Severe Learning Difficulties

Mencap

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Contents

 

Historical Overview and Key Guidance

Key Research Findings

Video Resources

Implications for Practice

Key Resources

References

 

 

 

 

People with Severe Learning Difficulties (SLD) tend to have significant restrictions in relation to their cognitive and/or intellectual capacities. These can co-exist with physical, sensory, social and/or emotional difficulties thus making it difficult for a child with SLD to follow the school curriculum without substantial support. As a result they will have difficulties with learning skills and applying them to differing contexts. Children with SLD may also use symbols (Rebus), or signing such as ‘Makaton (See key resources section) to help with communication. A child with SLD will require support in gaining independence and/or self-help and social skills and it is likely that most areas of academic achievement (Hewitt and Hind, 1988) will be affected with attainments likely to remain below level 1 of the National Curriculum (in the upper P scale range, P4-P8). As part of supporting children with SLD it is important to embrace the social model of disability in which this requires those supporting young people to respond proactively to modify and adapt practices and services to meet their individual needs. Additionally, in supporting children with SLD there will be a need to also appreciate the medical model of disability that focuses upon what the child's needs, restrictions and strengths are in order to then address any deficits in learning and development.

 

It is problematic to determine the number of children with SLD and/or the extent to which they are educated in mainstream or special schools.  This in part is due to SLD co-existing alongside other disabilities such as autism and/or communication difficulties which often supersede diagnosis (Department for Children, Schools and Families (DCSF), 2007). Classification of learning disabilities often comprises the terms mild, moderate, severe and profound to describe the degree of learning disability that a person has. Defining, classifying and diagnosing learning disabilities can therefore be complex (Fletcher at, 2007). One way to establish the ‘degree' of learning disability (Mather and Gregg, 2004) is to use a measure of Intelligent Quotient (IQ). This measure notes that people with an IQ of less than 20 will be described as having a profound disability, those with an IQ of 20 - 50, a severe learning disability, and 50-70, a moderate or mild learning disability. However, knowing the degree of intellectual impairment of a person via their IQ tells you little about who they are, the kinds of support required and how this impacts on their daily interaction with the world (Fletcher at al 2003). Therefore, in conjunction with traditional methods of diagnosis, teachers should embrace strategies which seek to understand the child with SLD ‘holistically' and then plan strategies accordingly to support the full range of their physical, social, emotional and learning needs.  

 

 

 

Historical Overview and Key Guidance

A brief historical review of terminology

There has been substantial discussion, debate and sometimes confusion in relation to terminology used to define learning disabilities (Male and Rayner 2007; Whemeyer, 2006). Indeed, terminology varies from country to country and also the extent to which they adopt medical or social models of disability (Swann, 1988). For example in the United States of America they use the term ‘learning disability' and ‘learning difficulties'  to denote educational problems of a specific nature, such as dyslexia. Within the United Kingdom the Department of Health and DCSF use the term ‘learning disability' as the preferred alternative to mental handicap. However it has been argued by authors such as Hewitt 1989; DFES, 2004; and Marks et al 2007) that ‘intellectual disability' is a more accurate term which also reflects the World Health Organisations definition. However, within the United Kingdom, moderate and SLD are used as a legal terms in the field of education (DCSF, 2009).             

The term ‘learning disability formerly known as ‘mental handicap' or ‘mental retardation' initially developed from the National Health Service and arose out of medical models of disability which tended to isolate and segregate people who were seen as ‘abnormal'. People with mental handicaps tended to therefore reside in long stay hospitals and be educated within segregating schools. In response to continued reports about poor conditions in the hospitals the Government published a paper, 'Better services for the Mentally Handicapped' (Department of Health and Social Security, 1971) which prepared the foundations for 'Care in the Community'.  Alongside this the concept of ‘normalisation' began to influence the delivery of care for people with a learning disability during the 1980s with an emphasis upon the unique value of the individual, their right to choice and opportunity, and the right to any extra support they need to fulfil their potential. Furthermore there was acknowledgement that existing segregated health and educational provision was producing barriers to inclusion.  It is important to recognise that people with SLD are capable individuals and can process information. However living with any form of learning disability can have an ongoing impact on friendships, school, work, self-esteem and daily life. However children with SLD can succeed when personalised models (Every Child Matters, 2009) of learning, teaching and assessment are provided.

