An outburst of bad behaviour, common in toddlers, usually indicating frustration and anger.
In the United Kingdom, the 1993 Education Act refers to ‘learning diffculties’: generalised (severe or moderate), or speci?c (e.g. DYSLEXIA, dyspraxia [or APRAXIA], language disorder). The 1991 Social Security (Disability Living Allowance) Regulations use the term ‘severely mentally impaired’ if a person suffers from a state of arrested development or incomplete physical development of the brain which results in severe impairment of intelligence and social functioning. This is distinct from the consequences of DEMENTIA. Though ‘mental handicap’ is widely used, ‘learning disability’ is preferred by the Department of Health.
There is a distinction between impairment (a biological de?cit), disability (the functional consequence) and handicap (the social consequence).
People with profound learning disability are usually unable to communicate adequately and may be seriously movement-impaired. They are totally dependent on others for care and mobility. Those with moderate disability may achieve basic functional literacy (recognition of name, common signs) and numeracy (some understanding of money) but most have a life-long dependency for aspects of self-care (some fastenings for clothes, preparation of meals, menstrual hygiene, shaving) and need supervision for outdoor mobility.
Children with moderate learning disability develop at between half and three-quarters of the normal rate, and reach the standard of an average child of 8–11 years. They become independent for self-care and public transport unless they have associated disabilities. Most are capable of supervised or sheltered employment. Living independently and raising a family may be possible.
Occurrence Profound learning disability affects about 1 in 1,000; severe learning disability 3 in 1,000; and moderate learning disability requiring special service, 1 per cent. With improved health care, survival of people with profound or severe learning disability is increasing.
Causation Many children with profound or severe learning disability have a diagnosable biological brain disorder. Forty per cent have a chromosome disorder – see CHROMOSOMES (three quarters of whom have DOWN’S (DOWN) SYNDROME); a further 15 per cent have other genetic causes, brain malformations or recognisable syndromes. About 10 per cent suffered brain damage during pregnancy (e.g. from CYTOMEGALOVIRUS (CMV) infection) or from lack of oxygen during labour or delivery. A similar proportion suffer postnatal brain damage from head injury – accidental or otherwise – near-miss cot death or drowning, cardiac arrest, brain infection (ENCEPHALITIS or MENINGITIS), or in association with severe seizure disorders.
Explanations for moderate learning disability include Fragile X or other chromosome abnormalities in a tenth, neuro?bromatosis (see VON RECKLINGHAUSEN’S DISEASE), fetal alcohol syndrome and other causes of intra-uterine growth retardation. Genetic counselling should be considered for children with learning disability. Prenatal diagnosis is sometimes possible. In many children, especially those with mild or moderate disability, no known cause may be found.
Medical complications EPILEPSY affects 1 in 20 with moderate, 1 in 3 with severe and 2 in 3 with profound learning disability, although only 1 in 50 with Down’s syndrome is affected. One in 5 with severe or profound learning disability has CEREBRAL PALSY.
Psychological and psychiatric needs Over half of those with profound or severe – and many with moderate – learning disability show psychiatric or behavioural problems, especially in early years or adolescence. Symptoms may be atypical and hard to assess. Psychiatric disorders include autistic behaviour (see AUTISM) and SCHIZOPHRENIA. Emotional problems include anxiety, dependence and depression. Behavioural problems include tantrums, hyperactivity, self-injury, passivity, masturbation in public, and resistance to being shaved or helped with menstrual hygiene. There is greater vulnerability to abuse with its behavioural consequences.
Respite and care needs Respite care is arranged with link families for children or sta?ed family homes for adults where possible. Responsibility for care lies with social services departments which can advise also about bene?ts.
Education Special educational needs should be met in the least restrictive environment available to allow access to the national curriculum with appropriate modi?cation and support. For older children with learning disability, and for young children with severe or profound learning disability, this may be in a special day or boarding school. Other children can be provided for in mainstream schools with extra classroom support. The 1993 Education Act lays down stages of assessment and support up to a written statement of special educational needs with annual reviews.
Pupils with learning disability are entitled to remain at school until the age of 19, and most with severe or profound learning disability do so. Usually those with moderate learning disability move to further education after the age of 16.
