Working Through Loss and Change With People With Learning Difficulties

The following is a short account of a two day workshop run on the theme of Loss and Change for people with learning difficulties and their keyworkers/supporters. The workshop was arranged by The Workers' Educational Association and tutored by Jill French, Occupational Therapist and Ed Kuczaj, Art Therapist.     

Developing Prognosis Tools to Identify Learning Difficulties in Children Using Machine Learning Technologies

The Mental Attributes Profiling System was developed in 2002 (Laouris and Makris, Proceedings of multilingual &; cross-cultural perspectives on Dyslexia, Omni Shoreham Hotel, Washington, D.C, 2002), to provide a multimodal evaluation of the learning potential and abilities of young children’s brains. The method is based on the assessment of non-verbal abilities using video-like interfaces and was compared to more established methodologies in (Papadopoulos, Laouris, Makris, Proceedings of IDA 54th annual conference, San Diego, 2003), such as the Wechsler Intelligence Scale for Children (Watkins et al., Psychol Sch 34(4):309–319, 1997). To do so, various tests have been applied to a population of 134 children aged 7–12 years old. This paper addresses the issue of identifying a minimal set of variables that are able to accurately predict the learning abilities of a given child. The use of Machine Learning technologies to do this provides the advantage of making no prior assumptions about the nature of the data and eliminating natural bias associated with data processing carried out by humans. Kohonen’s Self Organising Maps (Kohonen, Biol Cybern 43:59–69, 1982) algorithm is able to split a population into groups based on large and complex sets of observations. Once the population is split, the individual groups can then be probed for their defining characteristics providing insight into the rationale of the split. The characteristics identified form the basis of classification systems that are able to accurately predict which group an individual will belong to, using only a small subset of the tests available. The specifics of this methodology are detailed herein, and the resulting classification systems provide an effective tool to prognose the learning abilities of new subjects.     

Practising Partnership: Involving People with Learning Difficulties in Research

Traditionally, research has been done on people with learning difficulties, rather than with them. However, attitudes to this issue are changing. On the one hand some people with learning difficulties are seeking more active involvement, while on the other both researchers and funding bodies are exploring ways to involve people more widely within the research process. This article gives examples of people with learning difficulties helping to set the research agenda; advising and assisting with research projects; undertaking research themselves; and being both the target of, and actively involved in, the dissemination of research. It concentrates on describing practical examples of involvement rather than the theoretical context and debates surrounding it.     

Early Identification of Children Likely to Have Specific Learning Difficulties: Report of a Follow-up

In an earlier study, a group of pre-school children noted to have neurological dysfunction in the newborn period were given psychological tests and the results were compared with those from a control group of children with normal birth histories. The index children scored significantly more poorly on a number of items likely to lead to later learning difficulties at school(Frances Williams 1974). In the follow-up study, groups of the same index and control children were tested again between 8 and 9 1/2 of age. 11 of the 42 index children were unable to read, whereas there were no non-readers in the control group. A further 13 index children were backward by 12 months or more in reading accuracy, compared with five of the 43 control children. Only nine of the index children were reading at or above their appropriate age-level, compared with 22 of the controls. On a test for computational skill, many of the index children also scored much below the level expected for chronological age. These findings are discussed in relation to the possible identification of later learning difficulties from the results of pre-school examinations.     

Caring for People with Learning Difficulties in Scotland: Comparative Costs

This paper compares the costs of alternative forms of residential care for people with a learning difficulty in Scotland. The results suggest that whilst it costs less to care for adults with a severe and profound learning difficulty in hospital, it is cheaper to care for adults with a moderate or mild learning difficulty in the community. Evidence of economies of scale was found in providing care for these latter two groups in the community. Foster care placements were the cheapest form of care for children with a severe and profound learning difficulty. Other research has shown that community based small homes provide a superior quality of care.     

