Clearly, these issues are not new as the following essay illustrates, and historically some of these practices have been hidden within service cultures while others have been quite open but variously rationalized as behavior modification, relationships, control and restraint, or not giving in to attention seeking. Abuse was regarded as a central, and inevitable, feature of institutionalized provision in influential models such as that of Goffman (1961) and Wolfensberger (1975 and 1980) within an analysis whose focus was on organizations and ideology.
The new discourse is much more personalized and within it the focus is on the experience of the victim. This has some advantages for individuals and highlights some dilemmas for service organizations. It makes clear that people with learning disabilities are harmed, as any individual would be, by personal or sexual violence or exploitation. Harm is deemed equivalent whoever has caused it, for example whether it has been perpetrated by another service user, a member of staff or a stranger.
This way of framing harmful acts highlights conflicts of interest between service users: the discourse of challenging behavior for example, designed to neutralize the stigma of difficult behavior, inadvertently deflects from and discounts the experience of those on the receiving end of difficult behavior. Naming these acts as abusive confronts service agencies with the need for specialized, safe (expensive) placements for those who present a risk to others.
Men with learning disabilities who have difficult sexual behaviors, for example, are often placed alongside very vulnerable people, their needs for asylum taking precedence over the safety of more vulnerable people (Thompson and Brown 1998). But while this acknowledgement is a step forward for individuals ,the new discourse risks personalizing forms of mistreatment that arise out of societal and structural inequalities. At an individual level, when issues of power are overlooked or neutralized, abusive and exploitative interactions can be explained away as relationships of choice.
At a service level, new fault-lines between agencies and between purchasers, providers and regulators set up contingencies that make abuse more likely and less visible. At a societal level, there is growing inequality between the pay and working conditions of managerial, professional and so-called unqualified staff within and across the statutory, private (for-profit) and voluntary (not-for-profit) sectors. Gender and race exacerbate the unequal position of direct care staff and the disproportionate responsibility that falls on them. This paper divides into two parts.
First, I shall review the current usage of the term learning disabilities, looking at how it is being defined and categorized. Second, I will outline what is emerging as good practice in this field. WHAT DOES A LEARNING DISABILITY LOOK LIKE? Let me explain this with an exaomple: Saras lifelong difficulty with reading and writing had nothing to do with not being smart. Most individuals who have a learning disability are of average to above average intelligence and therefore have the intellectual potential to succeed at school and in careers. But they often do not reach this potential.
While effort and motivation are important for success, it is clearly unfair to say of someone with a learning disability that he or she just needs to try harder. No matter how hard Sara worked, her problems did not go away. We know that a learning disability is caused by specific dysfunction within the central nervous system. The central nervous system, made up of the brain and the spinal cord, controls everything we do: our ability to process and think about language and to express ourselves verbally, as well as our ability to process nonverbal information, including art or music.
Saras symptoms included reversing or rotating numbers (6 for 9), letters (b for d;p for q), and words (was for saw; on for no) when writing; omitting letters and sounds; and making sound and word substitutions when reading (tril for trial;then for there). Such problems make it difficult to decode words, and these decoding errors are most evident when reading aloud. Though never diagnosed, Saras symptoms became evident in first grade, when formal reading instruction began. As we learn to read we must of course master the alphabet, which is like a code, and learn the relationship between letters and sounds.
Reading is a process of decoding the clusters of letters, converting them into words, and then attaching meaning to the words. In many cases, problems with phonological processing the ability to receive, transform, remember, and retrieve the sounds of oral language interfere with the acquisition of reading skills. Phonological processing involves the ability to separate a word into its component parts or blend sounds to construct a word. Problems with these skills make it very hard for the beginning reader to achieve fluency.
Comprehension of written material depends on accurate and fluent decoding, a good vocabulary, and comprehension of the grammatical structure of sentences. When these skills are not developed that is, when they are slow and labored ” the reader must devote more energy and effort to identifying and comprehending each individual word, rather than constructing meaning from an entire paragraph or from general context. For many years, researchers believed that the reader automatically moved from reading the words on a page to comprehending, without participating in the process of constructing meaning.
But recent research points to the fact that the reader plays an active role: using background knowledge about the subject, calling on appropriate strategies for both decoding and comprehension, and applying the right amount of attention and concentration. Reading strategies are now considered essential components of the reading process. These might include paraphrasing while reading or summarizing afterward to help with comprehension. Competent readers are able to evaluate the reading task and select strategies that are a good fit or match to the task.