Although inclusion of children with SEN is moving a pace as part of the equalities and social justice agenda by government, children with SLD have not always fully benefited from this often due to the complexity of their needs. Thus whilst the 1981 Education advocated the integration of children with SEN into mainstream settings wherever possible the outcome for children with SLD has been mixed. Whilst statistically the number of children with SLD has increased threefold (Swann, 1988), this has not been combined with a similar increase of children entering mainstream inclusive school settings.

SLD and school contexts
According to the DCSF (2009) pupils should only be recorded as SLD if it is the pupil's primary or secondary SEN and they are at School Action Plus or have a statement. The most common types of SEN for which special schools are approved are SLD, followed by moderate learning difficulties (over 40% serve children with these SEN). A further one-third are approved for emotional and behavioural difficulties and autistic spectrum disorder and one-quarter for profound and multiple learning difficulties. Children with SLD have the same entitlements to the DCSF (2007) Children's Plan through which the government wants to make this country the best place in the world for children and young people to grow up.

Furthermore, the DCSF have noted that since January 2004 they have began to collect information about the numbers of pupils in the country with different types of SEN as part of Pupil Level Annual Schools Census (PLASC) returns The data is used to help with planning, to study trends and to monitor the outcomes of initiatives and interventions for pupils with different types of SEN. As a result it is envisaged that children with SLD will be easier to identify amongst the broad category of SEN and thus ensure their needs are being met. Furthermore, differentiation is an integral component of the National Curriculum (Qualification Curriculum Authority, 2007) for children with SLD in which it suggests there are three principles teachers should address in order to ensure they meet the needs of children with SEN.

These refer to:

  • Setting suitable learning challenges: Teachers should recognise that in order to reflect the full diversity of children with SEN (Pecek et al 2008) they should consider establishing different objectives for children based upon their individual needs and differences.
  • Responding to the diverse needs of pupils: This places a requirement on teachers to acknowledge difference and diversity of children with SEN and work towards addressing their individual needs.
  • Differentiating assessment and learning to meet individual needs of pupils: This suggest that if teachers are to set differentiated objectives and recognise children with SEN are all on a continuum of learning (Ring and Travers, 2005), they should also offer alternative methods of assessment which maximise opportunities for children to demonstrate their knowledge and understanding.

Thus by teachers noting the needs of children with SLD combined with an open approach to differentiate the curriculum through the three principles noted above it is envisaged that children will maximise their potential in learning and development.

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Key Research Findings 

Beecham, J; Chadwick, O; Fidan, D; Bernard, S, (2002) Children with Severe Learning Disabilities: Needs, Services and Costs, Children and Society, Vol. 16, 3, pg 168-181

This study looks at how services are used by children with severe learning disabilities living at home and explores the associated total and component costs.  Multivariate and bivariate analyses are employed and the results interpreted alongside information on parents' perceptions of their children's needs for heathcare.  Tehre is some evidence to suggest costs were associated with greater needs but there is also evidence of under-provision of formal care supports, particularly mental health services.  (Also see Kirby et al 2008 and McGill, 2008).

 


Downing, J, (2005), Teaching Communication Skills to students with Severe Disabilities, Brookes Publishing Company Baltimore

This books asks the question - How can educators and therapists best teach students with severe and multiple disabilities to communicate effectively?  Developed by a highly respected expert, this practical guide has the comprehensive, research-based information professionals need to support students with SLD as they learn and use communication skills.

 


Male, B; Rayner, M, (2007), Who goes to SLD Schools? Aspects of Policy and Provision for Pupils with Profound and Multiple Learning Difficulties who attend Special Schools in England, Support for Learning, Vol. 22, 3, pg 145 - 152

This article focuses on aspects of policy and provision for pupils with profound and multiple learning difficulties who attend special schools in England.  The findings reported below are from a larger study, which aimed to answer the question: "Who Goes to SLD Schools in England?"

