General learning disability
for parents and carers
This webpage describes what a general learning disability is and the possible causes. It also provides practical advice about the help that is available.
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We publish information to help people understand more about mental health and mental illness, and the kind of care they are entitled to.
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Learning disability used to be known as mental handicap or mental retardation. Other terms sometimes used are general or global developmental delay. A child with a general learning disability finds it more difficult to learn, understand and do things compared to other children of the same age. Like all children and young people, children with learning disabilities continue to progress and learn throughout their childhood - but more slowly.
The degree of disability can vary greatly. Some children will never learn to speak and so are likely when they grow up to need help with looking after themselves - feeding, dressing or going to the toilet. On the other hand, the disability may be mild and the child will grow up to become independent.
General learning disability is different from specific learning difficulty which means that the person has difficulties in one or two areas of their learning, but manages well in other areas of their development. For example, a child can have a specific learning difficulty in reading, writing or understanding what is said to them, but have no problem with learning skills in other areas of life.
In many children with general learning disability, the cause of the disability remains unknown.
In some there may be genetic factors, infection, brain injury or damage before, at birth or after birth. Examples include Down's syndrome, Fragile X syndrome and cerebral palsy.
Children or young people who have a general learning disability are aware of what goes on around them. However, their ability to understand and communicate may be limited, and they can find it hard to express themselves. Speech problems can make it even harder to make other people understand their feelings and needs.
They can become frustrated and upset by their own limitations. When they compare themselves to other children, they can feel sad or angry and think badly of themselves.
For a parent, it can be distressing to find out that their child has a general learning disability. It may be hard for them and other members of the family to understand why the child is like this.
It can also be hard to communicate with the learning disabled child, difficult to manage their behaviour and hard for other people to understand.
Brothers and sisters may be affected in a number of ways. They may feel jealous of the attention given to their disabled brother or sister or embarrassed by their behaviour.
They may even be teased at school. Quite often they can feel personally responsible for their disabled sibling or their distressed parent.
A general learning disability is not a mental illness.
However, children with learning disability are more likely to develop mental health problems, for example anxiety, or have additional developmental disorders, such as Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder (ADHD) than other children.
Recognising difficulties in learning and development
It is important to recognise, as soon as possible, that a child is learning and developing slowly. It is only when the problem is recognised that the child and their family can be offered the help and support they need. The health visitor plays an important role in recognising slow development in the years before school.
Child Development Team
As the child gets older, a number of people can help with the child’s particular needs. They will often work together in a group known as the Child Development Team.
This team includes specialists such as community paediatricians, nurses, psychologists and speech therapists. It sometimes includes a child psychiatrist or other members of the child and adolescent mental health service (CAMHS).
In some areas, there are special services for children with learning disabilities (Community Learning Disability Team). If necessary, a GP can refer the child to one of these specialist teams.
Schooling
School can be a particular challenge for children with learning disabilities because of both the learning and social demands. Local education departments can make special arrangements to meet the educational needs of each child.
However, there is an expectation that most children will receive their education in a mainstream inclusive environment. For example, children who are able to cope comfortably with other people are likely to attend an ordinary school, but have special forms of teaching. On the other hand, a child with a more severe disability may go to a special school.
For some children, a Statement of Special Educational Needs will need to be prepared. This sets out what special help the child needs, and takes into account the views and wishes of the child and their parents.
All educational authorities have a Parent Partnership Scheme to advise parents on educational provision.
In most areas, there are also other services. Respite care and holiday play schemes can extend the learning and social opportunities for the child. Parent support groups can put families in touch with other people who are coping with similar problems. The local social services department will be able to advise, both on these opportunities and on the benefits to which parents are entitled.
Disability does not stop a child from having a full and enjoyable life. The aim of all the specialist services is to help children with a general learning disability to have lives that are as enjoyable and fulfilling as those of other people.
Beth, a 15 year old girl with moderate Learning Disability was referred to us by her paediatrician who was concerned for her mental health. She had deliberately swallowed 2 antacid tablets and 2 diet pills. She had been increasingly aggressive and restless both at home and school. She was barely sleeping at night, she was ‘talking gibberish’ and very fast, running away and taking her clothes off inappropriately.
There had been similar episodes in the past for varying periods but none had been this severe. There was family history of schizophrenia and bipolar illness.
She was diagnosed as bipolar affective disorder, which was previously known as ‘manic depression’. She was started on medication, a mood stabiliser. Beth improved on the medication. A year later, Beth started becoming more agitated, and tearful. She had developed an episode of depression and needed an antidepressant. She has now recovered to her previous self. Beth is likely to have high and low episodes like these, especially if not on treatment. She will need to be monitored for a long time.
People with learning disability can have major mental illness like others. The way they appear to professionals will be different and they will need to see specialists who will look at behaviour and recognise any patterns suggestive of a psychiatric disorder.
British Institute of Learning Disabilities - Contains useful information to support people with learning disability and their families.
Contact a Family - offers information and advice for parents of children with any special needs or disability.
MENCAP - Leading UK charity for people with learning disabilities.
UK Government website for citizens - Contains useful information regarding special educational needs and navigating through the statement process.
The Children’s Trust - A national charity working with children who have multiple disabilities.
Further reading
Books Beyond Words - series of picture books for use by people with learning disabilities to make communication easier and allow for discussion.
Mental Health Needs of Children and Young People with Learning Disabilities, Pavilion Press, 2010.
First Impressions: this booklet is about emotional and practical support for families of a young child with a learning disability.
Seeing the Psychologist for a Cognitive Assessment
A leaflet by Cheshire and Wirral Partnership NHS foundation Trust.
References
- Dr Sarah Bernard & Professor Jeremy Turk, ‘Developing Mental Health Services for Children and Adolescents with Learning Disabilities’.
- Rutter, M. & Taylor, E. (eds) (2008)'Rutter’s Child and Adolescent Psychiatry' (5th edn). London: Blackwell Publishing.
- Gillberg, C. Harrington, R. & Steinhausen, H-C. (eds) (2006) ‘A Clinician’s handbook of child and adolescent psychiatry’ (1.st edn) University Press Cambridge.
- Information for people with learning disability and their carers
The Royal College of Psychiatrists' Faculty of the Psychiatry of Learning Disability and the Leicestershire Partnership NHS Trust have produced accessible information for people with mental health problems and learning disabilities. All these materials have been written and tested with people with learning disabilities and their carers.
Credits
Revised by the Royal College of Psychiatrists’ Child and Family Public Engagement Editorial Board (CAFPEB).
With grateful thanks to Dr Nadia Ranceva, Dr Alison Dunkerley , Dr Virginia Davies, Dr Vasu Balaguru, and Thomas Kennedy.
This resource reflects the best possible evidence at the time of writing.
Published: Jul 2015
© Royal College of Psychiatrists
