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PubMed1998

[A case of learning-disabled child with a white matter lesion in the left parietal lobe].

We reported a learning-disabled boy, 7-year-old and right handedness, who was similar to developmental Gerstmann syndrome. Dyscalcuria, right-left disorientation, dysgraphia and finger agnosia were correlated with his sequential disorder which was clearly presented by Kaufman Assessment Battery for Children. In this case, a small infarcted lesion was found in the white matter near the left semioval center on MRI. Hypoperfusion of left parietal lobe was also detected by SPECT. The hemisphere dominant in language was assumed to be on the left side by dichotic listening test. We suggested that left parietal lesion was associated with his higher cortical dysfunction.

Brain Diseases↗
PubMed2001

Contingent reinforcement or defending the self? A review of evolving models of aggression in people with mild learning disabilities.

This paper examines the changing approaches to working with people with a moderate to mild learning disability, who are frequently aggressive. Long-held assumptions about the lack of inter-personal understanding and impulsiveness continue to play a central role in clinical assessment and intervention for this group. Yet, there is a lack of controlled studies indicating the influence of such factors in frequent aggression. The dominant behavioural tradition has long encouraged such assumptions, but has focused on people with more severe disabilities where such assumptions are arguably more appropriate. The current review of the literature shows a clear evolution away from a strict behavioural approach towards cognitive-behavioural therapy (CBT) approaches that take account of the heterogeneous psychosocial causes of aggression. We find support for CBT in the child-development literature, which examines inter-personal difficulties from an information-processing perspective. Finally, we argue that much of the literature implicitly utilizes the concept of self, and we suggest that this should be made explicit in a reformulated theory of the 'person', incorporating the self concept and embedding individual cognitive processes and behaviour in a social context.

Aggression↗
PubMed1998

Hobson's choice: reproductive choices for women with learning disabilities.

This paper examines the present law in England and Wales concerning the sterilisation of women who are unable to give valid consent to medical treatment. In particular, it considers why sterilisation is frequently presented as the only meaningful reproductive choice that can be made by or on behalf of women with learning disabilities. In addition, the paper assesses the extent to which the best interests test, as formulated by the English courts, has been successful in the promotion of dignity and autonomy of women with learning disabilities. It is submitted that some of the issues presented to the courts have not received adequate consideration and others have been considered which are not relevant to the determination of the best interests of these patients. Furthermore, the best interests of the adult patient are determined by reference to the 'Bolam' test. This paper questions whether the Bolam test is the appropriate mechanism for determining the patient's best interests, having particular regard to the Australian model of decision-making for the intellectually impaired.

Adolescent↗
PubMed1986

The effects of cognitive-behavior modification on private speech and task performance during problem solving among learning-disabled and normally achieving children.

Recent research has supported the hypothesis that poor performance among learning-disabled (LD) children is frequently the result of deficits in self-regulation of strategic behaviors, rather than structural or ability deficits. As a result, cognitive-behavior modification (CBM) techniques that emphasize development of self-regulation through self-verbalizations (private speech) have been strongly recommended. The present study examined the natural occurrence of regulatory private speech among LD and normally achieving children during problem solving, as well as the effects of CBM training on private speech and task performance. Results indicated significant deficiencies in private speech and task performance among LD children; CBM training resulted in significant improvements. These results provide further verification of deficits in self-regulation of cognitive activity among LD children and import implications for intervention.

Behavior Therapy↗
PubMed1998

Learning disability care staff's emotional reactions to aggressive challenging behaviours: development of a measurement tool.

OBJECTIVES: To describe the development of a rating scale measure of caregivers' emotional reactions to aggressive challenging behaviour, and to report preliminary psychometric data for the scale. DESIGN: Using previous research on staff working with people with learning disabilities, a range of likely emotional reactions to challenging behaviours were selected for possible inclusion in a rating scale measure. METHODS: A total of 83 care staff from 23 community residences for people with learning disabilities rated their recent emotional reactions to aggressive challenging behaviour using 18 emotion items. A further sample of 18 care staff participated in a test-retest study after the initial stages of scale development. RESULTS: A rating scale was developed on the basis of a factor analysis and further item analysis. The measure has two subscales: feelings of depression/anger (10 items), and feelings of fear/anxiety (5 items). The subscales have a high internal consistency, good test-retest reliability and are relatively unaffected by social desirability biases. CONCLUSIONS: The emotional reactions to aggressive challenging behaviour scale has excellent face and construct validity, and other preliminary psychometric data are promising. The scale has a number of potential research and clinical applications.

Activities of Daily Living↗
PubMedDate not supplied

Falling through the cracks: rehabilitation services for adults with learning disabilities.