 


Reschy, D, (2005), Learning Disabilities Identification: Primary Intervention, Secondary Intervention, and Then What? Journal of Learning Disabilities, Vol. 38, 6, pg 510-515

The paper suggests that a broad consensus has been achieved regarding the importance of early primary and secondary interventions for children in academic domains for the purposes of improving overall academic competencies and preventing low achievement that often leads to a diagnosis of specific learning disability and long-term special education placement.  The paper argues that the characteristics of effective prevention programmes generally are well established, although the degree to which these programmes prevent learning disability is uncertain, and the subsequent procedures for determining eligibility are very much at issue.  Issues are discussed regarding what should be done about identification of specific learning difficulties after primary and secondary intervention efforts are proven inadequate for individual children.

 


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Video Resources

 

 

 

Action! Teacher Video - Special Schools: Communication Skills: Accessed at Teachers TV: http://www.teachers.tv/video/4890

 

This 15 minute programme features Jacky Wood, a teacher at Lexden Springs Special School in Essex and focuses upon her personalised curriculum for children with severe and profound learning difficulties. The Teaching of Early Communication Skills for Children with Severe Learning Difficulties, is part of a unique showcase of videos made by teachers about their work in schools, and features classroom scenes from her school.

 

The presenter of the programme is joined in the studio by Jacky, education consultant Adrienne Jones and fellow teacher, Lisa Rees, to discuss the project. They talk about the use of video to record and assess pupil progress and help with teacher confidence and continuing professional development. The panel also consider how video gives the wider school community an important insight into teaching and learning in this challenging context.

 

Special Schools - A Multi-Sensory Approach: Accessed at: http://www.teachers.tv/video/2551

This 30 minute video at Royal Schools for the Deaf in Manchester discusses teacher Chloe Bedford's works with pupils with severe communication difficulties and multiple learning disorders in her primary class. A multi-sensory approach is used to encourage communication. Objects of reference and picture exchange are some of the strategies Chloe uses in class and we see how sound and vibration are important in a Gamelan music lesson with percussion instruments.

 

 

 

 

Implications for Practice

a)  For teacher educators including mentors

Teacher educators and mentors should be able to talk confidently about the full range of children with SEN. Integral to this appreciation of the diversity of SEN is an understanding of the diverse range of learning difficulties including SLD. Teacher educators must then be able to discuss with trainee teachers the issues and implications of including children with SLD whilst identify strategies for supporting their learning, teaching and assessment.

Teacher educators and mentors ought to be able to direct trainees to resource materials related to SLD and assist them in interpreting their impact in practice. Furthermore, teacher educators can demonstrate through their own subject and pedagogical practice positive attitudes towards meeting the needs of children with SEN. As part of this they need to expect trainees to have equally high expectations and a commitment to assist children with SLD to reach their full potential.

Teacher educators and mentors must be confident in debating as part of professional development programmes with trainees the relative strengths and dilemmas in supporting children with SLD both within segregated and/or mainstream educational settings. As part of this discussion they should be able to identify a range of roles multi-disciplinary professionals (i.e. educational psychologists, physiotherapists, occupational therapists and speech and language therapists) play in the development of children with SLD.

 

b) For trainee teachers

Trainee teachers must be able to appreciate the history of learning disabilities from the early days of isolation and segregation through to modern day approaches of inclusion and equality of opportunity - particularly related to SLD children. As part of this developing appreciation of the needs of children, trainees should be able to identify how SLD is determined and defined within educational contexts.

Trainee teachers must also be expected to examine with experienced teachers the challenges and rewards of supporting children with SLD whilst considering a range of approaches to learning teaching and assessment. As part of this developing knowledge trainees must be prepared to identify research and pedagogically informed literature to help with their examination of strategies for inclusive learning and teaching.

Trainees must also seek opportunities to work with children with SLD as part of their training whether this is in special or mainstream school settings. For many programmes this will be a requirement of their training in relation to understanding the needs of children with special educational needs. However, were this is not the case trainees with support of mentors must seek out opportunities to work in specialised educational setting in order to appreciate the needs of children with SLD. They should also seek opportunities to discuss with SEN teachers and support workers of children with SLD the pitfalls, challenges and rewards of teaching such children in order to assist them in developing their own approaches to this area of their work.

