of interviews with students suggests that the project positively affected the students' perceptions by helping them reframe the social and emotional connotations of their learning disability. Students reported marked social and emotional change, including reduced stress and anxiety levels and increased self-esteem. CONCLUSIONS: Empowerment practices that are based on partnership, participation, advocacy and social change provide an alternative to rehabilitation via individual therapy.

Achievement↗
PubMed1976

Empathy in learning disabled children.

25 7- to 12-yr.-old boys with visual perceptual problems and learning disabilities were compared on the Borke Scales for Empathy with a greater matched control group. The learning disabled group had significantly greater difficulty recognizing and labeling emotions.

Child↗
PubMed2000

Learning disabilities: diagnostic considerations from an educational perspective.

This article reviews the current definitions of specific learning disability (LD). It describes the multiple causes among the specific learning disability (SLD) population, citing cognitive, neuroanatomical, cellular, and genetic research trends. Emphasis is placed on assessment components and processes, including typically used academic, cognitive, and neuropsychological measures and newly introduced dynamic or domain-based approaches. Researchers and practitioners now acknowledge that SLD represents a life-long condition, manifesting differently at each developmental stage. The impact of LD on adult adjustment and independence is described as the newest challenge in the field of LD research.

Adult↗
PubMed1990

The effect of task alternatives on vocabulary knowledge: a comparison of students with and without learning disabilities.

This study used a two-part task format to (a) describe the vocabulary knowledge of 10- and 12-year-old students with learning disabilities and (b) assess the effect of task alternatives on their vocabulary knowledge. We addressed these research objectives by comparing the performance of 24 students with learning disabilities to an equal number of their normally achieving peers. Vocabulary knowledge was first assessed through a production task. In the even the student's response was inaccurate or incomplete, an identification task assessing the same vocabulary term was presented. Results revealed that, compared to normally achieving students, students with learning disabilities are (a) significantly less able to construct fully specified responses to production tasks, (b) comparable in their ability to use pictorial responses to demonstrate vocabulary knowledge not accessible in production tasks, and, (c) when equated in reading achievement, only 10-year-olds are significantly poorer in composite vocabulary knowledge.

Achievement↗
PubMed1977

Nonverbal visual short-term memory as a function of age and dimensionality in learning-disabled children.

A serial recognition task was used to compare performance of 2 learning disability age groups with 2- and 3-dimensional representations of nonlabeled 8-point random shapes. Age-related increases in short-term memory (STM) performance for both dimensions were found. No significant differences were found between 2- or 3-dimensional stimuli. Contrary to reports of STM performance with normal children, learning-disabled children showed no primacy effect for the 2-dimensional treatment, and second choices were not consistently correct when the first choice was incorrect, These findings were interpreted according to Flavell's notions of mediational inefficiencies.

Age Factors↗
PubMedDate not supplied

The virtual courtroom: a view of justice. Project to prepare witnesses or victims with learning disabilities to give evidence.

PURPOSE: With the advent of 'The Youth Justice and Criminal Evidence Act 1999' passed by Parliament in August 1999, vulnerable witnesses can for the first time give evidence to the court with the support of 'special measures'. People with a learning disability fall into the category of vulnerable witnesses, and the purpose of this paper is to describe the development of the virtual courtroom, a virtual reality (VR) and multimedia based training platform to prepare this group of people for such an eventuality. METHOD: A user-centred design methodology was adopted, with a user group being formed of students and adults with learning disabilities. This group, working together with facilitators, experts on the new act, and experienced designers of VR based training systems, designed and implemented the virtual courtroom. RESULTS: The virtual courtroom model has been produced using the Realimation Virtual Reality software tool. The next stage of the project is to design and develop three multimedia-based scenarios showing a variety of situations in which a person with a learning disability could give evidence in court. CONCLUSION: One of the recommendations in the 'Speaking up for justice' report, suggested that the Home Office develop further material to assist vulnerable witnesses to prepare for their attendance at court. The virtual courtroom provides one of the first and most innovative of such solutions.

Adolescent↗
PubMedDate not supplied

A collective case study of nursing students with learning disabilities.

This collective case study described the meaning of being a nursing student with a learning disability and examined how baccalaureate nursing students with learning disabilities experienced various aspects of the nursing program. It also examined how their disabilities and previous educational and personal experiences influenced the meaning that they gave to their educational experiences. Seven nursing students were interviewed, completed a demographic data form, and submitted various artifacts (test scores, evaluation reports, and curriculum-based material) for document analysis. The researcher used Stake's model for collective case study research and analysis (1). Data analysis revealed five themes: 1) struggle, 2) learning how to learn with LD, 3) issues concerning time, 4) social support, and 5) personal stories. Theme clusters and individual variations were identified for each theme. Document analysis revealed that participants had average to above average intellectual functioning with an ability-achievement discrepancy among standardized test scores. Participants noted that direct instruction, structure, consistency, clear directions, organization, and a positive instructor attitude assisted learning. Anxiety, social isolation from peers, and limited time to process and complete work were problems faced by the participants.

