Learning disability

Chapter 60 Learning disability


The implications of a learning disability for the health of individuals who are affected and their families can be far-reaching, and they may need considerable clinical care and psychological and socioeconomic support.



What is learning disability?


‘Learning disability’ is the term currently used in UK legislation and policy for a range of conditions that fit within the World Health Organization criteria of:


image A state of arrested or incomplete development of mind

image Significant impairment of intellectual functioning

image Significant impairment of adaptive/social functioning

image Present from childhood.

This means that somebody with a learning disability will have difficulties in understanding, in learning new things and generalizing these to new situations, and difficulties with social tasks like communication, self-care, awareness of and responses to danger. These difficulties will be present in differing permutations and will vary in severity depending upon the extent and nature of the disability. Learning disability fits the social rather than the medical model of disability: it cannot be cured nor in any real sense can it be treated, although in some cases it can be avoided by prompt medical intervention or by improved antenatal care, and in many cases its impact can be mitigated by appropriate responses across a range of disciplines. UK & USA studies have confirmed that mild learning disability is more common among socially disadvantaged families. They have also shown that preventive strategies targeting children with mild learning disability are effective in preventing developmental delay and have long-term benefits. Moderate to severe levels of disability show little correlation with social class. Although their impacts can also be moderated by prompt and appropriate supports, significant levels of disability will remain.



Prevalence


There are no reliable figures for the number of people with a learning disability in the UK but estimates suggest a prevalence rate of 25 per 1000 population with a mild to moderate learning disability and a further 3 per 1000 with severe disabilities. In 2000 it was estimated the numbers would grow by approximately 1% per annum to 2010 but this is now thought to have been an underestimation.


Antenatal screening, with access to abortion if the fetus is shown to have significant disabilities, has reduced the number of babies with Down’s syndrome born to older mothers. However, there has been an overall increase in numbers due to better survival rates for very-low-birth-weight babies or others born with severe impairments; and both children and adults are living longer because of better health and community care.



Causes


The commonest causes of inherited disability are fragile X syndrome and Down’s syndrome. Birth-related disabilities are mostly caused by insufficiencies in the oxygen supply, or prematurity. After birth the most common causes are early childhood illness or physical accident.


The cause of mild learning disability is generally multifactorial and the precise mechanisms are not clear. However there is a statistical correlation with factors associated with poverty and deprivation (nine times higher in working-class families than in other social groups).



Health implications of learning disability for the individual


The incidence of ill health in people with learning disabilities is higher than in the general population. The most common coexisting health problems are mental ill health, problem behaviour, epilepsy and sensory impairments. For the parents of a child with learning disabilities problem behaviours and sleep disorder are frequently mentioned as having the greatest impact on family life.


Allocation of health resources is increasingly driven by targets focused on the major causes of morbidity and mortality. However, because these causes are different for people with learning disabilities, prevention and treatment campaigns are of lesser benefit to them and may only widen the existing gap in health and longevity.

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Jun 10, 2016 | Posted by in PSYCHOLOGY | Comments Off on Learning disability

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