Having a Voice: Involving People with Learning Difficulties in Research

This article summarises a symposium presented at the 1993 BILD conference by researchers based at the Norah Fry Research Centre, University of Bristol. The linking theme of the several contributions to the symposium was the need to involve people with learning difficulties in research. The article argues that a traditional model of research, in which detached observers set the agenda and present the results to their funders and academic colleagues, should not be seen as the only acceptable approach to research. This article advocates involving people with learning difficulties at every stage of the research process. The article then describes several pieces of work, carried out by or with the support of staff at Norah Fry, which illustrate the Centre's attempts to put this principle into practice. It is argued that the end result is better research, which is of more direct benefit to people with learning difficulties.     

A Generative Learning Approach to Sensor Fusion and Change Detection

We present a system for performing multi-sensor fusion that learns from experience, i.e., from training data and propose that learning methods are the most appropriate approaches to real-world fusion problems, since they are largely model-free and therefore suited for a variety of tasks, even where the underlying processes are not known with sufficient precision, or are too complex to treat analytically. In order to back our claim, we apply the system to simulated fusion tasks which are representative of real-world problems and which exhibit a variety of underlying probabilistic models and noise distributions. To perform a fair comparison, we study two additional ways of performing optimal fusion for these problems: empirical estimation of joint probability distributions and direct analytical calculation using Bayesian inference. We demonstrate that near-optimal fusion can indeed be learned and that learning is by far the most generic and resource-efficient alternative. In addition, we show that the generative learning approach we use is capable of improving its performance far beyond the Bayesian optimum by detecting and rejecting outliers and that it is capable to detect systematic changes in the input statistics.     

A Practice and Policy Agenda for HIV and Learning Difficulties

The aim of this paper is to review how issues around HIV and learning difficulties come together to present a challenge for health promotion/HIV prevention and services for people with learning difficulties. This review will also identify the key practice issues which services for people with learning difficulties need to address in relation to HIV and offer a model for developing policy and resources for carrying forward work in this area. The information and arguments presented in this paper are my personal interpretations based on the experiences and issues generated by two areas of work. The first is a series of learning sets organised for South East Thames Regional Health Authority (SETRHA) on HIV and HEP B and services for people with learning difficulties. These were open to managers and staff working in learning difficulty services across agencies and sectors, and have recently been completed. (1) SETRHA Learning Sets. Organised by Paul Cambridge and Hilary Brown at The Tizard Centre. Inputs involved SE London Health Promotion Service (James Nichol) and the Sex Education Team (David Thompson). The second is a needs assessment exercise funded by South East London Health Authority (SELHA), covering the special and ordinary needs of men with learning difficulties who have sex with men in public places. (2) SELHA Needs Assessment Exercise. The steering group developed and conducted the study and included Paul Cambridge (Tizard Centre), Simon Davies (Southside Partnership), James Nichol (SELHPS) and David Thompson (Sex Education Team).     

Attitudes of Speech and Language Therapists to Intimate Relationships Among People With Learning Difficulties: An Exploratory Study

This study explored the attitudes of speech and language therapists (SLT) to intimate relationships among people with learning difficulties. A stratified random sample of SLTs (n=66) were sent a short, written scenario concerning two young adults with learning difficulties who were about to set up home together. Half the SLT's received a scenario in which ‘John’ was said to have a severe learning difficulty, the other participants received a scenario in which ‘John’ had a mild learning difficulty. The two scenarios were otherwise identical. All participants were asked to rate the scenario using a semantic differential scale. Forty completed questionnaires were analysed and the results indicated relatively favourable attitudes toward someone with a mild learning difficulty. Attitudes toward a person with severe learning difficulties were significantly less favourable (p<0.001), however, it could not be concluded that the unfavourable attitudes were directly related to engaging in an intimate sexual relationship.     

Behavioural and Psychiatric Disorder in Adults with Mild Learning Difficulties

The study of the relationship between the presence of learning difficulties, with its the numerous possible causes, and the onset of behaviour problems or psychiatric disorder is complicated by confusion over terminology, difficulties in ascertaining population rates for these disorders and different theories and ideologies concerning how such problems should be managed. The complexity of such problems demands the collection of data in each individual case and the proper evaluation of the effect of any intervention, whether it be behavioural, social psychotherapeutic or the use of medication. Such an assessment has as its aim the identification of the biological, psychological and environmental components relevant to understanding why a particular person presents with a problem behaviour, and/or the onset of a particular psychiatric disorder, at this point in time. By identifying the relative importance of these different factors appropriate therapeutic interventions can be tried. People who are identified as having learning difficulties, of whatever degree, have the right to expect that help will be available for them, as the presence of behaviour problems or psychiatric disorder can severely affect their quality of life.     