Advice is available from the Mental Health Foundation, the British Institute of Learning Disabilities, MENCAP (Royal Society for Mentally Handicapped Children and Adults), and ENABLE (Scottish Society for the Mentally Handicapped).... learning disability
Because of its possible toxic effects – including kidney damage – lithium must only be administered under medical supervision and with monitoring of the blood levels, as the gap between therapeutic and toxic concentrations is narrow. Due to the risk of its damaging the unborn child, it should not be prescribed, unless absolutely necessary, during pregnancy – particularly not in the ?rst three months. Mothers should not take it while breast feeding, as it is excreted in the milk in high concentrations. The drug should not be taken with DIURETICS.... lithium carbonate
A child may avoid looking a person in the face, occupying himself or herself elsewhere to avoid direct contact. Obsessional motions include erratic movements of the fingers or limbs or facial twitch or grimace. Corrective efforts by parents to educate into more civilised behaviour meet with instant hostility, even hysteria. Hyperactivity may give rise to tantrums when every degree of self-control is lost. For such times, harmless non habit-forming herbal sedatives are helpful (Skullcap, Valerian, Mistletoe).
A link has been discovered between a deficiency of magnesium and autism. Magnesium is essential for the body’s use of Vitamin B6. Nutritionists attribute the condition stemming from an inadequate intake of vitamins and minerals at pregnancy. Alcohol in the expectant mother is a common cause of such deficiencies. Personal requirements of autistic children will be higher than normal levels of Vitamin B complex (especially B6) C, E and Magnesium.
Such children grow up to be ‘temperamental’, of extreme sensibility, some with rare talents. Medicine is not required, but for crisis periods calm and poise can be restored by:–
Motherwort tea: equal parts, Motherwort, Balm and Valerian: 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes; 1 cup 2-3 times daily. Honey renders it more palatable.
Alternatives:– Teas, tablets or other preparations: Hops, German Chamomile, Ginseng, Passion flower, Skullcap, Devil’s Claw, Vervain, Mistletoe, Ginkgo.
Diet. Lacto-vegetarian. 2-3 bananas (for potassium) daily.
Supplements. Daily. Vitamin B-complex, Vitamin B6 50mg, Calcium, Magnesium, Zinc. Aromatherapy. Inhalation of Lavender oil may act as a mood-lifter.
Note: A scientific study revealed a link with the yeast syndrome as associated with candidiasis. ... autism
Symptoms. May be many and varied; acute outbreaks of temper tantrums (Valerian); episodes of self-pity, paranoia; apparent paralysis; preparing for examinations. Subjects may be in constant need of reassurance. May be associated with loss of speech, muscle weakness, migraine, backache, ‘pain-in-the- neck’. Painful menses (Raspberry leaves, Motherwort).
Alternatives. General practice: Asafoetida, Betony, Cowslip, Hyssop, Lime flowers, Passion flower, Pulsatilla, Rosemary, Skullcap, Valerian, Vervain BHP (1983). Blue Cohosh, Oats, Ladies Slipper, Mistletoe. (Priest)
Combination: Blue Cohosh, Squaw Vine, Wild Yam. (Priest)
Tea: Mix, equal parts: Betony, Skullcap, Lime flowers. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup freely.
Traditional. Equal parts, Skullcap, Valerian and Mistletoe. Mix. 1-2 teaspoons to each cup water. Bring to boil; remove vessel when boiling point is reached. Half-1 cup thrice daily.
Formula. Black Cohosh 2; Liquorice 1; Asafoetida quarter. Doses: Powders: 375mg (quarter of a teaspoon). Liquid Extracts: 15-30 drops. Tinctures: 30-60 drops. In water or honey, thrice daily. Antispasmodic Drops.
Serious cases: Lobelia tea enema.
Practitioner: Liquid Extract Gelsemium, 1-3 drops, in water, when necessary.
Local. Hot foot bath. Cold water to head. Loosen tight clothing. Divert blood from the brain. Electric blanket. ... hysteria
Behavioural problems that are common in babies and young children include feeding difficulties (see feeding, infant) and sleeping problems, such as waking repeatedly in the night. In toddlers, breath-holding attacks, tantrums, separation anxiety, and head-banging are problems best dealt with by a consistent and appropriate approach. Problems with toilet-training are usually avoided if the training is delayed until the child is physically and emotionally ready.
Between the ages of 4 and 8, behavioural problems such as nail-biting and thumb-sucking, clinginess, nightmares, and bed-wetting (see enuresis) are so common as to be almost normal.
They are best dealt with by a positive approach that concentrates on rewarding good behaviour.
In most cases, the child grows out of the problem, but sometimes medical help may be needed.... behavioural problems in children
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