Health and Social Care DiplomaLearning Disability Pathway

Unit 245

Understand the context of supporting individuals with Learning

Disabilities.

Objectives

By the end of today you will:• Be able to describe the nature and some characteristics of learning disabilities

• Be aware of the historical context of learning disability.• Be able to describe ways in which social attitudes impact on the lives of individuals

with a learning disability and their families. • Be able to name strategies to promote communication and understanding with

individuals with learning disabilities. • Understand the basic principles and practice of advocacy, empowerment and

active participation.• Be able to state examples and relevant legislation and policies which support the

right and inclusion of individuals with a learning disability.

What is a learning disability

World Health Organisation – “a state of arrested or incomplete development

of mind”“significant impairment of intellectual

functioning” “significant impairment of adaptive/social

functioning”“present from childhood”

What is a learning disability

Intellectual impairment • difficulty in understanding, learning and

remembering• Difficulty in generalising learning to new

situations. Adaptive/Social functioning• Might include communication, self-care,

health and safety. (Bild 2004)

What is a learning disability

It is just a label

Lack of knowledge about learning disability revealed

• New figures in 2008 reveal that most people in the UK including MP’s do not know what a learning disability is.

• Almost 3 in 4 of the UK population cannot give an accurate example of a learning disability according to new research.

• There may be 1.5 million people with a learning disability in the UK, but there is widespread confusion around what a learning disability is.

Learning Disability – Facts and Figures

In the case of people with severe and profound learning disabilities, it is estimated there are about 210,000

• Around 65,000 children and young people• 120,000 adults of working age• And 25,000 older people(Valuing people: a new strategy for learning

disability in the 21st century)

Learning Disability – Facts and Figures

In the case of people with mild/moderate learning disabilities, lower estimates suggest a prevalence rate of

• Around 25 per 1000population i.e. some 1.2 million people in England

(Valuing people: a new strategy for learning disability in the 21st century)

Learning Disabilities Some Changes

Factors towards higher numbers:

Women have children later

More “at risk” infants survive

Factors towards lower numbers:

More pre-natal screening available

Improved health care and preventative support

For “at risk” infants and their families

Learning Disabilities – Some Causes

Pre – natal (before birth)Genetic disorder – various “syndromes”Downs,Prader-Willi, Fragile X, Tuberous

Sclerosis,Causes affecting the motherCauses affecting the mother

Infection e.g.. Rubella (German Measles)Exposure to toxins (alcohol)Damage (radiation)

Learning Disabilities – Some Causes

Peri – natal (during birth) Lack of oxygen to the brain due to breathing

problems e.g.. cerebral palsy

Injury to the head – brain haemorrhage

Learning Disabilities – Some Causes

Post – natal (after birth/childhood) Illness (meningitis) Injury (accident or abuse)

Environmental (extreme neglect –generally makes an existing cause more severe)

Learning Disabilities Some causes

• Among people who have a mild learning disability, in about 50% of cases no cause has been identified.

• In people with severe or profound learning disabilities, chromosomal abnormalities cause about 40% of cases. Genetic factors account for15%, prenatal and perinatal problems 10%, and postnatal issues a further 10%. Cases which are of unknown cause are fewer, but still high at around 25%. (BILD)

Discussion

• In Groups Discuss the possible impact on a family of having

a member with a learning disability.

Possible Impact• Financial Hardship: • Difficult to give equal time and attention to

siblings• Sense of guilt• Resentment – a lifelong “burden”• Reduced social life and activities• Having to “fight for child’s best interests with

education and social services.• Emotional stress leading to extra pressure on

relationships.

Possible Impact

• Siblings understand and accept difference at an early age.

• Siblings stick up for learning disabled child and include him/her in their social activities.

• Neighbours, friends and family offer help and support, drawing people closer together.

• A sense of purpose for parents who may be a positive role model and support for other families.

Royal Albert Hospital

Time Line

Consequences of Industrialisaton

• Congregation of people in towns

• Work became more skilled

• Families could not take relatives into the factories

• “ As soon as the nation reaches that stage of civilisation in which medical knowledge and humanitarian sentiment operate to prolong the existence of the unfit, then it becomes imperative upon that nation to devise such laws as will ensure that those unfit do not propagate their kind”

• Tredgold

The Medical Model • The ProblemThe person with the disability isn’t “normal”• The Effect A restricted life on account of the impairment• The Treatment Develop a cure through drugs, surgery, diet, exerciseRehabilitation or special schools, hospitals, day centres• The AttitudeProfessionals – Control – we know bestPatients/client s- compliance

Social Model of Disability• The problem Society puts barriers in the way of those with a disability • The EffectSegregation, Limited opportunities, discrimination, dependency.• Solutions.Civil rights legislation (employment, transport, education)Access to buildings, goods and servicesA right to control provision of support and assistanceA change in benefits system to encourage independence. Person centred ways of working• The AttitudeDisabled people – independence, control, choiceProfessionals – support, assistance.

Glynn Vernon

• Disability Rights campaigner• What do you think are my problems?

Glynn Vernon

• Disability Rights campaigner• What do you think are my problems?

• “I don’t get enough sex, and I haven’t got enough money”.

• "I am not disabled other than by the way others see and relate to me."

Who is pushing for change?

Current Policy/Guidance

• Human Rights Act (1998)• Equality Act (2010)• Mental Capacity Act/Deprivation of Liberty• Care Standards Act (2000)• Valuing People (2001)• Valuing People Now (2009)

Social Inclusion

• The taking of action to ensure that certain social groups, which due to deprivation, difference or poverty are at risk of being excluded from equal access to employment, adequate housing, health care, education or training.

• Action taken so that people are able to participate fully and have fair and equal access to the economic, social and political life of the society in which they live.

Empowerment

• Is about supporting a person make their own decisions and be in control of their own lives

• Staff should have power WITH people, not power OVER people.

Empowerment

It can be about:• Giving people information on which to base a

decision• Giving time for a person to make a decision• Helping a person to develop confidence• Including people in meetings and discussions

which affect their lives• Listening to what people say without judgement• Supporting people to take risks in their lives.

Advocacy

Taking action to help people say what they want, secure their rights, represent their interests and obtain services they need. Advocates and advocacy schemes work in partnership with the people they support and take their side.

Advocacy promotes social inclusion, equality and social justice.’

Action for Advocacy (undated)

Advocacy

• Case advocacy• Self advocacy • Peer advocacy • Paid independent advocacy • Citizen advocacy• Statutory advocacy

Communication

• What are the barriers to empowerment, inclusion, advocacy?

Verbal communication

• Short clear sentences• Using ordinary language• Give time for the person to process what is being said• Using “concrete”rather than abstract concepts(9.30 on Saturday, instead of “sometime this weekend)• Use pictures or signs to supplement verbal

communication• Avoid banter, jokes, irony when supporting a person

with autism

Non-verbal communication

• Eye contact (either use or avoid)• Use of gestures and pointing to help• Use facial expressions• Use signs (makaton/ signalong)• Body language and posture –open, non-

threatening• Use pictures, signs, objects of reference