In Saras case, she read slowly and had to reread material several times, so she found it difficult to comprehend content or recall important facts when questioned about them later. Unlike good readers, she did not rely on strategies that could help her. She also struggled with writing. Many times she was ashamed to submit patient reports because she knew they were filled with spelling, punctuation, and grammatical errors and were not organized or structured well. Her reports never reflected her knowledge or keen insight into patient care.
Writing problems can be seen at any age, although they become more evident as academic or work demands increase. While Sara knew what she wanted to say, she had trouble getting started, focusing on the essential facts, and editing effectively. She tended to use the same words over and over. This was so different from her spoken language, which was rich and varied. Not surprisingly, it took her a long time and a good deal of effort to complete her reports. Her mathematical skills, though, were more than adequate.
But there are people with learning disabilities who have problems understanding mathematical concepts or difficulty solving verbal or written mathematical problems. These problems may stem from more than one source, including inadequate spatial or directional sense and difficulty understanding abstract symbols or the language of mathematics. To use a basic example, someone who does not have a good understanding of concepts such as plus and minus is going to find it hard to identify the process needed to solve a mathematical problem. Learning strategies will be of great help to this person.
Sara was also troubled by her erratic performance at work. Some days, she would be fine. But when she was fatigued or stressed, she found her attention was poor and she made more than the usual number of errors. At these times, she did not feel in control and usually needed to take a break and call on the support of friends to help her get back on track. While Sara felt her social life to be strength, some individuals who have learning disabilities have difficulty in social situations because they cannot perceive others needs and make or keep friends.
Relationships with family and friends and associates on the job may suffer. As a way of compensating, an individual may avoid social situations altogether and thus become isolated. Others may struggle with low self-esteem and a lack of assertiveness, which can lead to self-fulfilling prophecies of failure. Moreover, repeated negative experiences in school and at home can discourage an individual from even trying. Many individuals who have learning disabilities have difficulty planning ahead and then evaluating their performance in academic courses or work-related tasks.
Planning involves the ability to determine the outlines of a task and the skills it will require. Planning helps us generate strategies or know when to ask for outside help. We are not always conscious of initiating this type of planning because so many tasks are performed automatically, such as remembering a frequently called phone number by using a mnemonic, or writing notes in a book or on a memo. But when tasks are new or complex, active planning is needed. Other learning problems may stem from an inability to manage ones time effectively to get something done on schedule.
For example, many college students do not leave sufficient time to research and write a term paper, and end up frantically completing it the night before it is due. Or a manager may delay writing a budget or marketing report, finding it hard to begin. In order to use strategies at school, at home, or on the job, we need to be aware of ourselves as learners. Researchers have suggested that each of us has our own built-in executive function that directs and controls our actions. If this executive is efficient and aware of individual skills and the strategies needed to accomplish a task, the appropriate plan of action can be put into effect.
If the plan is unsuccessful, then the executive reevaluates and initiates a new course of action. Individuals who have learning disabilities have a less efficient executive, the theory goes, and are therefore less able to generate and use effective strategies in their personal and professional lives. In addition to learning disabilities, a large number of adults suffer from attention-deficit/hyperactivity disorder (ADHD). ADHD affects an individuals ability to focus and concentrate on school or work tasks, and to make good use of strategies. The struggle to achieve is so much harder with the added burden of ADHD.
Although external factors do not cause a learning disability, we know that they do play a significant role in learning. It is well documented that the environment we live and work in influences and helps to shape our learning patterns, behavior, and sense of self. Research has consistently shown that the type and quality of support provided both at school and within the home are strong determinants of success in school, at work, or in ones personal life. For example, a supportive family, early identification of learning problems, and appropriate intervention may make all the difference in helping an individual compensate for the disability.
Learning disabilities are found throughout the world and in all socioeconomic groups ” they are not bound by culture or language. Approximately the same numbers of males as females have learning disabilities, and the problem tends to run in families. Many prominent figures in politics, science, and the arts are reported to have had a learning disability, among them Nelson Rockefeller, Winston Churchill, Albert Einstein, Thomas Edison, and Auguste Rodin. Einstein, for example, was described as having difficulty learning a foreign language and mathematics ” of all things!