The present study investigated the knowledge and perceptions of vocational rehabilitation (VR) of adults with learning disabilities (LD), as well as control variables which describe adults with LD and may have a bearing on access to VR services. This was accomplished by (1) determining the knowledge adults with LD had of their rights under federal rehabilitation regulations; (2) examining demographic control variables (e.g., sex, age, education level, hometown population, employment history, and income), which may have a bearing on the need for or access to VR services by adults with LD; and (3) examining experiences/perceptions of adults with LD regarding the VR application/eligibility process. A pretested questionnaire appeared in the January 1989 ACLD Newsbriefs. Findings indicate that while there was a group of respondents who were satisfied with the rehabilitation services they had received, there was also a large group of respondents who were either ineligible for rehabilitation services or dissatisfied with services they received. Generally, respondents' knowledge of VR was limited.

Achievement↗
PubMed1987

Brain stem evoked response in the assessment of learning disabilities.

Evidence has accumulated rapidly to support the hypothesis that neurological anomalies underlie specific forms of learning disability (LD). This article reviews recent studies directed at the electrophysiological assessment of LD children, with emphasis on the brain stem evoked response(BSER) methodology. Child studies appear to indicate that there are significant differences in BSERs between LD and age-matched normal controls. The methodological and statistical differences among these studies, which have clouded the findings and made replication difficult, are reviewed. Improvements in sampling and empirical procedures are suggested, including the use of discriminant analysis to explore BSER asymmetries in LD children. Future inquiry into the measurement and analysis of BSER activity in LD populations is warranted on the basis of these preliminary findings. New information may bring professionals closer to an understanding of the neurological causes of specific subtypes of LD and permit earlier identification of these "at risk" populations.

Adolescent↗
PubMed1995

Developmental right-hemisphere syndrome: clinical spectrum of the nonverbal learning disability.

We report the clinical characteristics of the developmental right-hemisphere syndrome (DRHS), a nonverbal learning disability, in 20 children (9 girls and 11 boys; mean age = 9.5 years) who also manifested attention-deficit/hyperactivity disorder (ADHD), severe graphomotor problems, and marked slowness of performance. Diagnostic criteria for this study included (a) emotional and interpersonal difficulties; (b) paralinguistic communication problems; (c) impaired visuospatial skills, verbal IQ > performance IQ, and verbal IQ > or = 85; and either (d) dyscalculia or (e) neurological signs on the left side of the body. In this group, verbal IQ was significantly higher than performance IQ (106.6 +/- 13.0 vs. 85.1 +/- 13.1, respectively, p < .01). Arithmetic was the lowest score among the verbal subtests (7.8 +/- 3.5, p < .01) and Geometrical Design was the lowest score among the performance subtests (5.8 +/- 1.7). Thirteen children had soft neurological signs on the left side of the body. ADHD was seen in all 20 children, marked slowness of performance in 16, and severe graphomotor problems in 18. The latter two features have not been previously described as part of DRHS.

Adolescent↗
PubMedDate not supplied

One size still does not fit all in specific learning disability assessment across ethnic groups.

The use of IQ scores and discrepancy formulas for identifying specific learning disabilities (SLD) has been widely discredited by prominent researchers for more than a decade. Nevertheless, the overwhelming majority of state policies still specify the use of discrepancy formulas, including the simple difference method, which is psychometrically inferior to regression-based methods. This study compares the use of a minimum IQ cutoff score and a simple difference method versus a regression-based method for identifying SLD in a sample of African American and European American full-time college students (N = 117). Replicating the findings from previous studies using typically achieving children, typically achieving adults, and school-age children with SLD, this study adds to the chorus of voices criticizing the use of outdated assessment practices that can have deleterious effects for individuals with SLD. The implications for legislative policy are discussed in the context of the historical overrepresentation of African Americans in all special education categories except SLD and the increased access to higher education that students with SLD have gained during the past decade.

Adolescent↗
PubMed1980

The intervention of a modulator with learning disabled children.

Tested the role of a child modulator, an investigator, and coordinator of services for learning disabled children. Ninety regular third- and fourth- grade children with average intelligence were selected from a population of 1,030 children on the basis of low scores on the Pupil Rating Scale and at least one of four Metropolitan Achievement subtests and were assigned randomly to one of three groups. The first group received the services of the modulator for a 6-month period, while the respective schools were informed of the teachers' ratings and achievement test scores for the second group, and the third group was an untreated control. In addition to the selection procedures, school grades, the Piers-Harris Self-Concept Scale and the Connors Parents Questionnaire were completed before and after treatment. The results showed teacher ratings and achievement score changes for all groups with the modulation group superior only in teacher ratings of Personal-Social behavior. Follow-up testing 18 months later between the modulated and school informed group within the Piers-Harris Scale and ratings by unbiased teachers reflected numerous differences, which suggests a growing self-confidence in the modulated Ss. The positive usefulness of this form of intervention in meeting the general needs of the child and in treating the concomitants of school failure are discussed.

Canada↗
PubMed2001

The stress of progression from school to work for adolescents with learning disabilities em leader What about life progress?

