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This article reviews the efforts made since 1962 to define learning disabilities, provides readers with a clear picture of the current status of such definitions, and recommends that a consensus form around the definition proposed by the NJCLD.
The performances of 29 normal and 29 neurologically impaired-learning disabled children (aged 7.3 to 15.3 yr.) were evaluated on unfamiliar face and common object recognition tasks. Although the normal children performed better, the relative difficulty of face and object recognition was the same for both groups.
The effect of prolonged iodine deficiency on learning and motivation was studied. One hundred male children--matched for age, socioeconomic status, and formal education--were selected from both severely iodine-deficient (SID) and mildly iodine-deficient (MID) villages. Mean urinary iodine excretion was significantly lower in the SID than in the MID group (219.84 +/- 57.52 compared with 449.14 +/- 32.31 nmol/L, P < 0.001). The serum thyroxine concentration was significantly lower (90.36 +/- 6.46 compared with 123.70 +/- 15.42 nmol/L, P< 0.001) and serum thyroid-stimulating hormone (TSH) was significantly higher in the SID group than in the MID group (6.23 +/- 0.34 compared with 4.85 +/- 0.28 mU/L, P< 0.01). The children were administered maze, verbal, and pictorial learning tasks and a test of motivation. The results showed that SID children are slow learners compared with MID children. In both groups the rate of learning over trials was superior in younger (aged 9-12 y) children although the initial performance of older (aged 12-15 y) children was better (P < 0.01). SID children scored significantly lower than MID children on the achievement motivation scale (P < 0.01). The results are suggestive of neural impairment as well as poor sociopsychologic stimulation, resulting in learning disability and lowered achievement motivation. Unless iodine nutrition is improved in the community as a whole, these abnormalities may prevent millions of children from the SID areas from achieving their full potential even if learning opportunities are made available to them.
The recent case of Jo, a Down's Syndrome child who was initially refused a heart and lung transplant (BBC TV 1996) has raised the issue of rationing health care. This article discusses the issues surrounding rationing and looks critically at some of the definitions and assumptions it is based upon. The historical and the future impact of various types of rationing upon people with learning disabilities is highlighted. The author argues that people with learning disabilities would benefit from a more explicit rationing system to enable decisions, made possibly on prejudiced grounds, at least to be challenged.
Although research has documented overlapping and coexisting characteristics of learning disabilities and emotional/behavioral disorders, little attention has been paid to the subset of students who manifest symptoms of both disorders (LD/EBD). This gap in our professional knowledge/research base may be due to (a) exclusive language in federal definitions that promotes differentiation of disabilities rather than recognition of symptom overlap; (b) the lack of a conceptual model of concomitant learning and emotional/behavioral disorders; and (c) the absence of a research focus on this population. In this article, we construct a conceptual model involving six critical domains of relevance to students with LD/EBD. After describing the utility of this interactive and functional model, we highlight critical issues in screening, assessment, and programming for children with concomitant LD/EBD.
Cognitive and behavioral correlates of depression were examined in 33 learning-disabled (LD) and 99 nonlearning-disabled (NLD) adult students. Self-reported depressive symptomatology was significantly correlated with dysfunctional cognitions and reinforcement level in LD students. LD students reported engaging in significantly more unpleasant activities and experiencing significantly less pleasure than NLD students. There was a nonsignificant trend for LD students to report more depression than NLD students. These results are discussed in the context of cognitive and behavioral theories of depression.
There are few empirical studies of the adult outcomes of nonverbal learning disability (NLD). An overwhelming majority of NLD studies has been devoted to the nature of academic difficulties of school children, whereas the few follow-up studies have tended to be limited to college-age young adults. Herein, it is argued that the problems of adults with NLD do not fall solely in academic areas, and that early academic remediation programs might do well to include intervention in emotional and social skills enhancement.
Third and fifth grade children with and without learning disabilities participated in this study. Syntactically frozen and flexible idioms and transparent and opaque idioms were used as stimuli to examine the ability to identify the correct idiom and to explain idiom meanings. Grade and diagnostic category affected performance on the explanation task but not on the forced choice task. Idiom type was also a factor affecting comprehension and explanation. Literal responses occurred rarely and were more likely to occur on the forced choice task.
The immediate impact of viewing aggressive cartoons on emotionally disturbed (ED) and learning disabled (LD) children's willingness to hurt another child was assessed. Fifteen ED and 23 LD children (M = 7.25 years old) viewed either an aggressive or a comparison cartoon and then played the Help-Hurt game. The children who watched the aggressive cartoon pressed the Hurt button for significantly more time than did those who were exposed to the comparison cartoon. Across cartoon conditions, the ED children pressed the Hurt button significantly longer than did their LD peers.
Forty-two second-grade general education students and 42 students with learning disabilities (LD) were taught basic, one-digit addition facts (e.g., 5 + 3 = _). Students received instruction via (a) a minimum addend strategy, (b) drill and practice, or (c) control. The effectiveness of the two methods was measured through students' accuracy and latency scores on a posttest and a transfer task (e.g., 5 + 3 + 7 =_). Students with LD improved significantly only in the strategy condition, as compared to drill-and-practice and control conditions, whereas general education students improved significantly both in the strategy and the drill-and-practice conditions as compared to the control condition. However, in the transfer task, students from all groups became significantly more accurate only in the strategy condition, while all students were significantly faster than their control group peers regardless of teaching method. The implications for teachers' differential choices of methods of instruction for students with different learning characteristics are discussed.
