Learning Disabilities Ebooks Catalog

Adult Dyslexia

Adult Dyslexia

This is a comprehensive guide covering the basics of dyslexia to a wide range of diagnostic procedures and tips to help you manage with your symptoms. These tips and tricks have been used on people with dyslexia of every varying degree and with great success. People just like yourself that suffer with adult dyslexia now feel more comfortable and relaxed in social and work situations.

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Dyslexia Facts You Should Know

Dyslexia, Facts You Should Know Is A Unique Fact Filled E-book That Gathers Easy To Read Information About Dyslexia In One Place For The Interested Reader. Learn How to Cope With A Diagnosis of Dyslexia and What To Do Next. Every bit of this eBook is packed with the latest cutting edge information on Dyslexia. It took months to research, edit, and compile it into this intriguing new eBook. Here's what you'll discover in Dyslexia: Facts You Should Know: What is Dyslexia? History of Dyslexia. Is it Dyslexia or Something Else? How You Can Diagnose Yourself. Benefits of Catching Dyslexia Early. What is the Dyslexia Test? How to Get Everything You Will Need for Help in Coping with Dyslexia. Exploring Your Options for Schools and Programs. What is the Individualized Education Program? Alternatives to the Iep. The Roll Your Childs Teacher Plays. Your Part in Your Childs Education. Why Practice, Patience and Practicality are Most Important. Teens with Dyslexia. Success in Life: Adults Overcoming Dyslexia.

Dyslexia Facts You Should Know Overview

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Defining A Learning Disability

Before discussing needs and support issues, it is important to try to define this group of people that we term as 'adults with learning disabilities'. On the surface, this may seem a simple task. However, reviewing the historical context of learning disability care reveals a variety of ways in which the term has been defined over time (Department of Health 2001a Gates 2003 Grant et al. 2005 O'Hara & Sperlinger 1997). In March 2001, the Government produced a White Paper entitled Valuing People A New Strategy for Learning Disability for the 21st Century (Department of Health 2001a). Within this document, not only do they seek to define and identify this group of people with 'learning disability', but also attempt to provide policy guidance for staff and carers who work with and support adults with learning disabilities. This was the first White Paper produced in over a decade in relation to the care and support of adults with learning disabilities, and hence it has great influence in...

Issues Of Diversity Culture And The Needs Of Older People With Learning Disabilities

'People with learning disabilities from minority ethnic communities are at particular risk of discrimination in gaining access to appropriate healthcare. . . . Staff who understand the values and concerns of minority ethnic communities and who can communicate effectively with them have an important role to play in ensuring that minority ethnic communities can access the healthcare they need.' The Government clearly outlines the necessity to profile cultural considerations in Valuing People (Department of Health 2001a). It further commissioned a report, Learning Difficulties and Ethnicity, in 2001, to specifically explore the needs of black and minority ethnic communities. Comment is often heard from individuals and their families stating that they are doubly discriminated against, both having a learning disability and coming from a black or minority ethnic community When working with adults with learning disabilities, an obligation to provide culturally sensitive care is required. To...

Warning Signs of Learning Disabilities in Secondary School Children

As co-existing learning disabilities are common in children with ADHD, parents and teachers should be aware of signs of learning disabilities (LD). Some children may have learning disabilities that have gone undetected to this point. They may have achieved well in earlier grades, especially if they are very bright children. Academic performance problems most likely had been attributed to their ADHD. To determine whether or not a student has learning disabilities requires a psycho-educational evaluation. Educational interventions must be provided, addressing the student's individual learning needs. The following is a list of warning signs of possible LD in teens (Inland Empire Branch of the International Dyslexia Association, 2003).

Some Tips For Caring For Adults With Learning Disabilities And Challenging Behaviour

Challenging behaviour is any behaviour that interferes with the adult with a learning disability's learning development and success in daily routines or activities is harmful to the adult with a learning disability and other people or puts the adult with a learning disability at high risk for later problems and failures. Caring for an adult with a learning disability with challenging behaviour is a challenge in its own right - but it is one that carers can overcome with the appropriate strategies. Table 3.5 offers some ideas that have been proven to work and which can benefit all adults with learning disabilities, not just those with challenging behaviour. Table 3.5. Some ideas that may enhance care for all people with learning disabilities, not only those with challenging behaviour Caring for the adult with a learning disability - be sure that she or he knows that you care for him her and set aside time to spend with him her. Appropriate behaviour - this must be encouraged, thus...

Current Position Of Adults With Learning Disabilities

The reality for many adults with learning disabilities is a life with limited choice, rights, independence or inclusion - the four key principles at the heart of Valuing People (Department of Health 2001b). This state of affairs puts many adults with learning disabilities in a vulnerable position, as they are dependent on family, carers and professionals to help them live their lives. This can lead to potential vulnerability, as an adult with a learning disability is reliant on the honesty, integrity and professionalism of those caring for him her. Alongside this is the difficulty that adults with learning disabilities may have in making their needs and wishes known, and in being heard, listened to and understood by families, carers and professionals (Department of Health 2001b) 'People with learning disabilities are amongst the most socially excluded and vulnerable groups in Britain today. Very few have jobs, live in their own homes or have real choice over who cares for them. Many...

Prevalence And Causation Of Mental Health Problems In People With Learning Disabilities

The mental health needs of people with learning disabilities have only been on the learning disability healthcare agenda for the past 15-20 years. Reid (1994) suggests that historically it was thought that people with learning disabilities did not have the intellectual or cognitive ability to suffer from a mental health disorder. Any noticeable changes in their behaviour were interpreted as part of their learning disability and, on the unusual occasion that signs of mental illness were noted, they were passed on to the local general psychiatric services, as learning disability services were not able to treat them. Reiss (1992) identifies that the issue was in the assessment process, distinguishing whether a 'dual-diagnosed' person's primary need was the learning disability or the mental health problem, i.e. which was more significant to their lives or those around them. Concern was centred on the provision of care, such as whether the patient was to be cared for by those in the mental...

Learning Disabilities

It is estimated that 5 percent to 10 percent of schoolage children and adolescents have learning disabilities (LDs), with some estimates approaching 17 percent. LDs fall on a continuum and range in severity from subtle to marked impairment. A substantial number of learning-disabled students receive special education services. In 1975 the U.S. Congress enacted the Education for All Handicapped Children Act (PL 94-142), which was an educational bill of rights assuring children with disabilities a free and appropriate education in the least restrictive environment. Disabilities that qualified for services under this law included mental retardation, hearing deficiencies, speech and language impairments, visual impairments, emotional disturbances, orthopedic impairments, a variety of medical conditions (categorized as ''other health-impaired''), and specific learning disabilities. This law was reauthorized under the Education of the Handicapped Act amendments and, subsequently, the...

Definition of Learning Disabilities

Despite federal regulations, the definition of learning disabilities is controversial. The U.S. government defines a specific learning disability as a disorder in one or more of the basic psychological processes involved in understanding or use of spoken or written language, which may be manifest as an inability to listen, think, speak, read, write, spell, or do mathematic calculations. While the definition could include the conditions of perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia, it is not applicable to students whose learning problems are the result of visual, hearing, or motor handicaps, mental retardation, emotional disturbance, or environmental cultural disadvantage. The major premise is that a significant discrepancy exists between the child's potential and her actual level of academic or language skills. The psychiatric definition of LDs (as found in the American Psychiatric Association's Diagnostic and Statistical Manual...

Reading Disabilities Dyslexia

Roughly 30 to 60 percent of children with ADHD also have specific learning disabilities. Among the various learning disabilities, reading disorders are most common. Some children have specific processing deficiencies (auditory or visual perception, short-term memory, phonological awareness, or receptive expressive language) that affect their acquisition of reading skills. Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms that result in people having difficulties with specific language skills, particularly reading. Students with dyslexia may experience difficulties in other language skills such as spelling, writing, and speaking. Current studies suggest that 15 to 20 percent of the population has a reading disability of some kind. Of those, 85 percent have dyslexia (IDA, 2000). Note To determine whether a child teen has learning disabilities in reading (dyslexia) requires a psycho-educational evaluation.

Learning Disabilities Association

Have a learning disability if these are the primary factors in the learning problems. Both the discrepancy formulation for learning disabilities, and the role that exclusion of other conditions plays, have become subjects for increasing debate in recent years. Many researchers have proposed redefining the concept of learning disabilities to focus on specific language and thought processing problems that may be identified by appropriate testing, without necessarily involving the question of aptitude or intellectual potential. Some experts have argued that the exclusionary element in definitions of LD have led to the under-identification or misdiagnosis of individuals who come from poverty or from minority cultural, racial, or ethnic backgrounds. They argue that the difficulties such children have in learning are more likely to be ascribed to their backgrounds and upbringing than to a potential learning disability, and that approaches to diagnosis that depend on aptitude achievement...

