Learning Disabilities

Learning Disabilities by a Protégé Artist

“Do you have the time to listen to me whine?”
– ‘Basket Case’ by Greenday

Where you see the sky with clouds and birds, the roads with cars, buildings, trees & people, maybe I see colours, shapes and movements, hear noises that hurt and make me clasp my hands over my ears? Maybe I see bodies I can’t identify, or obstacles that make me confused?

For you it’s easy to open a door and walk to the pavement, stop and look in both directions before you cross the road. Maybe for me, I won’t make it to the outside, because I’ll fiddle with the door handle for a half-hour before I even open it? Maybe if I make it outside I’ll run into the open space and a car will run into me?

For you, your brain functions normally. You can have morals, rules and complex emotions and can communicate them with big or small words. Maybe I don’t know what I want to say, or how to even say it? Maybe I don’t have any spatial awareness, sense of danger, because maybe my brain doesn’t function the way it should?

Maybe I’m autistic? Maybe I know the word? Maybe I understand it, but in truth you’ll never know if I do or don’t, and maybe it doesn’t matter, does it?

Autism

Autism is a disorder that affects the development of the brain. Some would say it is a condition as opposed to a disorder. But what it actually is, we just don’t know.

What we do know is that it has a strong genetic basis and affects the brain, but how it affects the brain is not understood. This is probably because, in part, to the immense variety it manifests itself with (and in its varying degrees of strength within those manifestations). There are common themes that have been recognised throughout cases of people with autism and they can be seen in:

Social development
Communication
Repetitive behaviour

People with autism often lack social skills and intuition that we all take for granted. It is a daily struggle to make sense of the things we no longer need to register consciously. They often distance themselves from social stimuli and often ignore what is happening around them – they may answer less to their own names – and they won’t make much eye contact, using other people to communicate on their behalf by manipulating their limbs. Their level of social understanding, including interaction and social imagination, is limited.

What we consider to be an adequate level of social communication is not often found in those with autism. People with autism have great difficulty relating to the world around them. Around a third to half of individuals do not develop enough natural speech to get by. With all of the children I’ve worked with who have an autistic disorder, none of them were able to have a coherent or logical dialogue with me. This is not to say that there was no communication at all. We were able to swap jokes, play games, decide what to eat and in what order, where to go, what to do and (more often) what not to do. But these were sparse and did not occur for great lengths of time and ended abruptly.

A term that might be of interest is ‘Echolalic’ or ‘Echolalia’. Put simply, someone (not necessarily autistic) will hear a phrase, or noise, or word and then repeat it back often mimicking the tone. A few of the children I worked with had echolalic tendencies, so we were advised not to swear around them (which can be hard when you’ve just had food or shit thrown at you, your hair pulled at, bitten and kicked in the groin etc.) as they would pick up the word and repeat it all day. It has been suggested that echolalia is merely a way for someone to buy time whilst processing language. For example:

A child with autism is asked, “Do you want dinner?” the child echoes back “Do you want dinner?” followed by a pause and then a response, “Yes. What’s for dinner?”
(Source: – The OASIS Guide to Asperger Syndrome; Advice, Support, Insight, and Inspiration by Bashe, P. R., 2001)

There are many types of repetitive behaviour apparent in autistic individuals. The behaviour can be ritualistic, compulsive, or they can be against change – wanting to keep everything in order and the same. We all have our own rituals too, so this kind of behaviour isn’t exclusive to autism, but it is more frequent and more severe in autistic people. Something such as ‘Stereotypy’ – purposeless movement, such as hand flapping, head rolling, body rocking, or utterance – is easier to identify. More noticeable in times of high stress and/or anxiety, and because autistic individuals can be easily uncomforted, it is noticed.

Autism affects 1 in 100 people in the UK
It is more common in males
There is still no knowledge as to the exact cause of autism
(Source: The National Autistic Society, Autism: What is it? – www.autism.org.uk)

Asperger syndrome

There is an ‘Autistic Spectrum’ which is a spectrum of psychological conditions characterised by widespread abnormalities of social interactions and communication, as well as severely restricted interests and highly repetitive behaviour (Source: World Health Organisation – www.who.int), and Asperger’s is on that spectrum. Meaning, it is a form of the autistic condition.

It may appear to be the same but there are a few small differences that can categorise an individual with Asperger’s as opposed to Autism. These include fewer problems with speech and an average to above average intelligence not displayed in many Autistic cases. People with Apserger’s may not suffer from the learning disabilities associated with Autism, but may encounter specific learning difficulties such as:

Dyslexia: a disability/difficulty with written language, particularly with reading and spelling
Dyspraxia: an impairment or immaturity of the organisation of movement, also known as – Clumsy Child Syndrome; Developmental Co-ordination Disorder (DCD); and Motor learning Difficulty
Attention Deficit Hyperactivity (ADHD): Inattention, impulsiveness and hyperactivity are the 3 main symptoms of ADHD, or ADD

(Source: The National Autistic Society, Asperger syndrome: What is it? – www.autism.org.uk & Bupa – www.bupa.co.uk)

While Autism can be identified and diagnosed in a child between the ages of 2-3, children with asperger’s, may go undiagnosed until school start because many aspects of their early development will seem normal.