He also struggled with other academic subjects and with writing. All adults face the challenges and rewards of employment, home and family, leisure pursuits, community involvement, emotional and physical health, and personal responsibility and relationships. Adults who have learning disabilities must manage these life demands with an added set of problems. Society expects adults to be self-supporting, to function within a community, and to exhibit appropriate social behavior. Typically, to be self-supporting one must be employed. Employment for most adults spans a long period of time.
It may begin with the exit from high school and continue for fifty or more years. While research on the employment of adults who have learning disabilities is sparse, and the findings that are available reflect the heterogeneity of the population, the information reported is unfortunately discouraging. It suggests that individuals with learning disabilities, as a group, show higher rates of unemployment, have jobs of lower status, receive lower pay, and change jobs more frequently than those without learning disabilities. Of course, there are many individuals at all levels of the workforce who do attain professional success.
Further, there are well-documented accounts of persons with learning disabilities throughout history who have made significant contributions to society, among the most notable being Einstein, Edison, Churchill, and Rockefeller. It is important to keep in mind that adults who have learning disabilities who have above average intelligence, come from middle to higher economic backgrounds, and/or have completed postsecondary education, have higher rates of employment, higher job status, and greater job satisfaction than this research indicates.
Those who graduate from college are much more likely to hold professional or managerial positions, for example, than those who have only a high school diploma. What makes success on the job so difficult for some people with learning disabilities? For one thing, persistent problems with reading, writing, and arithmetic can interfere with their work. Many report that they continue to struggle with decoding skills, sight vocabulary, and reading rate. Banking tasks and money management often bring out their troubles with arithmetic.
Spelling is frequently reported to be the biggest problem of all. The level of basic skills that is required in the current job market is expanding to include more abstract abilities. Employers want their workers not only to be proficient in basic skills but also to be able to use these skills effectively and efficiently to solve on-the-job problems. Employers want the people they hire to be able to read for information, to analyze and synthesize the material, and apply the material read to on-the-job situations.
They further expect employees to analyze problems, formulate solutions, and communicate that process, in writing, to others. Workplace mathematics, like reading and writing, also requires identification of the problem, analysis, and then the ability to find a solution. Employers further expect good interpersonal skills. The ability to use technology and information systems is becoming more essential as well. To do all of these things efficiently and effectively, workers must have mastered basic skills and be able to apply thinking skills.
They also need personal qualities such as individual responsibility, self-esteem, and self management. The nature of a learning disability may affect the development of some of these competencies. For example, because of years of struggle and failure, self-esteem may be low and self-monitoring skills may not be functioning effectively. Employers often do not understand what a learning disability is, thus making it even more difficult for the adults with learning disabilities whom they supervise.
Because employers cannot see the disability and may have limited knowledge about learning disabilities, they may find it difficult to understand that the problems are real. Therefore, they may fail to provide the necessary accommodations and supportive environment. They may often fail to recognize that, with assistance, workers who have learning disabilities may be tremendous assets to the company. A learning disability is a lifelong condition. Some adults, by the time they have completed their formal education, have learned to compensate for their difficulties.
For many others, difficulties continue and to varying degrees impact on careers, social relationships, and activities of daily living. There are adults who were diagnosed as children and received services under the guidelines of PL 94-142. But more and more adults, who never knew why school was so hard, are now addressing the problem by initiating an assessment and seeking services to help them cope with their disabilities. Adults who have learning disabilities are a heterogeneous group.
Some struggle with reading and writing, some with mathematical tasks, some with the basic challenges of daily life. There are adults who have learning disabilities who have trouble finding and keeping a job; others are professionally successful yet cannot seem to develop a satisfying social life. And there are those who seem to have few problems as they successfully negotiate the range of lifes demands. Adults who have learning disabilities are not merely children with learning disabilities grown up. The impact of having a learning disability differs at each stage of development.
And adulthood itself has many stages, each with its unique challenges. Satisfaction or dissatisfaction at one stage does not guarantee the same degree of adjustment at another. At one point, the adult might deal with self-identity, at another with employment and economic independence, and still another with personal responsibility and relationships. As a group, adults who have learning disabilities represent a broad spectrum of the population. We see individuals of different ages, from different socioeconomic, ethnic, and cultural groups.
We see different clusters of social and learning problems that affect education, social, personal, and occupational adjustments. The field now recognizes the unique needs of the adult who has learning disabilities, and as such has responded by providing legal protection, programs, services, and an ever-developing information base. Where do we stand today?
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