The Ultimate Guide to SLCN

Learning Disability

A Learning Disability is an impairment of general cognitive ability which causes significant difficulty with everyday activities and impacts on a person for their whole life. In the UK, the term Learning Disability is most commonly used, although elsewhere in Europe and in the United States Intellectual Disability is the predominant term used to describe the same condition. A Learning Disability is typically defined as having an IQ score less than 70 and a significant impairment of adaptive or social functioning, with onset of difficulties before 18 years old. Historically, diagnoses were based almost entirely on IQ scores, but today a more holistic approach is taken with assessment focusing on a person’s ‘adaptive functioning’ – that is, the impact of their impairment on their daily living skills.

Many children, particularly those with more severe difficulties, will have received a diagnosis of Learning Disability before starting school. However, it is possible to receive a diagnosis throughout childhood, and indeed in adulthood. Children are usually diagnosed by a paediatrician, although other professionals may be involved in the assessment process.

Top Tip

Communication passports can be a great way to ensure that all staff understand the child’s personal communication profile and to ensure that the most appropriate strategies are applied consistently across home and school settings.

A Learning Disability can be categorised as mild, moderate, severe or profound. It can be difficult to diagnose a mild Learning Disability as the child may be able to cope quite well with most tasks and fit in with their peers, however, they may still need support with some tasks. Moderate Learning Disability (often abbreviated to MLD) is commonly identified amongst children who attend mainstream schools.

The cause of a Learning Disability is often never known. Causes can be genetic (e.g. Down’s syndrome), environmental (e.g. illness such as meningitis, oxygen deprivation at birth, experiencing deprivation or abuse) or there may be multiple causes, and these can happen pre-birth, during birth, or after birth.

Children with Learning Disability may also be diagnosed with additional developmental disorders such as ASD, and they may have other medical conditions, for example, epilepsy.

It is important to distinguish between the terms ‘Learning Disability’ and ‘learning difficulty’. Learning difficulties are conditions which impact on specific areas of learning and do not affect general intellect, such as dyslexia or ADHD. However, it is possible for a person to have both a Learning Disability and a learning difficulty. In practice you may find that the terms ‘Learning Disability’ and ‘learning difficulties’ are used interchangeably.

A child who is younger than school age may have a diagnosis of Global Developmental Delay (GDD). GDD applies to children under 5 years old who have a delay of 6 months or more in at least two developmental domains. For some children, developmental delays will be overcome with appropriate therapeutic support in their early childhood, however, when difficulties persist in the long-term this may indicate that the child has a Learning Disability. GDD does not apply to children older than 5 years, however, in practice, many children retain this diagnosis on their documentation for longer periods.

Prevalence

Approximately 2.5% of children in the UK are thought to have some level of Learning Disability. MLD is the second largest type of primary area of need for children with SEN Support at 22.8% and the 5th most common primary need for children with an EHC plan at 11.5%.

What to look for

A child with a Learning Disability will find it more difficult to learn, understand information and carry out everyday activities when compared with peers of a similar age. Generally, a child with a Learning Disability will have difficulty acquiring literacy and numeracy skills. They are likely to require extra support at school to meet their best potential. A child with a Learning Disability may also have associated SLCN including attention and listening difficulties and social interaction difficulties. Children with severe language difficulties are likely to be given a diagnosis of ‘Language Disorder in association with (mild/moderate/severe) Learning Disability’.

Difficulties

• Up to 80% of children with a Learning Disability have a communication need. A child with
  a Learning Disability may have impairments in any area of their speech, language and communication skills and the extent of these difficulties can vary considerably between individuals. Communication difficulties can be associated with challenging behaviours.
• Understanding spoken and written language and using language expressively.
• Restricted vocabulary leading to difficulties communicating a range of ideas, desires and feelings.
• Poor attention and listening skills which can cause difficulty maintaining concentration in order to communicate with others.
• Limited understanding of abstract concepts and difficulty understanding and communicating about things which are not happening in the ‘here-and-now’.
• Poor at abstract reasoning tasks, inferencing, and understanding non-literal language.
• Social vulnerability.
• Poorly developed social skills compared to their peers, which can limit positive interactions with others.
• Unclear articulation of speech sounds can result from associated physical factors in some cases.

Myth Busting

Will children with a Learning Disability be able to live independently as adults?

Most people diagnosed with a Learning Disability will be able to lead independent lives as adults with the right support. The level and type of support a person requires depends on the individual.

Should all children with a Learning Disability go to a specialist education provision instead of a mainstream school?

Many children who have a mild or moderate Learning Disability will be able to receive appropriate support within a mainstream school. Early identification of the particular needs of a child is really important to ensure that they receive the right support. A child is only able to attend a specialist provision if they have an Education and Health Care (EHC) plan stating so, and while consideration is given to parental preference, the ultimate decision lies with the Local Authority. There are currently 347,013 children (under 18) in the UK who have some level of Learning Disability. In England, there are 519 state-funded and non-maintained special schools which have approved provision for MLD and 540 which have approved provision for Severe LD, but these schools will also support children who have other primary needs. For context there are more than 16,500 mainstream primary schools in England.

Are there fewer people living with Learning Disabilities now, because of advances in medicine?

In fact, the opposite is true. Advances in medical science mean that more babies born with complex medical needs and associated Learning Disabilities are surviving to adulthood, so there are actually increasing numbers of people living with Learning Disabilities.

Is it always easy to tell when somebody has a Learning Disability, because of the way they look and act?

In reality, ‘Learning Disability’ describes a wide spectrum of conditions and needs. People who have a mild Learning Disability may be able to communicate well and learn to read and write, whereas others with a severe Learning Disability may need high levels of support to communicate and with everyday activities. Learning Disability can often be a hidden disability.

Strategies

Many of the general strategies for supporting children with SLCN will be very applicable for children with a Learning Disability. Children with Learning Disabilities can have a wide range of skills and needs, and professional assessments as well as information from those people who know the child well are essential to ensure that any specific strategies which benefit that child are applied consistently across the whole school environment.

Role of SaLT

SaLT can sometimes be involved with the care of children with Learning Disability. Depending on the child’s individual needs, this could include directly working with the child to improve their speech, receptive language or expressive language skills, supporting adults to adapt the environment and develop functional communication strategies, or supporting with eating and drinking safely.

The focus of any SaLT intervention is likely to be maximising the child’s functional communication skills so that they are able to communicate their wants and needs as effectively as possible, to maximise understanding of functional language, and to advise adults working with the child on adaptations that can be made to the general communication environment. This may include developing an appropriate Augmentative and Alternative Communication (AAC) system depending on the child’s needs.

Should you have concerns about the speech, language and communication skills of a child with a Learning Disability, you should discuss these with your local SaLT team.

Further Information

Mencap – www.mencap.org.uk