Fragile X

A relatively newly diagnosed condition – I only encountered a child with Fragile X in the later years of my work as a carer for children with mental and physical disabilities. Could Fragile X be placed on the Autistic spectrum? I don’t know. It shares many similarities – learning disabilities as well as social, language, attentional, behavioural and emotional problems.

It was first found in 1969 but was not associated with developmental problems until 1977. It wasn’t until 1991 that they found the gene which identifies Fragile X – called FMR1 – which is present in all of us and needs to function properly in order for normal intellectual development to take place. In Fragile X, it is an increase in this gene which causes the problem.

The condition is hereditary and affects both men and women alike, though it is more common to find suffers who are male because of genetics. Why? Okay, quick lesson. A female has 2 ‘X’ chromosomes, whereas a male has an ‘X’ and a ‘Y’ chromosome. So in females a Fragile ‘X’ can be balanced out by a good ‘X’. In males there is no good ‘X’ to balance this out, only a ‘Y’, so he retains his Fragile ‘X’ chromosome and it will affect him more.

As well as sharing common difficulties experienced with people who suffer from ADHD, Fragile X is different in the way that it manifests itself physically. Individuals with Fragile X have a long narrow face with prominent jaw bones and ears, a triangular shaped head, flat feet and low muscle tone. They may have a severe leaning difficulty and exhibit the characteristics of children much younger than them.

But they are by no means ‘fragile’. They are just as healthy and robust as other people and often live to the same age as every one else (Source: Fraglie X society – www.fragilex.org.uk).

ADHD & ADD

Attention Deficiency (hyperactivity) Disorder is a hidden impairment. Meaning, it might not be immediately obvious that someone has ADHD or ADD. It could be viewed as an extreme case of continuous traits found throughout ALL the people of the world. Most people will exhibit some of these behaviours, like hyperactivity and inattention, but not to the point where they significantly interfere with a person’s work, relationships, or studies. Although common with children, it tends to disappear as we move into adulthood, but half of the children who suffer from ADHD will continue to be affected into their adult lives. Though it hasn’t been proven, it seems that people may outgrow their ADHD as they mature and offset their impairments – both treated and untreated cases alike.

Much like the above mentioned disabilities / conditions / disorders, there is little understanding as to the cause, but there are many theories.

Common themes or symptoms are:

Impulsiveness: acting without thought to consequence, disorganisation, jumping from one activity to another, etc.
Hyperactivity: restlessness, fidgeting, climbing on things and restless sleep (for both child and parent/carer!)
Inattention: day-dreaming, not finishing work, easily distracted with a difficulty in listening
(Source: National Institute of Mental Health – www.nimh.nih.gov)

ADHD is the most common behavioural disorder in the UK. It is estimated that the condition affects between 3-9% of school-aged children and young people. Many children will exhibit the types of behaviour found in ADHD but may not suffer from it. There are several criteria that must be met before a child is diagnosed with ADHD (Source: NHS – www.nhs.uk).

Like all the above, there is no ‘cure’ but there is medication which allows people to manage. I only know of Ritalin which acts like a focusing tool, allowing the hyperactivity to be dispersed for a while and for the child to have more control over their attention.

Final Note

First and foremost, get expert advice. If you need advice or help it is best to go to people who have been trained to understand and deal with these conditions / disorders. Do not assume a condition just because you see symptoms. The problems are genetic that manifest in behavioural and emotional ways, and a misdiagnosis could do more harm than good. So always seek the help of properly trained and properly informed people.

In the UK, we are lucky to have a positive attitude towards people who suffer from various learning difficulties / disabilities / conditions. We are in a position where we can diagnose these conditions and find out what they are and what they mean to us as a population. If you, or someone you know works, lives, care’s for someone with one of the above mentioned difficulties, then you may know just how hard it can be.

In my work I encountered many struggling parents who were at breaking point because they found it so difficult to cope. Children with severe cases of disability require constant attention and care, not through their inability to do anything (some can be quite high functioning) but because they are often prone to self-harm through anxiety or stress. It can be a challenge to manage a normal life on top of all that.

We all have a breaking point in our patience and if you live with it daily, I can only imagine how many times you see that breaking point, but there are methods of care which can allow for a little ease every so often. Schools are now better equipped with dealing with children who suffer from a disability and the integration of these children with others could be a key factor to an increase in their mental well being. There are care centres, before and after school programs run by amazing people who give their time so you can reclaim back some of your own.

Below is a list of links to further information. I hope I have been informative to a point but I have only touched the tip. Due to the constantly changing variations there is no right-way to care for someone with disabilities. But there is no wrong-way either. Autistic people do form bonds with their primary care-givers and there are always moments that will make you smile and you will often realise that you are lucky to have someone like that in your life. Because this is life and it’s not meant to be lived in one way with uniform experiences – You can colour it anyway you choose, or let the people in your lives colour it for you. Either way, it’s your picture and it’ll be much richer when it turns out to be something you didn’t expect.

Learning Disabilities