Learning Difficulties and Learning Disabilities

Learning Difficulty

The term learning difficulty is usually used in educational contexts and by educational professionals (for example by the Department for Education, Ofsted and schools).  A learning difficulty is a type of Special Education Need, which affects areas of learning, such as reading, writing, spelling, mathematics etc, the types of learning difficulty are usually defined in as follows:

• Specific Learning Difficulty  - a particular difficulty in learning to read, write, spell etc. A specific learning difficulty does not affect general intelligence
• Moderate Learning Difficulty  - achievements well below expected levels in all or most areas of the curriculum, despite appropriate interventions
• Severe Learning Difficulty  - significant intellectual or cognitive impairments
• Profound and Multiple Learning Difficulty  - multiple Learning Difficulties have severe and complex learning needs, in addition they have other significant difficulties, such as physical disabilities or a sensory impairment.

Learning Disability

The term learning disability is more likely to be used in health and social care contexts and by health and care professionals. Often the terms learning disability and learning difficulty are used interchangeably by parents and professionals.

A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life. People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated information and interact with other people. (MENCAP)

A person has a learning disability when they have:

• A significantly reduced ability to understand new or complex information and to learn new skills (Significantly impaired intelligence – IQ less than 70) AND
• A reduced ability to cope independently (Impaired social / adaptive functioning) AND
• Which started before adulthood (onset before aged 18) with a lasting effect on development

What is Developmental Delay

This term is used to describe children who do not meet their developmental milestones within the expected range. Children can have a specific delay, such as a delay in language skills, but otherwise be developing as expected or a general delay in most or all of their developmental milestones, this can sometimes be called Global Developmental Delay (GDD).

A child with developmental delay and no learning disability, will continue to develop and the gap between themselves and their peers will reduce over time. However, when a child has a learning disability, their development will tend to slow down and the gap between themselves and their peers will widen.

There are a number of medical conditions which will mean your child has a Learning Disability, for example Prada Willi Syndrome or Angel Syndrome. If your child sees a Community Paediatrician, you will be able to speak with them about a diagnosis, to confirm if they have a learning disability, if this has not been shared previously.

If you are concerned that your child has a learning disability you can speak to your GP about this. They will be able to complete the Learning Disability Screening Tool which will indicate whether a LD is present. However, this is not a formal diagnosis. If a diagnosis is indicated your child can be added to the GP LD Register and from the age of 14 will be entitled to an Annual Health Check with their Doctor.

A GP may also refer school aged children with significant and complex learning difficulties to the Community Paediatric service for an assessment of a possible underlying medical cause (e.g. signs of genetic conditions ( e.g. neurofibromatosis), metabolic or neurological conditions (Duchenne Muscular Dystrophy)

Prior to referral to a Paediatrician children should be at least on the ‘My Plan Plus’ (or equivalent) level of the educational Graduated Pathway.  Evidence of Learning Difficulties will need to be provided with the referral letter, this should include professional reports from the School SENCo and any other specialist reports.

Please note: There currently is not one single pathway to receiving a formal Learning Disability diagnosis in Gloucestershire. 

The GP surgeries hold a register of all of their patients who have a learning disability. If your child is on the GP’s Learning Disability register, the doctor’s surgery will be able to tailor appointments to better meet your child’s needs, this could include:

• appointments at the beginning or end of the day when the waiting room is quiet
• extra time for your child to talk about their concerns and how they’re feeling.
• additional help for your child to understand written information they are given by the Doctor or Nurse

 These are called “reasonable adjustments” and can be made to make accessing health care easier for you and your child. When your child turns 14 and they are on the Learning Disabilities Register they will be invited for an Annual Health Check. Annual health checks are designed to promote the early detection and treatment of physical and mental health problems.  Annual Health Checks are also an opportunity for the young person and the GP to get to know each other. When a young person becomes an adult the GP may be the main health professional supporting their care so this early contact is invaluable.

Supercharged Me

Supercharged Me is an initiative set up by Kingfisher Treasure seekers to encourage more Young People aged 14 and over to get signed up to their GP Learning Disability Register and in turn have their Annual Health Check completed with their Doctor to ensure they stay… Supercharged! Annual Health Checks are a way for healthcare Professionals to ensure Children, Young People and Adults stay well, as well as allowing individuals to ask questions about their health and wellbeing. For more information and some videos on Supercharged Me click here.

A health passport can be used to make services aware of a Young Person’s (or an Adult’s) disability. The health passport is an easy read document that enables Professionals to know what your child needs in order to feel supported and ensure any special considerations can be undertaken.

The health passport is encouraged to be taken to any medical appointments or hospital admissions, so it’s a good idea to always have an up-to-date version ready.

All health services in Gloucestershire are aware of and use the health passport, so it can be presented to Doctors at hospital or if your child gets support from community services like Physiotherapy or CAMHS.

You can fill in the Health Passport template (PDF, 912.5 KB) today.

Inclusion Gloucestershire have developed some short films for Individuals and Professionals to help provide a better understanding on accessing health care services when you have a disability. The videos included are: medicine management, mental health and the Emergency Department and many more.

To view these films either by yourself or with you child, follow this link.

All health services across Gloucestershire are required to provide reasonable adjustments to support young people (and adults) with a learning disability. A reasonable adjustment essentially means to adapt ways of working with people who have additional needs to ensure they are able to access the services they need – for example this could include having a longer appointment with the GP, having letters sent in easy-read or an alternative print or having an extra person attend your appointment.

Whilst all universal health services should be offering reasonable adjustments there may be times when people with a learning disability need more specialist support from professionals who are specifically trained to work with people who have a Learning Disability. In children’s services there are 2 specialist Learning Disability Health Services:

Learning Disability (LD) Child and Adolescent Mental Health Service (CAMHS)

The team work with children and young people who have a moderate to severe learning or development disability, attend a special school and are registered with a Gloucestershire GP. Children may be seen in a range of settings such as: the home, the school or one of their sites across the county.

It is a multi-disciplinary team made up of learning disability nurses, consultant psychiatrists, clinical psychologists and family support practitioners.

CAMHS LD provide assessment, intervention and support with:

• behavioural difficulties
• sleep problems
• mental health
• risk management
• puberty and sexuality issues
• epilepsy awareness and monitoring
• medication
• health promotion

Referrals can be made to LD CAMHS by a professional such as the GP, school or social worker following verbal consent from parents or carers.

Learning Disability Intensive Support Service (LDISS)

LDISS provides an all age specialist service for individuals with learning disabilities who have behaviours that can be described as challenging, and/or mental health needs that cannot be met in mainstream services.

This service aims to:

• increase the number of adults and children whose support is delivered in their homes and communities
• Be proactive and preventative
• improve quality of life and inclusion within society

This service is an enhancement to the CAMHS LD Service (and Community Learning Disabilities Team for adults), working closely with services to manage and prevent any admissions into learning disability inpatient provision and facilitating discharges. LDISS helps people to move back into Gloucestershire from out of county, which could include inpatient services, educational services or residential care.