Learning Disabilities and ASHFA

The fact that there are major distinctions between the cognitive challenges posed by autism spectrum disorders and those posed by learning disabilities does not preclude the possibility that a child will have both. While it is relatively uncommon for children with autism spectrum disorders to have dyslexia too, it does occasionally happen. If your child is experiencing trouble with phonics, by all means have him or her evaluated for dyslexia. Most school psychologists and many clinical psychologists in the community are trained to perform these specialized evaluations. One learning disability is actually somewhat common among children with autism spectrum disorders. It is known as nonverbal learning disability, or NLD. As discussed in Chapter 2, children with NLD expe

Health Screening For People Who Have Learning Disabilities

Since the late 1980s, there have been numerous reports highlighting unmet health needs for people who have learning disabilities (Howells 1986). There is also evidence of the poor uptake of screening services nationally (Whitfield et al. 1996). Women who have learning disabilities are less likely to undergo cervical smear tests than the general population - 19 compared with 77 per cent (Djuretic et al. 1999) - and, despite a 90 per cent attendance rate at mammography clinics, are less likely to engage in breast examinations or receive invitations to mammography than the general population (Davies & Duff 2001). Many stereotypical reasons exist to back the theory, such as the assumption that Health Minister Rosie Winterton announced that from April 2006, a national bowel cancer screening programme would be phased in. Men and women aged 60-69 years will be screened every two years. With an ageing population in learning disabilities, it is also vital that people are accessing this...

What Research Tells Us About Learning to Read and Reading Difficulties

What can be done to prevent reading difficulties One of the main sources of the current information is the National Institute of Child Health and Human Development (NICHD), National Institutes of Health. The high rate of illiteracy and reading difficulties in the United States (roughly 17 to 20 percent of the population) is considered not only an educational problem, but a major public health problem. To address this issue, the NICHD has supported scientific research continuously since 1965 to understand normal reading development and reading difficulties. NICHD developed a research network consisting of forty-one research sites in North America (and other parts of the world), which conducted numerous studies on thousands of children many over a period of years. In addition, more research findings on this topic come from the Committee on the Prevention of Reading Difficulties in Young Children, National Research Council. This committee was entrusted by the National Academy of Sciences...

Developmental Learning Disability

About three decades ago, I was listening to Norman Geschwind speak about dyslexia to members of the Orton (dyslexia) Society. Norman liked to say things that would shock his audience, and during his talk he said, Dyslexia is a social disease. At that time when someone spoke about social diseases, they were usually speaking about sexually transmitted diseases, such as gonorrhea and syphilis. There were many dyslexic people and parents of dyslexic children in the audience who appeared to be angry when he made this comment. He, however, held up his hand and said, Wait, let me explain. He mentioned that in the history of humans, it is only recently that reading has become so critical for success. He asked who would be our leader if we lived in a hunter-gatherer society the person who could read and write the best or the person who could get us back to camp after the hunt He also mentioned that he would not be surprised if the people with the best visual-spatial abilities have a higher...

Common Reading Difficulties in Children and Teens with Attention Deficit Disorders

Because of the inherent difficulties associated with poor executive functioning and sustaining focused attention to task, it is common for individuals with ADHD to have difficulty with recall and comprehension of reading material (Rief, 1998, 2003). Although they may have strong decoding and word recognition skills (if they do not have the co-existing learning disability of dyslexia) and appear to be skilled readers, it is still most common to find that individuals with ADHD are generally not strategic readers and have spotty comprehension. The following are common difficulties many children and teens with ADHD and or learning disabilities experience with reading

Learning Disability Subtypes

There are many different subtypes of learning disabilities. Byron Rourke, writing in 1993, reported three major groupings (1) reading spelling, (2) arithmetic, and (3) reading spelling arithmetic. Larry Silver, also writing in 1993, suggested a model that includes input disabilities (visual perceptual, auditory perceptual, and sensory integrative), integrative disabilities (sequencing, abstraction, and organization), memory disabilities, and output disabilities (language and motor). Reading spelling disabilities are by far the most prevalent form, with such disabilities estimated to comprise from 5 percent up to 17 percent of the child and adolescent population. Estimates for the occurrence of disorders of written expression range from 2 percent to 8 percent. Although Learning disabilities, such as dyslexia, can be caused by premature birth or asphyxia at a younger age. In other cases, the direct cause of a learning disability is not known. (Ellen B. Senisi Photo Researchers, Inc.)...

Deep Dyslexia Interpreting Error Types

Patients with a reading disorder known as deep dyslexia make two very different types of reading errors, which have been interpreted as indicating that two functionally distinct lesions are needed to account for the reading errors of these patients. Deep dyslexic patients make semantic errors, that is, errors that bear a semantic similarity to the correct word, such as reading cat as dog. They also make visual errors, that is, errors that bear a visual (graphemic) similarity to the correct word, such as reading cat as cot. The fact that both semantic and visual errors are common in deep dyslexia has been taken to imply that deep dyslexic patients have multiple lesions, with one affecting the visual system and another affecting semantic knowledge. However, Hinton and Shallice (1991) showed that a single lesion (removal of units) in an attractor network that has been trained to associate visual patterns with semantic patterns is sufficient to account for these patients' errors. Indeed,...

Protection Of Vulnerable Adults With Learning Disabilities

In recent years, there has been growing recognition that adults with learning disabilities, and those who have a mental illness or who are old and frail, need protection from potentially abusive situations over which they may have little control. In light of this, following on from the consultation publication of No Secrets (Department of Health 2000), the 'Protection of Vulnerable Adults Scheme in England and Wales for Care Homes and Domiciliary Care Agencies' was implemented by the Department of Health in 2004. It outlines best practice guidance that needs to be put in place to protect vulnerable adults. This guidance also includes changes that have been made to the need for Criminal Records Bureau Disclosures. This Protection of Vulnerable Adults scheme is more commonly known as POVA. The central tenet is to protect vulnerable adults by ensuring that potential care staff are screened to prevent those who have a poor track record of care or those who may intend to harm vulnerable...

Dyslexia

Dyslexia is a developmental disorder of READING that is based on abnormal brain development. The brain changes exist from before birth and persist throughout life, although they do not usually manifest themselves clinically until the early school years, and many sufferers of this disorder compensate significantly by the time they reach adult life. The etiology of dyslexia remains unknown, but it is clear that The term dyslexia is used in the United States to refer to a developmental disorder of reading, whereas in the United Kingdom acquired disorders of reading may also be called dyslexias. Whereas dyslexia appears as an entry in ICD-9-CM for Neurologists (Neurology 1994) to represent either developmental or acquired disorders of reading, DSM-IV (Association 1994) does not have an entry for dyslexia altogether and instead has one for reading disorder. In this article only the developmental form is considered. Some researchers have been unhappy with the term dyslexia and prefer to use...

Personcentred Planning

Until the 1950s, the idea that adults with learning disabilities' had unique individual needs and rights was unheard of. Since that time, significant conceptual ideas have influenced policy development and subsequently changed the way in which services are delivered for adults with learning disabilities. It is valuable to briefly explore the journey and progression of thinking that have moved ideas from this custodial climate to one of more personal power control and inclusion. The development of the Human Rights movement in the 1960s, and the work of Goffman (1961) in relation to the injustices experienced by people living in large institutional settings, laid the ground for radical change in service delivery for people with learning disabilities. Perhaps the most influential idea to emerge was introduced by Wolfens-berger in Sweden in the 1970s. The principle of 'normalisation' sought to direct us to utilise our resources to provide services that ensured that adults with learning...

Establishing Maintaining And Ending Therapeutic Relationships

The process of, and considerations for, effective communication with adults with learning disabilities will be discussed in Chapter 2 ('Communication and Adults with Learning Disabilities'). This section will explore key considerations and reflect on establishing, maintaining and ending therapeutic relationships. Reflecting my experience as a student nurse, contact with adults with learning disabilities prior to commencing the course related to working in a school for children with special educational needs and family contacts with individuals with mild learning disabilities and or Down's syndrome. As a student, arriving in a long-stay hospital for adults, with a variety of needs relating to their learning disabilities, while walking along a corridor, a fellow student and I encountered a young man with what could be described as significant facial Later opportunities to interact with this man enabled us to see the 'man behind the mask', and discover who he was as a person. The lesson...