 

c) For experienced teachers

Experienced teachers should be able to discuss with confidence the full range of learning disabilities including SLD and link less experienced staff to literature and resources to extend their appreciation of this aspect of teaching. Experienced teachers should also be able to promote the importance of multi-disciplinary approaches to support teaching, learning and assessment of children with SLD. In doing so they should be able to identify the role that teachers can play in a child with SLD's developing physical, social, emotional and intellectual development.

Experienced teachers should be able to explain how children with SLD can access the curriculum and the vital role in working with parents to ensure continuity of educational support both within school and home environments. As part of any discussions experienced teachers should be able to identify a range of resources where further advice and guidance can be made in relation to SLD.

A key role of experienced teachers is also to make sure that less experienced teachers do not dismiss children with SLD as ‘in-educable' or ‘less able' of progressing in schooling. Rather they should actively seek to challenge negative stereotypes of SLD and actively promote children's abilities to learn and develop if the right opportunities and resources are afforded to them.  Experienced teachers should make a note of appreciating the pioneering work of Jack Tizard (1919-1979) (See http://www.kent.ac.uk/tizard/About/history.html) who argued that no child was ineducable. Tizard advocated a move away from large stay residential hospitals for those then described as ‘mentally deficient'. Tizard was also a strong advocate for transformation of educational services away from a ‘deficit model' in which the child was considered the problem through to a more proactive approach that society has a responsibility to support and educate children. This work supported the work of the Warnock Report in 1978 which advocated that no child was ‘ineducable' and began to transform educational services for children with learning disabilities both within mainstream and special school settings.

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Key Resources

 

People First?

http://www.peoplefirstltd.com/


Symbols for self advocacy and evaluation

http://www.peoplefirstltd.com/


BECTA SLD forum. Accessed at:

http://schools.becta.org.uk/index.php?section=il&catcode=communities&rid=567

BECTA leads the national drive to inspire and lead the effective and innovative use of technology throughout learning. It's their ambition to create a more exciting, rewarding and successful experience for learners of all ages and abilities enabling them to achieve their potential. There are many examples of SLD which will be of relevance to those who teach and support learning, teaching and assessment.


The Foundation for People with Learning

Accessed at: http://www.learningdisabilities.org.uk/publications/?EntryId5=22343&char=T  [Also see attachments]

The Foundation for People with Learning Disabilities produces a range of publications, including reports, briefings and information booklets. Most of these can be downloaded free of charge from this site and will be of relevance to all teachers and support assistants working with children with SLD.


OFSTED: Teaching strategies for learners with moderate or severe learning difficulties

Accessed at: http://excellence.qia.org.uk/page.aspx?o=107558

This link offers an example of best practice in supporting children with SLD as identified by OFSTED. The case study focuses on Creative Connections a Department at Hamstead Garden Suburb Institute that runs courses for people with learning difficulties. This resource demonstrates the institutes clear commitment to students with learning difficulties and will be  a valuable resource for modeling best practice.


Valuing People: A New Strategy for Learning Disability for the 21st Century (2001)

Accessed at: http://www.archive.official-documents.co.uk/document/cm50/5086/5086.pdf [Also see attachments]

This documents states people with learning disabilities are amongst the most vulnerable and socially excluded in our society. Very few have jobs, live in their own homes or have choice over who cares for them - and this needs to change as people with learning disabilities must no longer be marginalised or excluded. 'Valuing People' sets out how the Government will provide new opportunities for children and adults with learning disabilities and their families to live full and independent lives as part of their local communities.

 


Makaton

Accessed at:  http://www.makaton.org/

Makaton is an internationally recognised communication programme, used in more than 40 countries worldwide. Most Makaton users are children and adults who need it as their main means of communication. But everyone else who shares their lives will also use Makaton. These include the families, carers, friends and professionals such as teachers, speech and language therapists, social workers, playgroup staff, college lecturers, instructors, nurses, and psychiatrists.

