Learning Disability: Intellectual Disability

Learning disability (formerly known as mental handicap) and referred to increasingly as intellectual disability covers a wide range of intellectual impairments. Generally someone is considered to have a learning disability when they function at a level of intellectual ability which is significantly lower than their chronological age. This is usually considered to be equivalent to having an IQ of seventy or less and occurs in approximately two to three per cent of the population. Increased difficulties in acquiring basic independence, self-care and life skills, and increased dependence on others are common. Specialist educational input is usually required. This is increasingly possible within mainstream school settings, though sometimes specialist school placement still proves to be most beneficial.

Mild learning disability (roughly equivalent to an IQ of fifty to seventy) is analogous to the educational term 'moderate learning difficulties'. It is usually caused by a combination of restricted learning and social opportunities plus a high rate of low-average intellectual ability and learning disability in close relatives. Moderate-to-profound learning disability (roughly equivalent to an IQ below fifty) is analogous to the educational term 'severe learning difficulties'. It usually has a specific biological cause. However there are exceptions either way.

Learning disability may occur in isolation, in association with other sensory or physical handicaps, or as part of a recognisable genetic syndrome. Emotional and behavioural difficulties are common in individuals who have a learning disability, for a variety of biological, psychological and social reasons. Assessment and management of such difficulties can be problematic and may require a specialist multi-disciplinary team involving professionals from health, education and social services as well as the private and voluntary sector.

The cause of learning disability is often undetermined (see Undiagnosed Children). However there are five main areas in which intellectual impairment can occur:

• chromosomal and genetic abnormalities such as Down syndrome and Fragile X syndrome;
• infections such as toxoplasmosis and congenital rubella (see entry, Rubella);
• toxins such as alcohol (see Fetal Alcohol Spectrum disorder) and certain medications (see Fetal Anti-convulsant syndrome);
• injury or physical trauma such as road traffic accidents (see Brain Injuries);
• socio-environmental factors such as profound neglect.

Once diagnosed, likely challenges and progress of children with intellectual disability will depend more especially on:

• the severity of the intellectual impairment;
• associated physical, sensory, emotional and behavioural issues;
• quality of care and education received;
• cause of the intellectual disability.

Broadly, important components of management include:

• breaking the news of the child's disabilities to parents as soon, professionally and supportively as possible;
• counselling on promotion of development;
• dealing with associated disabilities and any emotional and behaviour issues;
• advising on appropriate education;
• genetic and lifestyle counselling as appropriate;
• providing social and emotional support to individual and family members.

Inheritance patterns
These will depend upon the fundamental underlying cause of the condition. This is often unknown. Genetic counselling is important and is available through regional genetic centres. Genetic counselling appointments can be arranged through general practitioners or hospital specialists.

Prenatal diagnosis

This is dependent upon the underlying condition and may include 'chorionic villus sampling' (testing a small piece of material from near the placenta), ultrasound scanning, amniocentesis, fetal blood sampling and fetoscopy (examining the developing baby through a small telescope).

Early identification, evaluation and remedial input are essential to maximising the abilities and progress of individuals with learning disability.

Medical text written May 2001 by Professor J Turk. Last updated November 2005 by Professor J Turk, Professor of Developmental Psychiatry and Consultant Child & Adolescent Psychiatrist, Department of Clinical Developmental Sciences, St. George's Hospital Medical School, London, UK.

MENCAP

Mencap (The Royal Mencap Society)
123 Golden Lane
London
EC1Y 0RT
Tel: 020 7454 0454
Fax: 020 7608 3254
Tel: 0808 808 1111 Helpline (England)
Tel: 0808 8000 300 Helpline (Wales)
Tel: 0845 7636227 Advice line (Northern Ireland)
Tel: 0808 808 8181 Text
e-mail: help@mencap.org.uk
Web: http://www.mencap.org.uk
Web: http://www.askmencap.info

Mencap is a National Registered Charity No. 222377, established in 1946. It works with children and adults with learning disabilities in England, Wales and Northern Ireland. It offers information, advice and support through a network of Community Support Teams and affiliated groups. It campaigns and influences at a national and local level and provides housing, residential and domiciliary support. It also provides employment via the Pathway Employment services and leisure opportunities via Gateway Clubs. It publishes a national newspaper 'Viewpoint' and has a wide range of information available, details on request or via the website. Mencap has over 1,200 affiliated groups.

Group details last updated June 2006.

ENABLE Scotland

ENABLE Scotland
6th Floor
7 Buchanan Street
Glasgow
G1 3HL
Tel: 0141 226 4541 Information Service (Mon-Fri, 1pm-4pm)
Fax: 0141 204 4398
e-mail: info@enable.org.uk
Web: http://www.enable.org.uk

ENABLE Scotland is a Scottish charity No. SCO09024, established in 1954. It campaigns locally and nationally and provides information and legal advice. A network of local groups offers support and contact between families. In different parts of Scotland, its local services can provide vocational training and job support, after-school care, family-based short breaks for children, supported living and day services for adults. It publishes a quarterly newsletter 'Newslink' and has a wide range of information available, details on request. Members can join nationally or through a network of local branches. It has over 4,000 members.

Group details last updated May 2007.