Four students with learning disabilities were interviewed about their experiences at work. Two students, one male and one female, were high school seniors and two students, one male and female, were freshmen at a community college. Individual student interviews ranged from 2 to 4 hours. Informal interviews were conducted with students' teachers and parents. At the time of the interview, students had part-time, unskilled jobs in which they had worked for at least 6 months prior to participation in the study. Themes that emerged from analysis of the data included students' reactions to entering the workforce, stress in learning the job tasks, overcoming difficulties by developing coping strategies, learning work values and parental influences. Student interviews underscored the importance of practice runs and real life learning to reduce stress prior to entering the work force.

Journal Article↗
PubMed2002

Inbreeding and learning disability in Croatian island isolates.

The aim of this study was to investigate the prevalence of learning disability (LD) in isolate populations with different inbreeding coefficients (F). Prevalence of LD and F were determined in 10 villages from five Croatian islands: Brac, Hvar, Korcula, Lastovo and Susak. For the purpose of this study, LD was defined as the inability to attend the public school system. As the elementary schools (grade 1-8) in the place of the study are both public and compulsory, the assessment of child's inability to attend the school is performed at the age of six. This is required by all children in the country based on standard set of tests of cognitive performance defined by the Ministry of Education and Culture of the Republic of Croatia. The average inbreeding coefficients in each village population (F) were estimated in a random sample of 20-30% adults in each of the 10 villages based on 4 ancestral generations and using Wright's path method. Prevalence of LD ranged from 0.43% to 2.47%, and the inbreeding coefficients ranged from 0.8% to 4.9%. The Pearson's correlation coefficient between F and LD prevalence was 0.80 (p < 0.01). Although the relative risk per 5% inbreeding appeared very high (about 10), the absolute risk only increased from 0.18% to 1.77%. The genetic effect of inbreeding (GEI) was approximately 0.69% and the population-attributable fraction 76.6%. A review of the literature and the results of this study lead to a conclusion that a very large number of predominantly recessive genetic factors might mediate the genetic susceptibility to various forms of LD in these populations.

Adult↗
PubMed1991

Learning disabilities, distinctive encoding, and hemispheric resources.

The purpose of this study was to isolate possible sources of learning ability differences in distinctive encoding of item-specific and relational information. Two mechanisms postulated as underlying ability group differences were attentional capacity (as inferred from the magnitude and direction of correlations between primary and secondary recall) and resource monitoring strategies (as reflected in measures of selective attention and laterality). In Experiment 1, learning disabled and nondisabled childrens' word recall was compared on dichotic listening recall tasks that included nonorienting instructions, and orienting instructions that directed children's attention toward semantic, phonemic, or structural word features. Disabled children showed lower recall and more diffuse selective attention to word features than nondisabled children. Reciprocity (negative correlations) between targeted and background words within and between ability groups was comparable, except when targeted word features were phonemically organized. Experiment 2 indicated that disabled childrens' cued recall was inferior to that of nondisabled children, even though both ability groups produced comparable symmetrical recall patterns related to ear presentations. Taken together, the results suggest that the locus of disabled childrens' distinctive encoding deficiencies is related to resource monitoring strategies during interhemispheric processing.

Attention↗
PubMedDate not supplied

Transcultural therapy. 1: Mental health and learning disabilities.

In this article, the first of two parts, the issues surrounding healthcare provision are discussed in the context of the UK as a multicultural society. Concerns relating to nurse education and training are identified in regard to the implications for practice surrounding diagnosis across cultures, classification of illness, and the status and influence of psychological assessments within the field of mental health and learning disability. Finally, the concept of empowerment is critically reviewed, emphasizing that service providers need to collaborate with communities. Community mental health and learning disability nurses are required to make dynamic alliances with communities, through the individual, and so redirect the power relationship to the community and subsequently respond to the demands for cultural diversity sensitively from within healthcare provision and services.

Cultural Diversity↗
PubMed1996

[A specific disorder in Kanji writing in a learning disabled child with a visual cognition disorder--a cognitive-neuropsychological and electrophysiological analysis].

We reported a learning disabled child with a specific disorder involving Kanji writing. The patient was a 13-year-old boy. Although he manifested generally normal intellectual ability and his performance on WISC-R indicated that VIQ was 101 and PIQ 84, he could only write approximately 20% of Kanji, which he learned at age 6 to 7. On cognitive-psychological tests, he showed a visual cognition disorder that was different from that in a previously reported case during information processing. Electrophysiologically, he showed a disorder in visual task-relevant potentials. The mechanism underlying this patient appears to be a retrieval disorder for complex graphic forms in addition to a visual cognition disorder because of two reasons. One is that he could distinguish Kanji from similar graphic forms. The other is that he could read Kanji aloud.

Adolescent↗
PubMed1997

[A semantic-pragmatic learning disabled child who showed a discrepancy between the abilities of verbal and non-verbal comprehension].

A learning disabled (LD) child with disorder of verbal semantic comprehension was reported. This case showed normal ability of non-verbal semantic comprehension. He was not able to understand the meaning of what he read aloud and/or repeated, which he did well. The focus of his brain dysfunction in the left temporal lobe was revealed by SPECT in spite of MRI findings of no particular lesions. Neuropsychological and cognitive-psychological findings were similar to those reported of adult sensory aphasias with localized lesions.

Child↗