Adaptation, Psychological↗
PubMed1990

Effectiveness of the DISTAR reading program for children with learning disabilities.

The reading achievement of students with learning disabilities who received reading instruction through the DISTAR program was compared to that of similar students using basal reader materials. The overall reading scores of the groups were not significantly different following 1 and 2 years of instruction, although students in the DISTAR program had somewhat better word attack skills.

Achievement↗
PubMed1987

Comparison of the Luria-Nebraska Neuropsychological Battery-Children's Revision and the WISC-R with learning disabled children.

This investigation concerned the relationship between the Luria-Nebraska Neuropsychological Battery--Children's Revision and the WISC--R for a sample of 32 children identified as learning disabled. The children's mean age was 9 yr., 11 mo.; they were identified as learning disabled on the basis of ability (WISC--R)/achievement discrepancy test scores. The sample was of low average intellectual ability according to the WISC--R and the Luria-Nebraska T-scores. Intercorrelations between scores on the WISC--R and Luria-Nebraska lists were generally nonsignificant, with the exception of language and arithmetic measures on each test. Also, 84% or 27 of the present sample of 32 were correctly identified as learning disabled using a criterion of three or more Luria-Nebraska subscale scores greater than one SD above the mean.

Child↗
PubMed1991

Language abilities and progress in a direct instruction reading program for students with learning disabilities.

Direct instruction reading programs have been found to be a successful way to teach reading to many, but not all, students with learning disabilities. This study investigated whether reading improvement for students with learning disabilities receiving reading instruction through a direct instruction reading program might be related to their language abilities. The reading progress of 26 students (19 male, 7 female), 7 to 10 years old, was measured over 2 years. In addition, phonological and syntactic abilities were assessed. The results indicated that phonological ability was related to progress in word attack skills and that syntactic ability was related to improvement in comprehension skills. These results have implications for the reading instruction of students with learning disabilities.

Achievement↗
PubMed1978

A comparison of the disturbingness of behaviors related to learning disability and emotional disturbance.

Behaviors thought to be characteristic of emotional disturbance or learning disabilities were investigated through ratings of teachers with regard to the relative disturbingness of the behaviors. Obtained differences suggested that behaviors characteristic of emotional disturbance were rated as more disturbing than those of learning disabilities; differences within sets of characteristic behaviors were also indicated. Results are discussed with regard to implications for teacher expectancies and labeling research.

Adult↗
PubMed1989

Use of a motor creativity test with young learning disabled boys.

The Torrance Test of Thinking Creatively in Action and Movement, developed to measure the motor creativity of children ages 3 to 8 yr., has been subjected to little psychometric study. The purpose of this study was to examine the feasibility of using this instrument with young learning disabled boys and to determine whether differences between learning disabled boys and the test manual's nondisabled normative sample (n = 193) were significant. Subjects were 30 learning disabled boys (M = 8.11 yr.), representing seven different school systems. Significant differences were noted between two groups on fluency, imagination, and total motor creativity but not on originality. Test-retesting over 1 to 14 days gave coefficients of .71 to .89. The alpha coefficient for total test internal consistency was .79.

Child↗
PubMedDate not supplied

Infection control in learning disability services.

Services for people with a learning disability are provided by many sectors of the health and social care economy. These include: social services, health services, voluntary organisations, charities, private care agencies and family carers. Care interventions can take place in a variety of settings, from the client's own home to day care, respite care, educational establishments, workshops, social clubs, luncheon clubs, shared housing and the acute services.

Blood-Borne Pathogens↗
PubMed1986

Reading strategies in children with learning disabilities and minor neurological dysfunction.

The connexions between minor neurological dysfunction (MND) and learning disabilities (LD) are analysed in 48 children with LD with and without MND. The two groups did not differ in a set of reading/writing tests or in neuropsychological tests. What proved to be different were the profiles of correlation internal to reading and between reading and presupposed neuropsychological functions. The results highlight the importance of studying the connexions between MND and LD and the need to take neuromotor parameters into account in the construction of clinical subtypes of learning disabilities.

Child↗
PubMed1975

A special neurological examination of children with learning disabilities.

Children with "minimal brain dysfunction" and learning disabilities were found to have significantly more minor neurological signs than control children. Many of these signs become less obvious or disappear by the age of 11 years; therefore older cases are more similar to controls, whereas younger cases show lags or deficits at the highest levels of central nervous system functioning-language, fine motor co-ordination and cross-modality integrations.

Age Factors↗