A reduced ability to cope independently (impaired social functioning) and
Which started before adulthood and with a lasting effect on development.
Alternatively, learning disability can be seen as:
An arrested or incomplete development of mind (Mental Health Act 1983, Section 1)
That impacts upon most if not all areas of human life: intellectual, spiritual, physical, educational and social
And ranges in severity and impact from borderline to profound
With the likelihood of multiple neurological and physical disabilities increasing with serious and profound learning disabilities
And that often requires additional supportive resources in order to facilitate optimum physical, mental, spiritual, social and emotional health and engagement within society.
Hanif: I think I understand these two meanings, Ziva.
Ziva: However, both of these definitions could be argued to pose a number of questions or problems. First: the Department of Health definition. ‘Valuing People’ was the first learning disability White Paper for nearly a quarter of a century.
Hanif: What is a White Paper, Ziva?
Ziva: A White Paper is formal Government policy on a given subject such as learning disability, as opposed to a Green Paper which is a discussion or consultation document and a Bill or Act of Parliament. A White Paper has no force of law behind it and cannot, therefore, be enforced in the same way as an Act of Parliament such as the Autism Act 2009. The definition given in the White Paper is apparently the ‘definition of choice’ and can be found as such in many learning disability textbooks and is both concise and accurate. However, it lacks in its apparent objectivity and simplicity the possibility that learning disability is not a single condition, but a series of conditions. These conditions range from ‘Borderline’ learning disability through to ‘Profound’ learning disabilities via ‘Mild’, ‘Moderate’ and ‘Severe’ learning disabilities.
Hanif: Would I be right in thinking that the more severe the learning disability is, the more likely that such learning disability will include increasing physical disabilities such as cerebral palsy, musculoskeletal issues such as scoliosis, neurological conditions such as epilepsy and medical conditions such as respiratory and cardiac problems?
Ziva: Yes, you would. Again, although succinct and relatively easy to understand, it could be argued that this definition runs the risk of locating the disability within rather than outside the person. My brother Marcel is disabled and must learn to adapt to society, rather than Marcel having a disability imposed by societal attitudes and practices – attitudes and practices which prevent Marcel from fully engaging with society.
Hanif: OK. But where would one place those with Asperger’s syndrome or high-functioning autism in this learning disability range?
Ziva: Interesting question, Hanif. I must declare a personal interest here as I am Asperger’s. Few people would argue that ‘classic autism’ is not a form of learning disability, as it shares many of the cognitive issues and impairments of learning disability. However, do people such as Bill Gates (founder of Microsoft), Keith Joseph (British politician), Ludwig Wittgenstein (Austrian philosopher), Peter Sellers (British comedian) and Gary Numan (British electronic musician), all of whom are suggested to have Asperger’s syndrome, fit comfortably within a traditional learning disability framework? Probably not!
Hanif: Since those with Asperger’s tend to have higher than average IQs, given the names mentioned above (some of whom I know of), is Asperger’s an aspect of learning disability?
Ziva: Another interesting question and the jury is still out on this one! Anyway, the second definition is based on the opening section of the 1983 Mental Health Act and probably comes closest to providing a ‘legal definition’ of learning disability. However, this definition also applies to those with mental health issues and is not specific to learning disability. Again, the concept of ‘mind’ is introduced but, sadly, is not defined or developed. Having said that, this definition appears to be more ‘holistic’ in tone and acknowledges that learning disability is a spectrum of conditions.
Hanif: I mentioned a moment ago the idea of IQ and learning disability. Could you talk me through this connection?
Ziva: Although this definition is now seen as outmoded, learning disability has been defined in terms of intelligence quotient (IQ), a scale which was used to measure intellectual or mental ability. In general, IQ levels indicated that (Newcastle University, 2011):
| People with an IQ level of: | Were classified as: |
| 75 and above | ‘Normal’ |
| 70 to 75 | ‘Borderline’ learning disability |
| 60 to 70 | ‘Mild’ learning disability |
| 50 to 60 | ‘Moderate’ learning disability |
| 40 to 50 | ‘Severe’ learning disability |
| Less than 40 | ‘Profound’ learning disability |
Hanif: I have heard that the general effectiveness of IQ ratings in indicating the level of a person’s learning disability is contested as being arbitrary, crude and inaccurate (New Scientist, 2009), and may not therefore be the best method of indicating learning disability.
Ziva: You are right about that, Hanif. I too have often struggled with this concept of IQ. However, another way of viewing learning disability is to see learning disability as a combination of intellectual and physical or health conditions (Garvey and Vincent, 2006). A practical example of this view could be those with Down’s syndrome, such as my brother Marcel, who are likely to experience difficulties in a number of different ways (Garvey and Vincent, 2006).
Hanif: OK, Ziva, I understand that. What are these different ways that you mention?
Ziva: These could include communication problems, a tendency to being overweight, problems with balance and mobility, painful joints and muscles, mental health issues, sensory issues, heart problems and respiratory problems. I know that this may appear to be a rather long list of health problems and there may be other health care issues that those with a learning disability may experience. However, it has to be said that not every person with a learning disability will experience all of these health issues. Again, caution must be applied here as many people who do not have a learning disability may also experience some or many of the health issues above, at some point in their lives.
PAUSE FOR THOUGHT 2.2
Now here is a question: How many people in the UK do you think are affected by learning disability?
Ziva: Hanif, you would be forgiven if you either plucked a figure randomly out of the air or said that you did not have a clue. If you said the latter, you are not alone: estimates of how many people experience learning disabilities vary. For example, in 2001 the Department of Health (DH) estimated that there were approximately 1.4 million people (out of a population of around 49 million) with a learning disability in England, of whom 210 000 had a severe disability (DH, 2001). If there are approximately 63 million people living in the UK (Office for National Statistics, 2011), the DH figures would suggest that there are currently almost 1.8 million people with learning disabilities across the four nations that make up the UK, of whom about 265 000 have a severe or profound and multiple learning disability (PMLD). Mencap (2011) suggests that there are currently about 1.5 million people who have a learning disability within the UK; that is around 2.5% (or 1 person in every 40) of the UK population, given a current UK population of 60 million.
Hanif: Is the wording in Pause for thought 2.2 a bit naughty? I spotted that the question