Defining Communication

The majority of work with adults with learning disabilities involves a considerable amount of communication in any given interaction. Therefore, it is important that an understanding of some of the main dynamics that take place during any communicative activity is gained. All these areas are relevant to adults with learning disabilities. For example, the vocabulary used by adults with learning disabilities may provide an indication of their level of understanding, and communication with them can be adapted accordingly. Also, in terms of proxemics, adults with learning disabilities may be standing very close to the person speaking this might also convey that they have a hearing difficulty and need to stand closer than what would be considered usual, to hear what is being communicated. The sender or transmitter is the person who starts or initiates the communicative process, by sending a message. S he sends the message to someone -the receiver. The message is transmitted between the two...

Endings And Breaks In Communication Therapeutic Relationships

All of our interventions with adults with learning disabilities, or any other service user group, have a beginning, a middle and an end (Trevithick 2000). Adults with learning disabilities may not always pick up on cues that indicate that a period of being engaged with someone has ended and Trevithick (2000) highlights that this may be experienced in an abrupt fashion. This may be partly due to the issues relating to pace and understanding. In a world in which the pace of life is based on what is considered as 'normal', adults with learning disabilities may experience being left behind (Portner 2001). Some of these issues have been briefly discussed above. The immensely valuable contribution made to the learning disability field by Mattison and Pistrang (2000, 2004) cannot go without mention in this section. Their study not only considered the views of staff members and their thoughts and feelings about disengaging with service users, but also provided us with a moving insight into...

Antidiscriminatory Practice

Carers and students need to have a raised awareness of anti-discriminatory issues with regards to communication. This chapter started by outlining a basic model of communication and proceeded to explain the difficulties that may be encountered when interacting and communicating with adults with learning disabilities. There are also other influencing factors that could affect any communication with an adult with a learning disability from a discriminatory perspective. A cultural difference may be that the service user and the practitioner are from different cultural backgrounds and that they may not have a thorough understanding of each other's cultural considerations. There could be a misunderstanding in relation to non-verbal communication, as discussed previously, such as eye contact, personal space (proxemics) and touch (Ferris-Taylor 2004). Verbal communication may be impeded by dialects and by the fact that individual members of staff may use words in different ways (Thompson...

Summary Of Challenging Behaviour

When dealing with challenging behaviour, it is important to recognise the range of behaviours which challenge services, and the effect that these behaviours have on both adults with learning disabilities and those who support them. These behaviours have causes, many of which are identifiable and many of which are related to either the adult with learning disability's needs or the adult with a learning disability being unable to communicate his her needs effectively. Helping adults with learning disabilities to learn new skills and more appropriate ways of expressing their needs. Challenging behaviour will probably not 'go away', although, with a reasoned response, it may reduce. Therefore, ways of working with adults with learning disabilities who exhibit challenging behaviour need to remain in place permanently. Long-term, effective support for staff working with adults with learning disabilities who exhibit challenging behaviour is essential, as working in these situations is often...

Assessing Challenging Behaviour

Adults with learning disabilities who have challenging behaviour present acute management problems. Families and carers are often highly stressed and there is a huge temptation to use medication as an intervention. The aim of an intervention is to create and sustain the conditions under which the individual is most likely to be able to function. Challenging behaviour is functional it may be an indication of physical discomfort, pain, emotional distress, mental illness or conflicts in the person's environment. A person's behaviour will be defined as challenging when it is judged by another to be socially unacceptable and when it evokes significant negative emotional responses in the other.

Understanding Challenging Behaviour

Frameworks for understanding challenging behaviour have become more sophisticated over time, with important implications for assessment and intervention practices. These frameworks will be illustrated and their implications considered. An example of the assessment and intervention planning process will be illustrated. It is well recognised that 'demands' often set off challenging behaviour. If an adult with a learning disability is asked to wash the floor, s he may become aggressive. This often results in action to calm the person down or prevent injury to him herself or others. The adult with a learning disability may be moved to another room or restrained, or prescribed medication and so on. In any event, s he ends up not washing the floor. One of the earliest sensible conceptions of challenging behaviour depicted exactly this pattern (see Figure 3.1). The outcome of this process can be readily seen. The adult with a learning disability is more likely to become aggressive when...

Vulnerable Victims Of Crime

The Criminal Justice and Court Services Act 2000 requires the National Probation Service to make contact with victims who have experienced a violent or sexual crime, for which the offender received a custodial sentence of a year or more. The purpose is to inform the victim about the sentence, and to establish whether s he wishes to receive further contact from the Probation Service and whether s he wishes to be informed when the prisoner is due for release. Research suggests that where these offences have been committed, the victim usually knows the perpetrator, so there may be a higher risk of fear associated with these crimes. It is also known that, in general, adults with learning disabilities are at a much greater risk of having a crime committed against them than within the general public (Brown et al. 1995 Mencap 2001 Williams 1995). Unfortunately, adults with learning disabilities are also less likely to receive justice from the criminal justice system, therefore living in fear...

Challenging Behaviour

Moss et al. (2000) found that there was a strong relationship between mental illness and people with learning disabilities who present 'challenging behaviours' (for a fuller discussion of challenging behaviour, see Chapter 3). Their study showed that mental illness was twice as prevalent in those with challenging behaviours as those without. Depression and anxiety were the most prevalent with those described as having challenging behaviour. Confusion and fear can often turn into anger and physical aggression. Often, people with a learning disability struggle to cope with events in their lives because they may not possess the insight to realise that situations may, in time, improve. Depression is essentially an over-reaction to loss, whereas anxiety is an over-reaction to the threat of loss. For example, people with learning disabilities may not understand that grieving is a feeling that, given time, may become less overwhelming and they can expect to feel better (Reiss 1992). John's...

Assessment And Diagnoses

So far, it has been established that mental health is a major issue for people with learning disabilities and there are a large number of people with learning disabilities who suffer from a variety of mental health conditions. However, the true extent of the problem cannot be known, due to difficulties in assessment, and it is estimated that the actual numbers are far greater than those cited in this chapter. This is largely due to the service users being unable to sufficiently communicate their symptoms it follows that the more severe the communication problems, the more difficult it is to gain a true assessment. In these circumstances, much of the assessment is reliant upon observations from carers, i.e. changes in behaviour. This presents its own problems, as difficulties arise from differentiating which behaviours are indicative of mental health problems and which are attributed to the symptoms of the person's learning disability (Priest & Gibbs 2004). These problems are...

Therapeutic Interventions

The term 'therapeutic intervention' refers to a planned action that has the intent to 'heal' or 'cure' (Gates 2003). There are many types of therapeutic interventions that are used to treat mental health problems in people with learning disabilities generally, they are similar to those for the non-learning disabled population, but some require modification to be successful. Therapies can be used in isolation or with each other an example of the main therapies used for people with learning disabilities and mental health problems are provided in Table 5.3. It is important to note that many other less well-known types are in use and there are too many to mention in this chapter.

Barriers To Accessing Health Care

In spite of recent legislation and advances in the provision of care, the evidence suggests that the healthcare needs of adults with learning disabilities are still not being fully met Adults with learning disabilities are much more likely to be obese than the general population. Less than 10 per cent of adults with learning disabilities eat a balanced diet, with an insufficient intake of fruit and vegetables and a lack of knowledge and choice about healthy eating. Less than 20 per cent of adults with learning disabilities engage in physical activity at or above the minimum level recommended by the Department of Health, as opposed to 36 per cent of the general population (Robertson et al. 2000). '70 of people with learning disabilities visit their GP four or less times a year. The average for the general population is five times a year'. Adults with learning disabilities are less likely to receive regular health checks (Whitfield et al. 1996), and are 58 times more likely to die...

Health Improvement Clinics

Healthcare professionals working with adults with learning disabilities have been increasingly concerned with their interface with primary and secondary health care over the last decade. Notably, the 'Survey of GPs' Views of Learning Disability Services' (Marshal et al. 1996) highlights the disappointing attitudes of GPs toward adults with learning disabilities who attempt to access a service from the Primary Care Trust. Our Healthier Nation (Department of Health 1998) acknowledges that adults with learning disabilities are a 'vulnerable group' and set out to make vast improvements before 2010. Since the time of these publications, much has been written about the problem and, consequently, many initiatives within services for adults with learning disabilities have been undertaken, with varying degrees of success. One initiative that has certainly had a positive impact for adults with learning disabilities is the 'Health Improvement Clinic'. The clinic provides an opportunity for those...

