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Language, labels and diagnosis: an idiot's guide to learning disability
- Author:
- McCLIMENS Alex
- Journal article citation:
- Journal of Intellectual Disabilities, 11(3), September 2007, pp.257-266.
- Publisher:
- Sage
- Place of publication:
- London
The phrase `learning disability' is just one in a long succession of descriptors applied to those people in our society who are categorized by a matrix of psycho-medical assessments, marginalized by compromised intellectual function, characterized by increased health needs and excluded from the mainstream on the basis of reduced social opportunity. But what exactly is `learning disability'? Is there an empirical basis to the label, or is it just another example of bureaucratic language objectifying individuals in a process of medicalization? Historical examples will be used to illustrate the origins of the taxonomy that has subsequently formed the basis of the labelling process. The more recent words of individuals labelled with learning disability too will be introduced to offer some grounding to the debate. Any apparent problem belongs to language more than science. Narrative approaches to understanding are suggested as a useful alternative to traditional scientific inquiry.
Use of ICD-10 research diagnostic criteria to categorise psychiatric and behavioural abnormalities among people with learning disabilities: the West Midlands field trial
- Authors:
- CLARKE David J., CUMELLA Stuart, CORBETT John
- Journal article citation:
- Mental Handicap Research, 7(4), 1995, pp.273-285.
- Publisher:
- BIMH Publications
ICD-10 Diagnostic Criteria for Research (DCR) based on Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders were used to assign diagnoses to people with mental retardation who in addition had behavioural or psychiatric disorders. The trial showed that clinicians found the DCR to be a useful and comprehensive system for classifying psychiatric disorders occurring among people with mental retardation for research purposes, and for making diagnoses to allow communication in a succinct way with colleagues. The system was, however, felt to require modification for such, with an expansion of classification of behaviour disorders occurring in the absence of a specific psychiatric disorder.
Differentiating characteristics of deafblindness and autism in people with congenital deafblindness and profound intellectual disability
- Authors:
- HOEVENAARS-VAN DEN BOOM M.A.A., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(6), June 2009, pp.548-558.
- Publisher:
- Wiley
In persons with deafblindness, it is hard to distinguish autism spectrum disorders from several deafblind specific behaviours caused by the dual sensory impairments, especially when these persons are also intellectually disabled. As a result, there is an over-diagnosis of autism in persons who are deafblind leading to unsuitable interventions. Autism as specified by the DSM-IV was studied in 10 persons with congenital deafblindness with profound intellectual disabilities. Behaviours of people with deafblindness and autism (n = 5) and of people with deafblindness without autism (n = 5) were observed in a semi-standardised assessment. Results showed that all people with deafblindness had impairments in social interaction, communication and language. In contrast to persons without autism, people with deafblindness and autism showed significantly more impairments in reciprocity of social interaction, quality of initiatives to contact and the use of adequate communicative signals and functions. No differences between the groups were found for quantity and persistence of stereotyped behaviour, quality of play and exploration and adequate problem-solving strategies. This study indicates that there are some possibilities to differentiate autism from behaviours specific for deafblindness. It also confirms the large overlap in overt behaviours between people with deafblindness and persons with autism.
People with learning disabilities who have cancer: an ethnographic study
- Authors:
- TUFFREY-WIJNE Irene, et al
- Journal article citation:
- British Journal of General Practice, 59(564), July 2009, pp.503-509.
- Publisher:
- Royal College of General Practitioners
Cancer incidence among people with learning disabilities is rising. This study aimed to provide insight into the experiences and needs of people with learning disabilities who have cancer. A prospective qualitative study was carried out using ethnographic methods. The participants were 13 people with learning disabilities ranging from mild to severe, who had a cancer diagnosis. The main method of data collection was participant observation (over 250 hours). The median length of participation was 7 months. Participants' cancer experiences were shaped by their previous experience of life, which included deprivation, loneliness, and a lack of autonomy and power. They depended on others to negotiate contact with the outside world, including the healthcare system. This could lead to delayed cancer diagnosis and a lack of treatment options being offered. Most participants were not helped to understand their illness and its implications. Doctors did not make an assessment of capacity, but relied on carers' opinions. The authors conclude that urgent action is warranted by findings of late diagnosis, possible discrimination around treatment options, and lack of patient involvement and assessment of capacity in decision making. There are significant gaps in knowledge and training among most health professionals, leading to disengaged services that are unaware of the physical, emotional, and practical needs of people with learning disabilities, and their carers.