 


Mencap

Accessed at:  http://www.mencap.org.uk/

Mencap is the voice of learning disability within the United Kingdom and supports thousands of parents, carers and people with a learning disability to lead a full and valued life.


Glossary item written by: Philip Vickerman

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References

  1. Department for Children, Schools and Families, (2009), Cognition and Learning Difficulties, http://www.teachernet.gov.uk/wholeschool/sen/datatypes/Cognitionlearningneeds/
  2. Department for Children, Schools and Families, (2007), The Children's Plan: Building Brighter Futures, London, HMSO
  3. Department for Education and Skills, (2004), Removing Barriers to Achievement The Government's Strategy for SEN, London, HMSO
  4. Department of Health and Social Security, (1971), Better Services for the Mentally Handicapped, London, HMSO
  5. Every Child Matters, (2009), http://www.everychildmatters.gov.uk/
  6. Fletcher, J; Morris, R; Lyon, G; (2003), Classification and Definition of Learning Disabilities:  An integrative approach, In Swanson, H, (Ed.), Assessment of learning disabilities, New York, Guilford Press.
  7. Fletcher, J; Lyon, G; Fuchs, L; Barnes, M; (2007), Learning Disabilities: From identification to Intervention, New York, Guilford Press
  8. Hewett, D; Nind, M, (1988), Developing an Interactive Curriculum for Pupils with Severe and Complex Learning Difficulties, In Smith, B, (Ed),  Interactive Approaches to the Education of Children with Severe Learning Difficulties, Birmingham, Westhill College
  9. Hewett, D, (1989), The Most Severe Learning Difficulties: Does Your Curriculum Go Back Far Enough? In Ainscow, M, (Ed), Special Education in Change. London, David Fulton
  10. Kirby, A; Edwards, L; Hughes, A, (2008), Parents' Concerns about Children with Specific Learning Difficulties: Insights Gained from an Online Message Centre, Support for Learning,
    Vol. 23, 4, pg 193 - 200
  11. Male, B; Rayner, M, (2007), Who goes to SLD Schools? Aspects of Policy and Provision for Pupils with Profound and Multiple Learning Difficulties who attend Special Schools in England, Support for Learning, Vol. 22, 3, pg 145 - 152
  12. Marks, L; Woolfson; Brady, K, (2009), An Investigation of Factors Impacting on Mainstream Teachers' Beliefs about Teaching Students with Learning Difficulties, Educational Psychology, Vol. 29, 2, pg 221 - 238
  13. McGill, P, (2008), Residential Schools for Children with Learning Disabilities in England: Recent Research and Issues for Future Provision, Tizard Learning Disability Review, Vol 13, 4
  14. Mather, N; Gregg, N, (2004), Specific Learning Disabilities: Clarifying, Not Eliminating, a Construct, Professional Psychology: Research and Practice, Vo. 37, pg 99-106
  15. Pecek, M; Cuk, I, Lesar, I, (2008), Teachers Perceptions of the Inclusion of Marginalised Groups, Educational Studies, Vol. 34, 3, pg 225-239
  16. Qualification Curriculum Authority, (2007), The National Curriculum Key stages 1-4, QCA Publications, London
  17. Ring, E; Travers, J, (2005), Barriers to Inclusion: A Case Study of a Pupil with Severe Learning Difficulties in Ireland, European Journal of Special Needs Education, Vol. 20, 1, pg 41-56
  18. Swann, W, (1988), Backlash Integration? Look Twice at Statistics, British Journal of Special Education, Vol. 15, 3.
  19. Wehmeyer, M, (2006), Beyond Access: Ensuring Progress in the General Education Curriculum for Students With Severe Disabilities, Research & Practice for Persons with Severe Disabilities, Vol. 31, 4, pg 322-326

 

Images

  1. Mencap 2008 Competition http://www.mencap.org.uk/snap/snap_2008/big_pic.asp?ID=387

 

Article published to :

About SEN

Learning, Working with Statements

Type of Resource

Media Resources, Teachers TV, Video

Authors :

Philip Vickerman

Article Id :

15579

Date Posted:

8/7/2009