National Patient Safety Agency

The National Patient Safety Agency (NPSA) has, in recent times, published its report outlining key patient safety issues in relation to the quality of care of adults with learning disabilities in a number of areas, including physical restraint (NPSA 2004). The focus of this section concerns the 'vulnerability of people with learning disabilities in general hospitals'. One of the problems it highlights concerns the 'degree of harm' that adults with learning disabilities may come across as patients in a general hospital. It reports that 26 per cent of adults with learning disabilities are admitted to hospital every year. This compares with 14 per cent in the general population (Band 1998). The NPSA states that a number of concerns were raised, including reliance on carers and learning disability professionals to carry out full nursing care These are worrying issues and, coupled with a lack of accessible information and illnesses either misdiagnosed or undiagnosed, highlight the work...

Respiratory Disorders

Respiratory disorders are common in adults with Down's syndrome, with the underlying pathology often multifactorial. Structural and functional anomalies such as hypotonia and small lower airway volume can, for example, combine with cardiac defects, excessive mucus secretion and collection in the upper airways to confound accurate diagnosis. As with many adults with learning disabilities, especially those living within communal settings, gastro-oesophageal reflux (GORD) caused by the bacterium Helicobacter pylori is very common, causing significant discomfort from gastritis. Sleep disturbance caused by frequent intermittent periods of breathing cessation (sleep apnoea) is common in adults with Down's syndrome and needs investigating to enable an accurate clinical picture of respiratory disturbance from which a diagnostic pathway can be established.

The Human Rights Act 1998

Introduced in to the United Kingdom in October 2000, the Human Rights Act 1998 did not actually create any new rights for individuals. Nor did it specifically refer to people with learning disabilities. So why is it important Well, the Human Rights Act enshrined within UK legislation, for the very first time, the articles and protocols found in the European Convention on Human Rights. Quite simply, following the introduction of the act, all UK legislation such as any amendment to the Mental Health Act or any legislation that relates to people with learning disabilities must now comply with the rights contained within the act. Table 9.1 outlines the Articles. The act is also intended to protect individuals from abuses by the state or the institutions of the state. It is now unlawful for any public authority, such as a health or local authority, to breach the rights set out in the Convention. For example, an adult with a learning disability who has a heart condition is now legally...

Mental Capacity Act 2005

The latest and quite possibly most controversial piece of legislation that relates to people with learning disabilities is the Mental Capacity Act 2005. The Mental Incapacity Bill, as it was originally known, received Royal Assent in April 2005 and is expected to come into force in England and Wales in 2007. (Scotland has its own Adults with Incapacity Act 2000.) When it does come into force, it will affect everyone over the age of 16 years whose mental capacity is in doubt, and those who care for them. Mental capacity, in relation to the legislation, refers to the ability of the individual to make a decision about some aspect of his her life. Although the act is not limited to specific conditions, mental capacity can be affected by many conditions, such as dementia, stroke or mental illness this legislation will have major implications for a substantial number of people with learning disabilities and their carers. In brief, the stated aim of the act is to provide a statutory...

The Historical Perspective

Historically, in England, there were two main themes underpinning society's attitude towards people with learning disabilities one in which they were seen as innocent and in need of protection and one in which they were seen as ignorant, irresponsible and promiscuous and, without proper control, could be a danger to society. The idea that adults with learning disabilities were child-like and naive and described as 'innocents', with the inability to develop their mental capacities beyond those of children, dates back to early English history, as illustrated in this seventeenth-century legal definition This patronising view continued to be upheld until the mid-twentieth century and became more formally acknowledged in 1946, when a group of parents set up the National Association of Parents of Backward Children. This organisation, which would later become Mencap, promoted a child-like and vulnerable image of people with learning disabilities, who needed help, care and protection....

Discrimination And Diversity

Discriminatory assumptions against people with learning disabilities need to be better understood before being condemned or disregarded, especially if society is to be expected to be less discriminatory in its behaviour towards these individuals (Thompson 2001). In particular, for adults with learning disabilities who become or wish to become parents, the perception that they can be seen as 'child-like' needs to be better understood. Initially, this perception was probably derived from an intention to be protective towards individuals who, due to their reduced cognitive abilities or limited speech, were seen as vulnerable and unable to fend for themselves. Further protection could be given if they were dressed in children's clothes and labelled as asexual and incapable of sexual feelings. Even the activists who promoted institutional care considered that they were protecting vulnerable people from society, as much as protecting society from them. The belief that people with learning...

Eugenics And Ethical Issues

History, unfortunately, for adults with learning disabilities is not the only barrier standing between them and their credible status as parents or potential parents. The science of genetics has impacted on society's tolerance towards people with learning disabilities by providing parents-to-be with a means to determine whether their unborn children with disabilities live or not. Parents-to-be can choose not to give birth to seriously disabled babies, as clarified in the Abortion Act 1967, in which it states that it There are up to 100 conditions detectable in the womb (Hernstein & Murray 1994) and over 90 per cent of those who know that their foetus has Down's syndrome terminate the pregnancy (Ward 2001). Such figures bring to mind the consideration of ethical issues such as Will parents who choose to have the disabled child feel discriminated against And will there be further implications for adults with learning disabilities who are, or who wish to become, parents Genetic...

The Disability Discrimination Act 1995

Not that many years ago, this was the world as many adults with learning disabilities in the United Kingdom knew it. Yet, amazingly, this was not discrimination. There was no such offence as disability discrimination. That, however, has now changed with the introduction of the Disability Discrimination Act 1995. Introduced in phases between 1996 and 2005, the Disability Discrimination Act is the first piece of legislation to specifically address issues of disability in the United Kingdom since the Chronically Sick and Disabled Act of 1945, and the first in the United Kingdom to address the discrimination faced by disabled people. With eight Parts and 70 sections, the most important sections of the act for people with learning disabilities are contained in Parts I-V. Clearly, this broad definition encompasses those with a learning disability, and, as such, they are entitled to the protection that this legislation affords. So what protection does it afford Part III also puts a separate...

The Legal Framework For Protecting Vulnerable Adults

The regulations relating to the ill-treatment of vulnerable adults with learning disabilities are often complex and not always easy to understand. However, laws are in place which can be used either to protect vulnerable adults or to act on their behalf if a crime or offence has been committed against them. It does require carers, students and professionals to have some knowledge of the law and knowledge of whom to contact for further assistance. If a criminal offence is suspected, it should always be referred to the police. Advice should always be sought from senior colleagues and managers on the next stages that should follow. 'Doing nothing' is not an option. The sections outlined below are based on the definitions outlined in the No Secrets guidance (Department of Health 2000). The following list is not complete, but is meant to denote laws that can help and support vulnerable adults with learning disabilities, and offer them protection within a legal framework. The detention of...

Verbal And Nonverbal Communication

This code is a system of rules for arranging random symbols in an ordered and recognised manner that enables someone who understands the code to draw out the meaning of the code. If the arbitrary codes of language are not produced in the order familiar between the people interacting, understanding and communication are inhibited. For example, if some of the random symbols contained within the alphabet were presented in the manner of 'nruFtireu', you may be able to recognise the individual symbols but they would not be in an order that you are familiar with. However, if they were rearranged to 'Furniture', you would recognise the symbols and the order. This is because you and I have a shared understanding of the code. Therefore, language can be described as an organised system of codes, used by humans to communicate. There are inherent difficulties with the issues contained within the concept of language and adults with learning disabilities, such as basic understanding, the use of...

Concluding Comments On Challenging Behaviour

When dealing with challenging behaviour, it is important to recognise the range of behaviours which challenge services, and the effect that these behaviours have on both adults with learning disabilities and those who support them. Bear in mind that behaviours have causes, many of which are identifiable and many of which are related to either the needs of adults with learning disabilities or their inability to communicate these needs effectively. Careful and comprehensive assessment of the causes and functions of behaviour is essential, as are interactions which are designed to respond to the behaviour, which should be non-aversive (i.e. punishment of challenging behaviour is not the intervention of choice). Helping adults with learning disabilities to learn new skills and more appropriate ways of expressing their needs. Challenging behaviour will probably not 'go away', although, with a reasoned response, it may reduce. Therefore, ways of working with adults with learning...

Psychotropic Medication

The most prevalent form of intervention remains medication psychiatric drugs are used in the treatment of all forms of mental illness and there is a strong evidence base to support its appropriate use (Gates 2003 Hardy & Bouras 2002 Pilgrim 2005). There is also evidence to support the use of these drugs for behaviour problems that are not necessarily connected to a mental health problem with people with learning disabilities (Crabbe 1994). For this reason, it is virtually unheard of for a person with a learning disability who presents behaviour difficulties and or mental health problems not to be on a Table 5.3. Therapeutic interventions that are commonly used to treat mental health problems in people with learning disabilities The last of these reasons accounts for large numbers of people with learning disabilities being prescribed anti-psychotic medication. Crabbe (1994) suggests that there is an 'overuse' of anti-psychotic medication for this purpose with people with learning...

