General learning disability

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.

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

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.