The Evolutionary History and Tissue Mapping of Amino Acid Transporters Belonging to Solute Carrier Families SLC32, SLC36, and SLC38

Members of the solute carrier families (SLC) 32, 36, and 38, together also designated the β-group of SLCs, are known to transport neutral amino acids. In this paper, we show that these three families were present before the split of the animal lineage and that they are likely to share a common decent. We also show that the APF transporters found in plants are most likely homologous to the mammalian β-group, suggesting that this type of transporters arouse early in the evolution of eukaryotes. We performed detailed tissue expression analysis of all the members of the β-group in rat and found several examples of highly specific expression patterns, with SLC38A7 being exclusively found in liver, SLC38A5 in blood, and SLC38A4 in muscle and liver. Moreover, we found that SLC38A10 is expressed in several endocrine organs. We also found that SLC38A1 is highly up regulated in the cortex from rats treated with diazepam and that SLC38A2 is significantly down regulated in the same tissue. In addition, we performed a detailed expression analysis of SLC38A1 and SLC38A6 in mouse brain using in situ hybridization, which showed that both these transporters are widely expressed in the brain. Electronic Supplementary Material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Predictors of Barriers to Treatment and Therapeutic Change in Outpatient Therapy for Antisocial Children and Their Families

This study examined the role of parent psychopathology and quality of life in predicting barriers to participation in outpatient treatment and therapeutic change among clinically referred children. Children (N = 169) referred for oppositional, aggressive, and antisocial behavior and their families participated. The major findings were that (1) higher levels of parent psychopathology and lower levels of quality of life predicted the subsequent emergence of perceived barriers to treatment in the parents and therapeutic changes among the children, (2) these effects were not explained by socioeconomic disadvantage or severity of child dysfunction, (3) perceived barriers and therapeutic changes were related and this relation was not explained by other family and child predictors, (4) as the level of perceived barriers increased among families, the amount of therapeutic change and the proportion of children who made a marked change decreased, and (5) parent perception of the relevance and demandingness of treatment were salient dimensions contributing to the relation between perceived barriers and therapeutic change. The conceptual and applied implications of relating barriers to treatment and therapeutic change are discussed.     

Burnout and Workload in Teachers of Children with Severe Learning Difficulties

This paper addresses the possibility that teachers of children with severe learning difficulties (SLD) may be especially vulnerable to heightened stress levels. A postal questionnaire posing investigative questions relating to workload and sources and quality of stress was sent to eight SLD schools in inner city, urban and rural areas in the south-east of England. Fifty-seven SLD teachers responded. Results indicated that SLD teachers were subject to high workload and long hours of work. High scores were obtained for the variable Emotional Exhaustion as measured by the education version of the Maslach Burnout Inventory. Qualitative data identified workload and challenging behaviour as the most frequently cited sources of intense stress. Results are discussed with reference to the need to develop effective job-related coping strategies for SLD teachers.     

Families,Culture, and Mental Illness: Constructing New Realities

Abstract

Motherhood is a vulnerable phase in the life of any woman, one that may be associated with an increased risk of mental illness. Despite the major clinical significance of this patient group, only a few psychotherapeutic treatment programs are tailored to the needs of mothers of infants. Even when treatment is urgently needed, many mothers of infants reject inpatient psychotherapy so as not to be separated from their children. The outcome may be chronification of disorders, in some cases with a negative impact on their children's development. A new psychotherapeutic outpatient treatment program adapted to the special needs of mothers and offering a substitute to inpatient treatment is presented. First empirical results show that the presented treatment concept led to significant improvements in the symptoms, whose stabilization continued up to the follow-up two years after the start of therapy.