Dedication

I would like to dedicate this book to the many adults with learning disabilities I have had the pleasure to meet and work with over the years, who have enriched my life and taught me patience, understanding and compassion. The students I have taught have given me hope for the future of learning disability nursing and continue to inspire me.

About the Editors

Debra Fearns is a Senior Lecturer in the School of Nursing and Midwifery at the University of Hertfordshire. She is a Registered Nurse (Learning Disabilities), and teaches on Learning Disability nursing across pre- and postregistration courses. Debra completed an MA in Health and Social Policy in 1998. The dissertation focus was centred on how Custody Officers recognise vulnerability, especially in people with learning disabilities. The research was carried out in a Shire police force. Publications include Appropriate Adults and Appropriate Adult Schemes Service User, Provider and Police Perspectives, Ed Brian Littlechild (2001), published by BASW, Venture Press and Debra has recently jointly edited Mental Disorder and Criminal Justice Policy, Provision and Practice (2005) with Brian Littlechild, published by Russell House Publishing Ltd.

Contemporary Society

It is estimated that there are over 800,000 people in the UK aged over 20 years who have a learning disability (Department of Health 2005a) putting this into context can help you to understand the needs of those whom you may need to provide care and support for, as well as the extent of the challenges. This number is expected to rise by 14 per cent to 900,000 by 2021. Furthermore, the number of those with severe learning disabilities may also rise by 1 per cent per year for the next 15 years (Department of Health 2005a).

Key Terms

The choice of terms used in this text is diverse. It is important to define terms from the beginning different terms may mean different things to different people. There are a variety of terms that can be used to describe people with learning disabilities. The use of any term has the ability to label the person to whom the term is being applied. Labelling may lead to prejudice and discrimination, and can result in stigmatisation. Stigma is powerful and can have negative consequences for an individual's identity. 'Adults with a learning disability' is a term that has been used in the title of this text and also in this introductory aspect of the book. This is a broad definition, often used by various health and social care agencies. It has the potential to recognise that many people can and do have a learning disability, but they may not necessarily have an illness or a disease. Various terms are used in this text with the aim of promoting the care and support of individuals with...

The Chapters

It is impossible to discuss all elements of health and social care related to the person with a learning disability. We have arranged the chapters in such a manner as to provide you with some insight into the intricacies associated with the care and support that may be required by an individual who has a learning disability. Primarily, we aim to provide you with the essence of care and a fundamental understanding of some of the issues that may impinge on a person's well-being. Central to Chapter 1 is the importance of fostering good working relationships with adults who have learning disabilities. Key concepts such as person-centred planning will be considered and debated in detail, as well as the diversity of the varying needs of adults with learning disabilities. Approaches to care are examined. Chapter 2 focuses on effective communication strategies that can be used for adults with learning disabilities processes and forms of communication are outlined. The chapter makes clear how...

Care Philosophies

Historically, we have moved from a situation in which adults with learning disabilities were cared for within institutional settings, such as learning disability specialist hospitals, to people being cared for in the community (Gates 2003). Many adults with learning disabilities have been, and will continue to be, cared for at home. Our encounters with adults with learning disabilities as carers, support staff and students tend to focus on those people receiving a higher level of support within a variety of service contexts. You may find yourself working with people to support them within their own homes, as noted above, or complementing the care provided by family members. Other settings may include NHS services, such as assessment and treatment services social care environments run by local authorities or private and or voluntary organisations such as Mencap. We have moved away from a philosophy according to which the person with a learning disability was cared for to a situation in...

Conclusion

This chapter began by defining 'learning disability' and highlighting the importance of carers developing their awareness of potentially labelling a group of people because they have a particular area of need, i.e. learning disabilities. The government White Paper Valuing People A New Strategy for Learning Disability for the 21st Century (Department of Health 2001a) clearly sets the agenda for us, in offering appropriate and effective support for adults with learning disabilities in their everyday lives. The PCA has ensured a shift in the value base and the way in which we think about care delivery for adults with learning disabilities. The emphasis is placed on power and control, resting squarely with the individuals themselves. As students and carers working with people with learning disabilities in a variety of contexts, we need to ensure that we are adequately equipped with knowledge, skills and information to enable people to lead fulfilled lives. Fostering good working...

Anxiety Disorders

Anxiety disorders are characterised by a persistent and sometimes overwhelming feeling of apprehension, accompanied by a range of physical and psychological symptoms (Priest & Gibbs 2004). In a lifetime, any given individual has a 5 per cent chance of suffering from an anxiety disorder. Anxiety disorders are normally considered in several different categories people with learning disability are more likely to suffer from three of these, which are obsessive-compulsive disorder (OCD), generalised anxiety disorder and panic disorders (American Psychiatric Association 2000). Anxiety disorders are nearly always related to stress and stressful situations, which can often be the trigger to provoke an attack. Anxiety is a natural response to stress and only becomes a problem if individuals are unable to deal with this stress and it has a detrimental effect on a person's ability to function. Those with learning disabilities are more likely to find themselves in a greater number of...

Service Provision

People with learning disabilities often have problems accessing generic mental healthcare services there are many identifiable reasons for this. Within the recent White Paper Valuing People A New Strategy for Learning Disability for the 21st Century (Department of Health 2001), an emphasis has been placed on the mental health needs of people with learning disabilities' being met by generic services with specialist support from learning disability services. Firstly, it is important to establish what is actually meant by 'generic' or 'specialist' services. The terms 'generic' or 'mainstream' refer to those mental health services provided for the whole population, and 'specialist' services refers to services which provide knowledge, skills and expertise to supplement mainstream services where needs cannot be fully met within those generic services. Specialist learning disability services vary across the United Kingdom however, they would usually consist of assessment and treatment units,...

Prevalence

Nonetheless, epilepsy rates and prevalence are much higher amongst adults with learning disabilities. The Department of Health (2001) point out, for example, that the prevalence of epilepsy in adults who have a mild learning disability is 10 times greater than in the general population, i.e. 5 per cent. Having a learning disability does not cause epilepsy, nor does having epilepsy cause learning disabilities. However, both epilepsy and learning disabilities may be due to fundamental brain damage existing from birth or as a result of infection or head injury, hence explaining this higher incidence. Stokes et al. (2004) indicate that a general practitioner (GP) with 2000 patients will typically have 36 patients who have learning disabilities, and six of those will have severe learning disabilities. McVicker et al. (1994) believe that adults with Down's syndrome have a higher rate of epilepsy as they age, with 46 per cent aged over 50 having epilepsy. These figures are broadly replicated...

Women And Aeds

There are particular considerations that need to be taken into account when supporting women with learning disabilities who have epilepsy. Women with learning disabilities should not be excluded from the same services available to all women, but information may need to be modified in order to meet their needs. The issue of contraception needs to be considered carefully with women of child-bearing age. Women with mild learning disabilities and epilepsy need to be offered advice about pregnancy, preferably before becoming pregnant, in the same way as other women with epilepsy. These issues should be discussed at every annual review of epilepsy (or when the woman's condition dictates) while the woman is of child-bearing age. Where pregnancy occurs, the woman will still need to continue taking AEDs, although adjustments to the dosage may be made by the epileptologist. The danger to the mother and baby from not taking AEDs and having seizures is usually greater than that associated with...

Health Facilitation

Valuing People (Department of Health 2001a) clearly states the existence of inequalities in health and in healthcare delivery for adults with learning disabilities. It sets out guidance that incorporates key principles of rights, independence, choice and inclusion for adults with learning disabilities. The emphasis is very much on social inclusion, and this extends to the areas of health care and healthcare delivery. Adults with learning disabilities should expect to have the same support in relation to their health needs as anyone else. Historically, the health experience and life expectancy of people with these additional complications were potentially poor. However, improvements in health care have meant that people can now expect to live longer with appropriate healthcare intervention, and hence the need to ensure that equal access to such health care is facilitated for adults who have learning disabilities. To achieve this, an inter-agency approach is proposed and adopted....

The Legislation

People with learning disabilities are, for the most part, subject to the same laws as every other member of society. There are, however, several pieces of legislation that are of particular interest to people with learning disabilities and their carers. Throughout this chapter, four key pieces of legislation that reflect society's current perceptions of people with learning disabilities will be explored. This exploration will, by necessity, be quite brief an in-depth exploration of the legislation cannot be accommodated in a single chapter. However, the salient points will be discussed. At first sight, the study of learning disability legislation may appear daunting to those embarking upon it for the first time. The Mental Health Act 1983 alone contains 10 parts and 149 sections, but do not despair. Unless you are intending to pursue a legal career, most readers of this chapter will not require an in-depth knowledge of every part of every section of every act. Therefore, to ease your...

