Learning Disability

Learning disability is a general umbrella term encompassing a range of different conditions that affect the ability of the child to develop new skills. The amount they are affected varies from mild to severe. In mild cases the child may simply need extra time and help with learning new skills. In severe cases there can be significant intellectual impairment and they may need help with all activities of daily living.

 

Types of Learning Disability

Dyslexia refers to a specific difficulty in reading, writing and spelling.

Dysgraphia refers to a specific difficulty in writing.

Dyspraxia, also known as developmental co-ordination disorder, refers to a specific type of difficulty in physical co-ordination. It is more common in boys. It presents with delayed gross and fine motor skills and a child that appears clumsy.

Auditory processing disorder refers to a specific difficulty in processing auditory information.

Non-verbal learning disability refers to a specific difficulty in processing non-verbal information, such as body language and facial expressions.

Profound and multiple learning disability refers to severe difficulties across multiple areas, often requiring help with all aspects of daily life.

 

Classification

The severity of the learning disability is based on the IQ (intelligence quotient):

  • 55 – 70: Mild
  • 40 – 55: Moderate
  • 25 – 40: Severe
  • Under 25: Profound

 

Causes

Often there is no clear cause for the learning disability. A family history of learning disability increases the risk. Environmental factors such as abuse, neglect, psychological trauma and toxins can all increase the risk.

Certain conditions are strongly associated with learning disability:

  • Genetic disorders such as Downs syndrome
  • Antenatal problems, such as fetal alcohol syndrome and maternal chickenpox
  • Problems at birth, such as prematurity and hypoxic ischaemic encephalopathy
  • Problems in early childhood, such as meningitis
  • Autism
  • Epilepsy

 

Management

The key to managing learning disability is with a multidisciplinary approach to support the parents and child. This involves:

  • Health visitors
  • Social workers
  • Schools
  • Educational psychologists
  • Paediatricians, GPs and nurses
  • Occupational therapists
  • Speech and language therapists

TOM TIP: Examiners may test you on your communication with someone that has learning disability. Remember to involve the child in any discussions where appropriate, regardless of their intellectual ability. When talking to someone with learning disability it becomes more important to make things simple to understand, give only small amounts of information at a time and always check understanding. Use tools to assist your communication, such as pictures and emojis. For example, there is a pain scale with a series of faces from happy to sad that can be used to help patients with learning disabilities communicate their level of pain.

 

Capacity

It is important to remember that capacity is decision specific, and having learning disability does not prevent patients from being able to make decisions. They may require more time, effort and decision aids to be able to fulfil the criteria. It may take several attempts on different days or at different times of day to be able to make a decision. Capacity becomes more important as they approach adulthood, as most decisions about a child will be made by their parent or guardian.

To have capacity a patient must demonstrate the ability to:

  • Understand the decision that needs to be made
  • Retain the information long enough to make the decision
  • Weight up the options and the implications of choosing each option
  • Communicate their decision

TOM TIP: Remember the four key words for demonstrating capacity, as these are very frequently tested in exams. Remember that capacity is decision specific, meaning someone may have capacity to decide what they want for breakfast but not to decide whether to undergo complex surgery.

 

Last updated January 2020
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