Disabilities and learning difficulties

Disabilities and Learning Difficulties

 

            Learning difficulties and disorders have been viewed primarily from the perspective of special education for many years. Diverse observers, the numerous behavioral characteristics resulting in varied clinical syndromes, and the problems in developing effective remedial educational programs have produced many definitions and diagnostic labels, some with false implications.

Establishing an accurate and comprehensive picture of the physical health of people who have learning disabilities is a complex task. There are several reasons for this. First, information relating to the health of people who have learning disabilities in practice often refers only to those known to agencies providing services to them; that is, the population base for any conclusions about disease prevalence is defined administratively. Second, much research evidence on health and learning disability has in the past come from studies of long-stay institutional populations. A third difficulty is that administrative definitions of learning disability vary from country to country. Information on health status which is based on this broader definition of learning disability may not be helpful when considering the risks to health of adults in contact with services in the UK (2001).

Since definitions of learning difficulties and disabilities vary and it is likely that a variety of disorders with similar and overlapping symptoms is being considered, diagnostic criteria are mostly not precise. A multidisciplinary evaluation of medical, cognitive, sensory processing, educational, and psychologic parameters is required to establish baselines, to plan treatment, and to follow the child’s progress. Additionally, there are many bill and state laws that have been passed in relation to people with disabilities and learning difficulties. Among these is the Special Education Needs and Disability Bill in the United Kingdom.

            The Special Educational Needs (SEN) and Disability Bill received Royal Assent in 2001. The Act makes changes to the existing framework for children with SEN. It also places new anti-discrimination duties on schools, colleges, universities and providers of adult education – removing the exemption of education from the Disability Discrimination Act (1995).

            The SEN Code of Practice (2001) deals with general principles and policies, partnerships with parents and pupil participation. It details clearly the system for identifying, assessing and providing for the needs of children with SEN and for carrying out a statutory assessment. There are comprehensive sections on Statements, Annual Reviews, the role of the Special Educational Needs Coordinator (SENCO) and on working in partnership with other agencies.

Because the Act covers the whole life of the school and because the tribunal will be able to hear disability specific cases, mediation services will need the capacity to handle a wide range of different referrals and to have the capacity to create positive dialogues about creating more accessible school environments. There are also likely to be new and extended roles for parent partnership services, whose potential role has been strengthened by the new legislation and the revised SEN Code of Practice (2002).

            Access to the service needs to be fairly open to all and thus it is important that any literature is available in community languages and Braille, and is provided on tape where needed. The service needs to take care not to discriminate against people with disability from minority groups and diverse backgrounds. Interpreters and others to support and represent the family may be needed.

             The challenge of responding to the health needs of people who have learning disabilities has therefore proved to be a difficult one for health services, which have been criticized for inadequacies in the detection and treatment of established conditions (particularly mental illness) and in the preventive care aimed at reducing risk factors. Part of the problem stems from the reliance on the self-report of symptoms and health concerns in order to trigger healthcare. People who have learning disabilities acting unaided may be unable to fulfill this expectation and healthcare professionals may lack the communication skills necessary to compensate (2001).

For example, failure to report or detect visual or hearing defects is likely to compound learning difficulty and cause communication difficulties and isolation. In the same way, not reporting side-effects of medication may encourage poor prescribing practices. Practitioners should be aware of the dangers of repeat prescribing, particularly of antiepileptic and other neuroleptic drugs, and of polypharmacy, where a range of medications are prescribed and not necessarily adequately monitored.

            Recognition of the generic character of special educational needs ironically opens up a debate not only about the ways in which the inadequacy of provision highlights conditions under which existing needs cannot be met, but also about how needs are generated by the inadequacy of provision (2004). The Act seems to assume that special educational needs may arise where the child does not benefit from what is normally available to all children. A more critical view of the relationship between needs and provision might suggest that the failure of any child to learn reflects upon the quality of teaching and learning taking place. It does so because in every educational context there is a dynamic learning relationship between the facilities and activities of instruction and the child.

 

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