Parenting

Traditionally, the role of a parent is seen predominately as an adult one, not suited to children. So, for people with learning disabilities, the discriminatory connotations associated with their being child-like can be further complicated by beliefs that it is not appropriate for children to take on a parenting role. Reder et al. (2000) saw parenthood as 'Not an activity which sits comfortably within the paradigm of childhood as constitutes the child's appropriate role and place in the adult world'. This indicates that if an adult with a learning disability is considered to be child-like in behaviour, then assumptions about the ability of this adult to be a parent could be made based on assumptions of a child's ability to be a parent. This assumption also implies that before an adult with a learning disability can be considered as suitable to be a parent, s he must first be seen as an adult. This then leads to questioning what adult qualities and behaviours contribute towards an...

Caring For Children

Significantly, parents who have learning disabilities are more likely to have their children placed on the register than any other parent group and a service audit in the United Kingdom stated that 93 per cent of children born to parents with learning disabilities had interventions via child protection (Woodhouse et al. 2001). Another survey revealed that 40 per cent of children born to English mothers with learning disabilities were put into care, long-term fostering or were adopted following child protection proceedings (O'Hara & Martin 2003). Some of these 'negligent' behaviours, especially the emotional ones, may be difficult or too vague to classify. For many adults with learning disabilities, these ambiguous terms can be used to make judgements by professionals on their parenting abilities, even before their children are born. Booth et al. (2005) found, on surveying Child Protection Reports, that a significantly high number of newborn babies whose mothers had learning...

Provision Of Support

A steadily increasing number of parents with learning disabilities are being referred to social and health services for support and advice in parenting skills, although there are no reliable estimates of the number of parents with learning disabilities residing in Britain (Booth & Booth 1998). Added to this, more people with learning disabilities are experiencing greater opportunities to choose how they wish to live, since it has been officially acknowledged that they have the same rights as others through the Human Rights Act 1998, The Disability Discrimination Act 1995 and the White Paper Valuing People (Department of Health 2001). However, the Law Commission (1995) reported that 'Community living has exposed many vulnerable people to new or at least different dangers, when they are put at risk by being allowed to live their lives as they choose'. It is still not known how effectively the principles and ethos underpinning Valuing People (Department of Health 2001) will work in a...

Attitudinal Barriers

Adults with learning disabilities are a marginalised group within society, and, unfortunately, this is reflected in attitudes expressed by professional health and social care staff. Shanley and Guest (1995) highlighted that adults with learning disabilities are stigmatised by adult nurses. Slevin and Sines (1996) reported that adult nurses showed an unenthusiastic attitude towards people with learning disabilities. This may be explained, in part, by their lack of exposure to adults with learning disabilities and that even in a 'Common Foundation Programme' (CFP), the majority of content and teaching centred on adult nurses. It is possible, though, that even with a more balanced CFP and exposure to adults with learning disabilities in a short practice experience, these attitudes may still not change. Fitzsimmons and Barr (1997) identified a number of factors that could influence attitudes. These included poor preparation and education and awareness of people with learning disabilities...

Antiepileptic Drugs

As a student or carer of an adult with learning disabilities who has epilepsy, it is essential that you familiarise yourself with the AEDs used by the adult with a learning disability whom you are caring for. All drugs or medications have two names the 'generic' name, which is the drug's 'chemical' name, and its 'brand' name, which the drug manufacturer gives it. For example, carba-mazepine is the generic name, and its brand name is Tegretol. However, you must ensure that the adult whom you are supporting always takes the same 'brand' of drug, as there may be subtle differences in the way in which drugs are prepared by different manufacturers, and this could have an effect on their effectiveness in controlling seizures. Many adults with moderate and severe learning disabilities may have other associated health conditions (co-morbidity) which could be a complicating factor both in diagnosing epilepsy, but also in ensuring that AEDs do not interact with any other medication that they...

Americans with Disabilities Act ADA

For people with learning disability, the ADA provides legislative support for accommodations within both educational and workplace settings. Unlike the federal legislation governing public education for children with learning disabilities, the ADA places a much greater burden of responsibility on the person seeking services or accommodations. The ADA also clearly protects educational institutions and employers from being required to provide accommodations that place unreasonable burdens or that represent significant lowering of educational standards. At the same time, the ADA also provides broad protection for children with learning disabilities in a wide variety of contexts.

Attention deficit hyperactivity disorder ADHD

ADHD and learning disability frequently occur together, but they are not the same. Learning disabilities include difficulty with receiving, organizing, processing, understanding, remembering, and offering information. ADHD involves difficulty with paying attention to information. Between 10 percent and 20 percent of all school-age children have learning disabilities. Of those with learning disabilities, between 4 percent and 12 percent of all school-age children will also have ADHD, making it the most common childhood neurobehavioral disorder.

Kathryn E Patten Stephen R Campbell

What follows in Chapter 4 is Michel Ferrari's view of educational neuroscience as 'an exciting renovation' of cognitive neuroscience and other neurosciences that will advance our understanding of how knowledge and cognition is embodied. Michel, Head of the Centre for Applied Cognitive Science at the Ontario Institute of Studies in Education, advocates that while neuroscientific investigation typically addresses pathologies of learning disabilities, our focus as educational researchers should be to understand the larger underlying context of personal learning and development and to avoid neu-roscientific labeling of atypical students in manners that are limiting and potentially stigmatizing. He cautions against an all-too-common practice of over-generalizing laboratory results to learning situations in situ, and against acceptance of frameworks that negate the presence and importance of agency. Ferrari argues, in some contrast to Howard-Jones, that educational strategy must follow the...

Hyperactivity and Antisocial Behavior

In children, there is an increasing frequency of the diagnosis of ADHD, a condition characterized by inattention, impulsive and disruptive behavior, learning difficulties, and increased levels of gross motor activity and fidgeting. Also, the prevalence of food allergies and intolerances has been increasing. Perhaps it is not surprising that dietary explanations and treatments for ADHD have been sought regularly for several decades, given theories of allergic reactions or intolerance to food additives, ingredients in chocolate, and even refined sugar (often grouped as the 'Feingold theory', after an early instigator of unproven dietary intervention). There has also been a long-standing interest in the possibility that antisocial behavior in children and adults might in part result from poor nutrition, although early studies were poorly designed. Behavioral effects of sugar and of many additives have by and large not been supported by controlled studies however, determining...

ADHD and Other Disorders

Many children with ADHD also have a specific learning disability, which means that they might have trouble mastering language or other skills, such as math, reading, or handwriting. Although ADHD is not categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school. The issue of coexisting conditions makes diagnosis, treatment, and understanding of ADHD particularly complex.

Assessment Of Substance Abuse Hiv Risk Assessment Battery

The forty-five questions of the RAB are simply worded and use discrete response categories. Respondents are asked to ''check off'' the answer that best describes their behavior. There are no open-ended questions, minimizing the need for writing skills. A brief set of instructions is included on the first page of the RAB. However, as with all self-administered questionnaires, it is particularly important to provide the respondent with a proper introduction and explanation of the form, its purpose, and how it is to be completed. A staff member should be available during administration of the test to screen for reading difficulties, answer questions as they arise, and ensure that the form is being filled out properly. Given the very sensitive nature of the information collected, it is also important that individuals administering the RAB address the issue of confidentiality. Although the more private approach of the self-administered questionnaire should reinforce the confidential nature...

Distinguishing High Functioning Autism from Asperger Syndrome Is There a Difference

When PDDNOS is diagnosed accurately, it clearly falls on the autism spectrum. The problems experienced by children with PDDNOS cannot be explained by any other category of disorder. Children with learning disabilities, attention problems, or obsessive-compulsive disorder (OCD), for example, do not have the highly focused interests or trouble making eye contact that Chad has. Thus PDDNOS is best thought of as atypical autism (in fact, that is what European doctors call it). It involves autistic-type symptoms but is less severe and has a pattern of symptoms that is not quite the same as the patterns associated with high-functioning autism or Asperger syndrome. Yet the interventions that help children with these conditions also help those with PDDNOS, so this book will be helpful to parents of children with PDDNOS as well.

