The term learning disability is a broad term which covers a multitude of overlapping and interrelated clinical entities all with different aetiologies and degrees of severity. Although in this essay we are considering the topic in specific relation to cerebral palsy, we should acknowledge the wide scope and application of the term.
We can cite evidence (Xenitidis K et al 2000) to show that the incidence of learning disability in the population is steadily increasing and currently stands at about 2%. The cause for this rise is unclear and is certainly multifactorial. One of the prime causes is said to be increased sophistication in diagnosis
(Meehan S et al. 1995). Aspray TJ (et al. 1999) points to the fact that there is now a greater survival chance in pre-term babies who would otherwise have perished and both cerebral palsy and learning disability are more highly represented in this group.
The recent paper by Colvin (et al.2004) is an excellent tour de force on the subject and cites evidence to suggest that the outcomes for babies born after 32 weeks gestation are generally the same as for the general population in terms of academic attainment. The problem group is the 20 -32 week gestation babies who have a significantly higher risk of both cerebral palsy and eventual learning disability. This appears to be primarily due to the phase of rapid brain growth that occurs at this stage of development. Problems with illness, undernutrition and infection can result in:
- serious neuromotor problems (principally cerebral palsy), visual and hearing impairments, learning difficulties, and psychological, behavioural, and social problems.
In the context of this essay we should note that although the seriously pre-term infant has the greatest statistical risk (as a group) of developing cerebral palsy and learning disability, in absolute numbers the majority of cerebral palsy sufferers are not born pre-term. (Bhutta AT et al 2002)
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Patients with learning disability in the community
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Cognitive and behavioural outcomes of school-aged children who were born preterm: a meta-analysis.
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Colvin M, William McGuire, and Peter W Fowlie 2004
Neurodevelopmental outcomes after preterm birth
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People with intellectual disabilities. Their health needs differ and need to be recognised and met.
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Nursing : Empowerment and the problem of power
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Cervical screening for women with learning disability.
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Specialist services for people with learning disabilities.
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Screening for breast cancer is necessary in patients with learning disability. BMJ 1998; 316: 1979-1980
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Reliability and validity of the CANDID-a needs assessment instrument for adults with learning disabilities and mental health problems.
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