Neuropsychology has a relatively brief history in the assessment of developmental learning disabilities (DLD) in adults. For a discipline that conceptualizes clinical assessment on the basis of neurologic understanding, DLD continues to be a challenge, even today because its neurology remains relatively unknown. Nonetheless, there have been important advances in understanding the underlying brain differences in this population as well as the advancement of theory-driven models for assessment. In the context of this body of information, neuropsychological assessment provides a comprehensive means of diagnosing DLD in adults. This article describes components of a specialized neuropsychological protocol developed to diagnose DLD in adults.
Speech and language therapy aims to increase the functional communication of adults with learning disabilities through the implementation of interaction group programmes but the full therapeutic benefit may be reduced because of individual clients' presenting challenging behaviours. The pilot Anger Management Programme aimed to reduce clients' challenging behaviour through increased communication use and with a focus on multidisciplinary collaborative NHS health trust and social work team working practices. An in-service training package and two client-group programmes were devised and positively received both from a client provision and multidisciplinary skill-merge perspective. The paper details the introduction to the study, its objectives, methodology and qualitative analysis.
60 learning disabled students, 43 males and 17 females, enrolled in a high school special education resource-room program listened to content presented at variable rates. The 60 subjects were randomly assigned to six experimental groups of 10 students each. Three groups were assigned to listen to content in history each at one of three predetermined rates. The same procedure was used for the three groups assigned to listen to biological content. Measures of comprehension of the content indicated no significant difference in the amount of information each group of students retained when the historical or biological content was presented to their particular group aurally at an expanded, normal, or compressed rate of speech.
A hospital-based adult learning disabled population (n = 371) was screened for polydipsia with the help of a purpose-designed questionnaire. Polydipsia was defined as excessive drinking of more than 3 l of non-alcoholic fluid over a 24-h period. Altogether, 23 (6.2%) subjects were found to have polydipsia. The polydipsic group was compared with the whole hospital population on variables such as age and IQ distribution. A matched group of 23 individuals without a history of polydipsia was drawn from the same hospital population. The polydipsic and the matched group were compared using various biochemical and psychological measures. Thirty-five per cent of polydipsic patients, compared to 13% of the matched group, showed evidence of compensated hyponatraemia. This difference was not significant. There was no significant difference between the polydipsic and the matched group in the frequency of psychiatric illness, behavioural problems or autism. There also was no significant difference in the IQ levels of the polydipsic patients and the total hospital population. Polydipsia in this population is largely seen as part of an abnormal behavioural repertoire without any evidence of possible organic cause, except unidentified diabetes mellitus. Klein Levin syndrome and pica were represented in the polydipsic group, but not amongst the matched group.
The use of antiepileptic agents for individuals with learning disabilities (mental handicap) resident both within National Health Service facilities and the community was surveyed in the UK. There was no difference in rates of polypharmacy, but there were significant differences in choice of antiepileptic agent. In particular, individuals resident in the community were more likely to be in receipt of phenytoin, primidone and phenobarbitone, which are particularly recognized as producing adverse effects on cognition and behaviour.
BACKGROUND: Many people with learning disabilities (LD) show aggressive behaviour, but the extent of the problem and its associated factors and effects are unclear. METHODS: A cross-sectional analysis was carried out using interview data from 3065 adults with LD on the Leicestershire LD Register. Physical aggression towards others was defined as carers reporting frequent (more than three times per week) and/or severe episodes. Individuals with and without aggression were compared using multiple logistic regression models for potential physical and psychological factors. RESULTS: Carers reported that 443 (14%) of adults were physically aggressive towards others. Men (P = 0.001), younger individuals (P < 0.001), people with more severe LD (P < 0.001) and those in institutional settings (P < 0.001) had a significantly higher prevalence of physical aggression. People with Down syndrome had a lower prevalence of physical aggression (P < 0.001). After adjustment, we found no relationship between aggression and the presence of epilepsy or autism. Among psychological factors, symptoms of frustration (P < 0.001) and mood swings (P < 0.001) were associated with higher levels of aggression. Failure to cope among carers was reported by 14% overall: 42% of people caring for adults with aggression said they were unable to cope compared with 10% of those caring for adults without aggression. CONCLUSIONS: Physical aggression towards other people presents a significant challenge to carers of adults with LD. Further research is needed to identify aetiological factors with a view to finding effective interventions to reduce, and improve management of, this behaviour.
A study was conducted of 102 adults with learning disability for the purposes of (1) contrasting a rule-based with an empirical method of classification into subtypes based on academic achievement levels in reading and arithmetic; and (2) examining cognitive profiles obtained with the Luria-Nebraska Neuropsychological Battery and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) associated with each of the rule and empirically based subtypes. Both similarities and differences were found between classification methods. Both methods indicated that specific reading disability was associated with the most impaired cognitive profiles of the three subtypes identified. However, they did not agree concerning cognitive profiles of subtypes, characterised by a specific arithmetic deficit or a global deficit. It was found that both the Lurid-Nebraska and WAIS-R profiles distinguished among subtypes more by pattern than by level of performance.
Some children with autism and learning disabilities also have aberrant behaviours that are difficult to regulate and stressful for both the child and family members. This case study concerns experiences of 10 parents from five families before and 2 years after entrusting their 10- to 11-year-old child with autism to a group home. Hermeneutic phenomenological analysis of narrative interviews with the parents before the child's moving showed them experiencing grief and sorrow, total exhaustion because of inability to regulate their child's behaviours, social isolation, and negative effects on the child's siblings, but experiencing themselves as more sympathetic than previously towards other people with problems. Two years later they experienced relief for the family due to the group home arrangement and the child's improvement, but with an ethical dilemma which made them feel guilty, despite increased hope for the future. Some also felt unhappy with the staff situation at the group home.