All that remains to be said here is welcome to this short book. I hope that you will enjoy reading it, that it will challenge how you think about and interact with those who have a learning disability and that it will be of use and benefit to you in your daily work.
REFERENCES
Barber, C. (2011) Autism and Asperger’s Conditions: a practical guide for nurses. London, Quay Books.
Clark, L. & Griffiths, P. (2008) Learning Disability and Other Intellectual Impairments. Chichester, John Wiley.
Department of Health (2001) Valuing People: a new strategy for learning disabilities for the 21st century. London, HMSO.
Jay Committee (1979) The Report of the Committee of Enquiry into Mental Handicap Nursing and Care. London, Department of Health/HMSO.
Jukes, M. (2009) Learning Disability Nursing Practice. London, Quay Books.
Lowthian, S. (2011) Strengthening the Learning Disability Workforce. RCN Bulletin.
Mencap (2007) Death by Indifference. London, Mencap. Available at: www.mencap.org.uk/sites/default/files/documents/2008-03/DBIreport.pdf (last accessed 17 November 2014)
Nursing and Midwifery Council (2008) The Future of Pre-registration Nurse Education. London, NMC.
Peate, I. & Fearns, D. (2006) Caring for People with Learning Disabilities. Chichester, John Wiley.
Priest, H. & Gibbs, M. (2011) Mental Health Care for People with Learning Disabilities. Elsevier.
02
WHAT IS LEARNING DISABILITY?
AIMS AND LEARNING OUTCOMES:
The aims of this chapter are to:
Present two ‘dictionary’ type definitions of ‘learning disability’
Discuss these two definitions
Highlight the identity of learning disability.
By the end of this chapter you will have gained:
A basic understanding of the definition and meaning of learning disability from a number of different standpoints
A basic understanding of how these meanings have changed over time.
Marcel, a 39-year-old man with Down’s syndrome is admitted, having had a stroke, onto the general medical ward on which Hanif works as part of a 2nd year student nurse placement. This is the first time that Hanif has had a patient with Down’s syndrome and he knows very little about learning disability in general and Down’s syndrome in particular. At the handover at the start of Hanif’s shift, he asks: ‘What is learning disability?’
PAUSE FOR THOUGHT 2.1
A nurse, who during a debate at RCN Congress said that he considers himself to have Asperger’s syndrome, was asked: ‘What is this disease called Asperger’s?’ Do you, the reader, consider learning disability to be a disease? Do you consider that learning disability is catching?
INTRODUCTION
What is learning disability? Hanif would be forgiven for asking this question, particularly as he has not previously worked with people who have a learning disability. Following on from this initial question, it may be appropriate that a number of further questions could be asked: What does it mean to have a learning disability? Indeed, to develop this further, what does it mean to be ‘learning disabled’?
A careful reading of the above questions seems to highlight three different issues:
A possible need for a basic, clear and factual definition of learning disability
A possible need for a discussion around learning disability as possession in much the same way as having or possessing a broken leg or a broken arm or having a headache
A possible need for a discussion around learning disability as personal identity.
These are all valid and perfectly reasonable questions to ask, particularly if Hanif has had very little if any previous knowledge or experience of, or exposure to learning disability as either an ‘abstract’ or a ‘physical’ concept or reality. Appropriate theoretical learning and clinical experience opportunities around learning disabilities may not always be available to Hanif.
Again, there could well be a perception that learning disability is a ‘childhood’ condition or there may well be some confusion as to ‘learning disabilities’ and ‘learning difficulties’, with some people thinking that these two terms refer to the same condition or phenomenon. Learning difficulties or specific learning difficulties usually refer to the specific conditions of dyslexia, dyspraxia and dyscalculia. Specific Learning Difficulties (SpLDs) affect the way information is learned and processed. They are neurological (rather than psychological), usually run in families and occur independently of intelligence. They can have significant impact on education and learning and on the acquisition of literacy skills (British Dyslexia Association, 2012).
Hanif, as both a pre-registration nursing student and a future post-registration staff nurse, is very likely to encounter and work with those who have a learning disability in his day-to-day work, regardless of whether he works in a general hospital, in the community or in a GP practice or health centre. As such, Marcel’s sister, Ziva, would like to act as Hanif’s guide in the following pages.
DEFINITION
Hanif: So, Ziva, what does this term ‘learning disability’ actually mean?
Ziva: Thanks for asking, Hanif. Barber (2011) suggested that the term ‘learning disability’ cannot be defined easily. Learning disability can act as a category for a variety of conditions with different causes. Some forms of learning disability are:
As a result of ‘genetic abnormalities’. Down’s syndrome, phenylketonuria, Marfan’s syndrome and tuberous sclerosis (epiloia) are all examples of genetic causes
As a result of major difficulties during or immediately after childbirth
As a result of alcohol or ‘recreational drug’ use during pregnancy
As a result of environmental factors such as environmental or industrial toxins
Whilst other forms of learning disability just are (otherwise known as ‘idiopathic’)! An idiopathic (from the Greek idios (‘one’s own’) and pathos (‘suffering’)) disease or condition is one whose cause is not known or one that arises spontaneously.
Hanif: Thanks for that, Ziva. However, what you have just presented is some of the causes of learning disability, rather than what learning disability actually is (and is not).
Ziva: Yes, you are quite right about that, Hanif. Sorry. There are a number of ways of looking at the term ‘learning disability’ and hence those with a learning disability. The first of these is to focus on learning disability as a ‘dictionary definition’. Again, there are a number of such definitions that can be looked at. The first of these definitions is taken from the Valuing People White Paper (DH, 2001: 14). According to Valuing People, a person is described as having a learning disability if they have:
A significantly reduced ability to understand new or complex information (impaired intelligence and cognitive functioning)