Learning Disability

 WHAT IS LEARNING DISABILITY?
Learning disability is the administrative term used in Britain for people who have a pervasive developmental delay, so that they learn much more slowly than other people and therefore do not becomne as independent. The disability must be developmental - it must have been present at birth or in early childhood. Learning disability includes a wide range of levels of disability. Mild learning disability may lead to individuals being able to live independently but needing occasional help with managing their affairs; people with severe and profound learning disabilities are more likely to need help from other people to be available continuously, and for basic self-help and living activities. Nevertheless, individuals with severe or profound learning disabilities can often live much fuller and more independent lives than is commonly believed. Learning disability replaces the terfm 'mental handicap' and is synonymous with 'learning difficulties' or 'mental retardation'.

THE NUMBER OF PEOPLE WITH LEARNING DISABILITIES
Estimates of the number of people with learning disability vary depending on the classifications used. Many people with mild learning disabilities may not make much use of services and may not be identified as having a learning disability. Registers of people known to services in England report between 29 and 32 people with learning disabilities per 10,000 population. It is estimated that there are 160,000 people of all ages with severe and profound learning disabilities in England and Wales. Recent research suggests that the number of young children (0 - 10 years) with severe and profound learning disabilities is just over 20,000. These overall numbers are not expected to change very much, partly because of the age structure of the population and partly because termination of disabled foetuses is balanced by better survival.

CAUSES
There are many different causes of learning disability, ranging from genetic factors through birth injury to malnutrition and social disadvantage. Every person with learning disabilities is different and an individualised approach is therefore very important.

SUPPORT AND TREATMENT
People of all levels of learning disability benefit from taking part in full range of everyday activities at home, school and in the community. To do this well requires extra help, and sometimes specific teaching for the individual; the most effective approach to do this is behaviour analysis.

Modern behaviour analytic practice in learning disability includes:

  • assessing everyday activities and opportunities to identify the discriminative stimuli which cue different kinds of behaviour and the reinforcement which affects its likelihood
  • developing individual skills through precision teaching. This involves, for example, breaking skills into small, easy components and paying particular attention to how the individual discriminates what to do and when.
  • replacing problem behaviour with more acceptable alternatives. Functional analysis is used to find out what purpose the problem (or 'challenging') behaviour has and how this function can be served by more adaptive behaviour.

These methods often need to be used consistently throughout a particular situation (e.g. by all the staff in a day centre), rather than in one-to-one treatment sessions with the person with learning disability. This is especially true for people with severe and profound learning disabilities.

People with learning disabilities may have other health and social needs; their carers will also have needs for emotional and practical help. It is important that these needs are not overlooked while attending to the individual's learning disability. At the moment behaviour analysis is often conducted by clinical psychologists and sometimes by other professions working in health or social services.