Learning difficulties
- Author:
- WARD Linda
- Journal article citation:
- Research Matters, 11, April 2001, pp.54-56.
- Publisher:
- Community Care
Reports on an accessible digest of up-to-date research which provides information for people working with, or for, people with learning difficulties.
Reluctant diagnosis
- Author:
- WATERS Jo
- Journal article citation:
- Nursing Times, 24.9.97, 1997, pp.14-15.
- Publisher:
- Nursing Times
Reports on the poor rate of early diagnosis for the condition of Dyspraxia.
“Reasonable adjustments” under the UK's Equality Act 2010: an enquiry into the care and treatment to patients with intellectual disabilities in acute hospital settings
- Authors:
- REDLEY Marcus, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 32(6), 2019, pp.1412-1420.
- Publisher:
- Wiley
Objectives: To understand the views of qualified medical practitioners regarding “reasonable adjustments” and the quality of the care and treatment provided to adults with intellectual disabilities when admitted to acute hospitals as inpatients. Methods: Semi‐structured interviews took place with 14 medical practitioners, seven from each of two acute hospitals, with a thematic analysis of the resulting data. Results: All 14 medical practitioners reported problems in the diagnosis and treatment of patients with intellectual disabilities. Most participants attributed these difficulties to communication problems and/or behaviours that, in the context of a hospital ward, were non‐conforming. However, a minority reported that, because they were likely to have multiple comorbid health conditions, patients with intellectual disabilities were more complex. In addition, half of all these respondents reported making little use of “reasonable adjustments” introduced to improve the quality of the care received by this group of patients. Conclusions: Medical practitioners should make better use of the “reasonable adjustments” introduced in the UK to address inequities in care and treatment received by patients with intellectual disabilities. However, training should also focus on the biomedical complexities often presented by these men and women. (Publisher abstract)
Message received?
- Authors:
- GIBSON Lynn, MATTHEWS Dorothy, REGNARD Claud
- Journal article citation:
- Learning Disability Today, 10(8), October 2010, pp.24-25.
- Publisher:
- Pavilion
- Place of publication:
- Hove
This article examines the identification of distress in people with learning disabilities who have trouble communicating. Correct identification of distress among this group will lead to enhanced diagnosis, better symptom control, and ultimately much improved health care. Undetected symptoms in people with learning disabilities are often due to lack of communication. This article argues that meaningful communication depends on the ability of people to recognise and translate the many different cues available and not just those verbally expressed. Observation by key people in the lives of people with learning disability, particularly carers, can be crucial to identify and treat the symptoms of distress. The article describes the Disability Distress Assessment Tool (DisDAT), an observational tool developed to document content and distressed states. DisDAT can be completed with the involvement of friends and family, and ensures that the carers’ knowledge and contribution is accepted in any discussions on what is wrong with the patient.
Autistic thinking: this is the title
- Author:
- VERMEULEN Peter
- Publisher:
- Jessica Kingsley
- Publication year:
- 2001
- Pagination:
- 159p.,bibliog.
- Place of publication:
- London
People with autism think in a specific way: linear and rigid and yet at the same time focused. The author tries to present some insights into this way of thinking. He compares autistic thinking to a computer process. It recognises just one truth. Everyday life knows many truths which does not fit into the thinking process of an individual with autism. This leads to confusion and uncertainty. One thing becomes clear: individuals with autism think in a linear fashion so that the notion of manipulation is never present. They are naive and ask for our sincere support without subterfuge.
Sodium-valproate-induced pancreatitis in a man with profound intellectual disability: the significance of diagnostic difficulties
- Authors:
- HINDER Steve A.J., PERRY David W.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 13(4), 2000, pp.292-297.
- Publisher:
- Wiley
Pancreatitis is a common but under-reported complication of treatment with sodium valproate, a drug frequently prescribed for people with intellectual disabilities. The present authors report a case of valproate-induced pancreatitis in a man with profound intellectual disability and review the relevant literature. The wider implications of problems experienced with diagnosis are discussed, emphasizing difficulties in recognizing pain and physical illness in this client group.