How Can We Be Sure Our Child Has ASHFA and Not ADHD or OCD or Something Else

Caused this rapid rise, one factor that has certainly contributed is that as professionals and the general public have become more familiar with the autism spectrum disorders, the number of children diagnosed with them has soared. And as their diagnosis has become more prevalent, misdiagnosis is also more likely. Sometimes a proper assessment by a specialist reveals that this diagnosis is wrong. It's been our experience that in earlier years almost all children referred to our specialty clinics for a diagnostic evaluation did in fact meet criteria for an autism spectrum disorder. In the last year alone, however, one-quarter of the diagnostic evaluations performed in our clinics overturned previously suggested diagnoses of either high-functioning autism or Asperger syndrome.5 Almost all the children had multiple serious behavioral difficulties. It was never a straightforward case of dyslexia or ADHD having been misdiagnosed as Asperger syndrome, but one of a child presenting a...

Other Students Perception That a Certain Child Is Being

International Dyslexia Association (2003, Fall). The Warning Signs of Learning Disabilities. Inland Empire Branch of the International Dyslexia Association . The Resource, 18(2). www.dyslexia-ca.org. Rief, Sandra. (1998). The ADD ADHD Checklist. San Francisco Jossey-Bass.

What Should I Tell My Child

This brings us to the third issue how to share the news. The following is relevant for telling not only your child, but also siblings, grandparents, friends, and neighbors, about AS-HFA (more about disclosing diagnosis in adulthood appears in Chapter 9). It is critical that the way the diagnosis is framed be positive, emphasizing your child's strengths and special skills. In discussing the difficulties that are part of AS-HFA, we often find it helpful to compare it to a learning disability. You can ask your child if he or she knows anyone who has trouble with reading, or math, or paying attention and staying seated. Emphasize that most of us have weaknesses of some sort or another some people wear glasses, others walk with a cane, others are slow readers, others are very clumsy on the playground. But those people aren't bad at everything there are many things they can do well. You might say, The girl in your class who can't read well can do math just fine, has lots of friends, and is...

Challenges Results and Implications

In the extreme dualist camp, some educational issues are in danger of becoming entirely 'medicalised'.When educational issues become associated with biological issues, they can sometimes be characterised as entirely biologically determined and so removed from educators' domain of influence. One example is management of the increasing numbers of pupils considered to have challenging developmental disorders such as ADHD. Here, the increasing use of psychoactive drugs and images of differences in brain activity can lead to an increased sense of biological determinism (Degrandpre, 1999), and thus a diminished sense that outcomes are amenable to educational intervention. Another example might be the tendency for debates around dyslexia to be unhelpfully characterised as two options in conflict, a type of 'all-or-none' theorising that either dyslexia is a mental construction or derives entirely from a biologically determined cause (Nicolson, 2005). In the extreme monist camp, of course,...

In the Autism Spectrum Disorders

There appear to be a variety of traits that run in the families of people with autism and Asperger syndrome, especially related to the areas of language and social abilities. Higher rates of language delay, articulation problems, learning difficulties, social difficulties, and social anxiety are more often found in relatives of people with autism than in family members of people with other disabilities, such as Down syndrome. Studies indicate that these milder difficulties show up in about 10-20 of siblings of individuals with autism and often in parents as well.

Provide Many Visual Prompts and Cues

Students with ADHD, but also many others (for example, English language learners, students with learning disabilities in auditory processing), respond better to visual cues and prompts as opposed to a lot of verbal reminders and directions. Teachers should always maintain a visual schedule, write on the board or other consistent location all class and homework assignments, and post all daily weekly student responsibilities.

Developmental Disabilities

The term developmental disabilities'' includes all mental and physical impairments or combination of mental and physical impairments that (1) occur before a person is twenty-two years old (2) are expected to continue indefinitely (3) result in limitations in one or more areas of development such as physical, cognitive, behavioral, emotional, or social development and (4) reflect a child's need for individualized services or treatment in school or community-based settings. Developmental disabilities is a generic term that includes medical or diagnosed conditions such as Down syndrome and cerebral palsy that have a known biological, genetic, or neurological cause. In addition, children with developmental disabilities may be delayed in attaining developmental milestones such as walking and talking for reasons that are unknown or thought to be related to environmental conditions such as poverty. Examples of common broad categories of developmental disabilities include mental retardation,...

Language Communication Therapy

Another method proposed for treating some of the language needs of children with AS-HFA is the Fast ForWord program. This computerized intervention was originally developed for children with more general (nonautistic) language delays and language-based learning disabilities (for example, dyslexia), but it has become relatively popular in recent years for children with AS-HFA, despite limited research evidence to support its effectiveness with this population. The software runs computer games that work on language-related skills, such as discriminating different sounds in language. Children involved in this program must perform exercises on the computer daily for approximately an hour and a half, for several months (the duration of therapy varies according to the specific child's needs). The developers of this

The Foundation of Early Intervention

In addition to understanding the importance of the environment and early experiences, scientists know that the brain's capacity for learning is not fixed in the early years but can actually increase as a result of early intervention. For example, if an at-risk child with a language delay receives early intervention services, she can often overcome this delay and do just as well as her peers in school. By contrast, if a child has a language delay and does not receive any early intervention services, not only will she fail to close this gap, but the gap will also often widen, leading to further learning difficulties throughout her life. Scientists also believe there are certain times in a child's development that are critical periods for learning certain skills. Although children and adults can acquire new skills throughout their lives, windows of opportunity in the early years open and then close, thus affecting development.

Step 1 Acknowledge Something Happened

Ronald was clear there was no exchange of personalities, while acknowledging the pleasure he took in seeing my mistake. Ralph was typically less responsive, but also dismissed any difficulty with it, commenting on similar mistakes he had made. I then acknowledge, at times, showing some dyslexia, for some reason confusing their names not their personalities simply because both names start with an R. That helped Vince, another longtime group member, who is severely dyslexic, express how he feels when he makes such mistakes.

Language Impairment Developmental

Developmental language impairment has been shown to be a risk factor for other childhood disorders. For example, epidemiological studies showed that children referred to child guidance clinics for a variety of social and emotional conditions were found to have a higher-than-expected incidence of developmental language disorders (Beitchman et al. 1986b). Conversely, children diagnosed with developmental language disorders also have been found, upon examination, to have a preponderance of behavioral and emotional disorders (Cantwell, Baker, and Mattison 1979). Longitudinal research studies that have followed children with early developmental language impairments prospec-tively from the preschool though elementary school years have demonstrated a striking link between early developmental language impairments and subsequent learning disabilities, especially dyslexia, a developmental reading disability (Aram et al. 1984 Bishop and Adams 1990 Riss-man, Curtiss, and Tallal 1990 Catts 1993)....

Deductible medical expenses

Medical expenses that could be deducted for 2001 were acupuncture, ambulance, artificial limb, artificial teeth, expenses to modify your home to provide medical care for your child, chiropractor, crutches, dental treatment, HMO fees, hearing aids, hospital services, insurance premiums, laboratory fees, special school or tutor for child with learning disabilities, lodging costs for family when child is hospitalized, meals at hospital, physicians services, medicines, nursing care, operations, osteopath, oxygen, psychiatric care, psychological care, therapy, transplants, transportation to obtain medical care, trips for medical care, wheelchair, and x-rays.

Care in the Community

Most people with Down's syndrome live in the community some live with parents or caregivers, but adults often live independently or semi-independently. Many people with Down's syndrome can learn about healthy eating and manage their own diets. A dietitian's role in a community learning disability support team is likely to encompass not only individual assessment but also teaching and educating people with Down's syndrome as well as parents, caregivers, and other professionals.

Planning Around College

It is important to know that, for children receiving special education services, services can be provided through the age of 21. Although there are differences between high schools and post-secondary programs in the services that they must provide, colleges will provide accommodations to enable the student with a disability to access the curriculum. In addition, many colleges offer more extensive supports for students with disabilities, and there are colleges and post-second-ary programs around the country that have been specially designed for students with ADHD, learning disabilities, and or emotional difficulties. More minor accommodations that may be helpful to students entering college include reducing the number of courses taken (in some instances, a college student with bipolar disorder may be considered a full-time student even with a reduced course load),

Implications For Handedness Research

Further, as shown in Table 2, the percentage of participants with a history of a learning disability (LD) who had an LS between 0 and +70 was almost 2.5 times greater than the corresponding percentage of participants without a history of LD (32 vs. 13 ). Again, there was a significant correlation of LD with LS when a trichotomous analysis was used (LS < 0, vs LS 0 to + 70, vs LS > +70), but not with a dichotomous analysis, (LS < 0 vs LS > 0), because the weak-right-handed range strongly contributed to the statistical association. Table 3. Association between learning disability (LD) and LS (Schachter et al., 1987) Table 3. Association between learning disability (LD) and LS (Schachter et al., 1987)

The Development of Competence Related and Efficacy Beliefs

Both the Nicholls and Dweck perspectives point to the importance of developmental changes for understanding the emergence of a sense of industry versus inferiority during the middle childhood years. If children begin to think of ability as more entity-like during these years then the consequences of learning difficulties for developing a sense of industry increase. Evidence from a few studies (see Dweck, 1999) suggests that this is exactly what happens to children growing up in the United States. Furthermore, evidence is beginning to emerge suggesting that the developmental increase in entity beliefs is due in part to an increased emphasis by the adults (both teachers and coaches) on social comparative evaluative feedback and stress on doing better than others rather than improving one's own competence over time (see Dweck, 1999 Eccles, Midgley & Adler, 1984 Midgley, 2002)

Identifying cognitive late effects

It is important that parents and educators remain vigilant for potential learning problems to allow for quick intervention. The signs of possible learning disabilities are problems with You should also suspect learning difficulties if When she entered adolescence, my daughter became very angry about her learning disabilities. She used to be gifted, and now does very well, but it is a struggle for her. We honestly explained that the choices were life with the possibility of some academic problems versus death, and we chose life.

Overview of the Memory System

The multi-store model of memory developed by Richard Atkinson and Richard Shiffrin has guided research in memory and its development. The model is supported by extensive experimental evidence and is applied productively in work with individuals who have suffered brain injuries and students with typical learning characteristics as well as learning difficulties. In this information-processing model, illustrated in Figure 1, human memory is seen as operating in a manner analogous to that of a computer. The model depicts three separate memory stores that function as the hardware of the memory system long-term memory, the sensory register, and working memory. Long-term memory, which is what people typically mean when they refer to memory, is a relatively permanent memory store with an apparently limitless capacity. It includes both semantic memory, a mental reference book that contains facts about the world, and episodic memory, a repository of stored traces of experienced events. It...

Other Important Resources

The NICHD Research Program in Reading Development, Reading Disorders and Reading Instruction A Summary of Research Findings. From Keys to Successful Learning A National Summit on Research in Learning Disabilities. New York The National Center for Learning Disabilities. Moats, Louisa. (1999, June). Teaching Reading Is Rocket Science What Expert Teachers of Reading Should Know and Be Able to Do. This report is from the National Federation of Teachers review of the reading research and describes the essential knowledge base for teacher candidates. www.aft.org edissues National Institute of Child Health and Human Development. (2000). Report of the National Reading Panel Teaching Children to Read An Evidence-Based Assessment of the Scientific Research Literature on Reading and Its Implications for Reading Instruction. This final report of the National Institute of Child Health and Human Development (NICHD) assesses the effectiveness of various approaches to teaching...

Minimal brain dysfunction

Historically, minimal brain dysfunction (MBD) was the term used to define and classify learning and behavioral difficulties now classified under the category of attention deficit hyperactivity disorder. It generally includes hyperactivity, impulsivity, and any of a number of learning and language disabilities such as dyslexia and problems with math. Students with identified learning disabilities can waive the tests, although some schools suggest that these students take the tests anyway in the freshman year. If the student fails the entire test, he could then take it again with modifications as stipulated in his individual education plan. Students with learning disabilities as a senior can waive the tests.

Challenges and Strategies

According to Sousa (2001), about 6 percent of school-aged children have some form of difficulty with processing mathematics. Among those children are frequently students with learning disabilities and or ADHD. This section will address common mathematical difficulties, current information regarding math standards and expectations in grades K-12, numerous strategies to build math skills and proficiency, as well as various accommodations modifications for struggling students.

Routes From Print To Sound

This description of the reading of individual words is oversimplified. The study of adult patients whose reading skills have been impaired due to brain damage suggests that there are several reading disorders, depending on which parts of the cognitive system involved in reading are damaged. Some of the major findings from the cognitive neuropsychological approach are discussed in the next section. Some of the processes and structures that may be involved in reading are shown in Figure 11.8. Ellis and Young (1988) identified these components on the basis of the study of acquired dyslexias (i.e., impairments Patients who adhere most closely to exclusive use of Route 1 were labelled as surface dyslexics by Marshall and Newcombe (1973). Surface dyslexia is a condition in which patients have particular problems in reading irregular words. The surface dyslexic JC, could read 67 out of 130 regular words correctly, but he was successful with only 41 out of 130 irregular words. More striking...

Math Difficulties Associated with ADHD

Many students with ADHD and or learning disabilities experience academic difficulty with mathematics, due to the multiple processes and brain functions involved in executing math problems. Some math challenges may be specifically related to weaknesses with ADHD (for example, inattention, organization, working memory, self-monitoring). Others may result more directly from a learning disability (for example, sequential learning, perceptual-motor, language). Remember, some children have both ADHD and co-existing learning disabilities.

Types of Muscular Dystrophy

Tually the muscles involved in breathing weaken, which can be fatal. Typically, children with Duchenne MD live only to about age 20 years. Although most children have average intelligence, learning disabilities (especially those involving verbal learning and reading comprehension) are more common in boys with Duchenne than in other children.

Neurofibromatosis 365

Between 30 percent and 40 percent of children with NF1 also have a high incidence of seizures, learning disabilities, attention deficit disorder, and speech problems. Children with NF1 are usually checked for height, weight, head circumference, blood pressure, vision and hearing, evidence of normal sexual development, signs of learning disability and hyperactivity, and evidence of scoliosis, in addition to examination of the skin for cafe-au-lait spots and neurofibromas. The causes of any unusual growth pattern are generally investigated, and early or late onset of puberty also suggests further study. Further diagnostic evaluations, including blood tests and x rays, are usually needed only to investigate suspected problems.

Drawing on Their Learning Strengths

Students with learning disabilities, attention deficit disorders, and other typically underachieving students often have learning strengths (and are sometimes highly gifted) in spatial awareness, logical thinking reasoning, and visualization. They may be able to excel in a balanced mathematics curriculum, which emphasizes patterns, geometry, measurement, probability, and logic.

Juvenile Onset Bipolar Disorder Longitudinal Studies Long Overdue

The clinical distinction between BD and ADHD is complicated by directly overlapping DSM-IV diagnostic criteria of talkativeness, distractibility, and psychomotor agitation. Other symptoms, although not identical in DSM-IV terminology, can be difficult to discern. For example, decreased need for sleep in BD can be confused with the sleep difficulties common in ADHD, flight of ideas in BD can be mistaken for difficulty sustaining attention in ADHD, and excessive involvement in pleasurable activities that have a high potential for painful consequences in BD may blur with impulsiv-ity in ADHD. Both disorders frequently involve impairments in social and family relationships, school performance, and self-esteem. Also, both are highly comorbid with other disorders, such as learning disability, oppos-itional defiant disorder, or conduct disorder. ADHD is quite commonly diagnosed in juveniles with BD 1 although the reverse is not true longitudinal studies of ADHD have generally not shown an...

Impact of Development on Diagnosis and Treatment of Bipolar Disorders

Shulman et al also highlight the decline in psychosocial functioning, which is a significant problem in children with BD. Muller et al. 9 examined 80 family members of BD patients and found that they more often failed a grade (nine compared to one in the control group), obtained lower grades (38 compared to 23) and less often succeeded in their final examinations (15 compared to 38). Among the BD patients themselves 30 did not finish school. When an otherwise intelligent child is failing at school, mood disorder and substance abuse should be considered hand in hand with learning disabilities.

Brain Dysfunction in Children

When one pair of chromosomes does not divide, the resulting cells have 24 chromosomes and others have 22. A fertilized egg will develop into a child with Down syndrome, where the child inherits genes on 46 chromosomes 23 coming from the mother and 23 from the father. The extra chromosome causes physical and cognitive abnormalities, ranging from mild-to-severe learning disabilities. The symptoms are similar to those of patients with Alzheimer's disease.

Communication Problems

In contrast, receptive aphasia can impair the ability to comprehend instructions at mealtimes and thus affects compliance with rehabilitative advice. If paralysis and visual field and perceptual deficits are combined with expressive dysphasia and dysarthria, then nonverbal communication can also be limited, resulting in an inability to denote assent or dissent by nodding the head or to use gestures to convey meaning or point to food items utensils. Early involvement of speech therapists is vital to enable individuals to regain lost functions in speech and language. In selected patients use of visual material, i.e., charts or pictures of food items and symbols, can he helpful. Use of short sentences, normal volume speech, avoidance of jargon, and patience in allowing individuals to respond to questions are also helpful in general communication.