Care Wish supports The British Institute for Learning Disabilities who say:
The term learning disability is a label and a label only ever describes one aspect of a person; a person with a learning disability is always a person first. When providing support the emphasis should always be on the person’s rights, dignity and individuality; people should not be labelled unnecessarily but the term learning disability is often used in health and social services. As such, it can be helpful to understand what this means. Valuing People: a new strategy for learning disability for the 21st Century (Department of Health, 2001) explains that it includes the presence of:
- A significantly reduced ability to understand new or complex information and to learn new skills;
- A reduced ability to cope independently;
- An impairment that started before adulthood, with a lasting effect on development.
A person with a learning disability may find it harder to understand, learn and remember new things, meaning they may have problems with a range of things such as communication, being aware of risks or managing everyday tasks. However, while a learning disability cannot be ‘cured’, with the right support it will have less of an impact on the person’s life; leading to the individual learning new skills and living a full life.
The term learning disability covers a broad range of individuals, each with different strengths and capabilities, as well as needs. Knowing the degree of intellectual impairment a person has tells you very little about who they are, but these terms may help the person and those who support them in understanding the needs they may have, and the kinds of support they may require. When providing care and support the person should always come first and the label or category second.
In the UK we have used the terms profound, severe, moderate and mild to describe people with learning disabilities, but there are no clear dividing lines between the groups. Furthermore, there is no clear cut off point between people with mild learning disabilities and the general population and you may hear the term borderline learning disability being used.
In the past, diagnosis of a learning disability and understanding of a person’s needs was based on IQ scores; today the importance of a holistic approach is recognised, and IQ testing forms only one small part of assessing someone’s strengths and needs. Assessments of adaptive function focuses on how people can manage their daily living skills and what support they may need; this form of assessment is considered more useful in assessing the impact of any learning disability on a person than an intelligence test.
People with profound intellectual and multiple disabilities may have the highest levels of care needs in our communities. They have a profound intellectual disability (an IQ of less than 20) and in addition they may have other disabilities such as visual, hearing or movement impairments, or they may have autism or epilepsy. Most people in this group need support with mobility and many have complex health needs requiring extensive support. They may have considerable difficulty communicating, doing so non-verbally, and characteristically have very limited understanding. In addition, some people may need support with behaviour that is seen as challenging.
People with a severe learning disability have an IQ of between 20 and 35; they may often use basic words and gestures to communicate their needs. Many need a high level of support with everyday activities, but they may be able to look after some if not all of their own personal care needs. Some people may have additional medical needs and some need support with mobility issues.
People with a moderate learning disability have an IQ of 35 to 50 and are likely to have some language skills that mean they can communicate about their day to day needs and wishes. Some people may need more support caring for themselves, but many will be able to carry out day to day tasks.
People with a mild learning disability have an IQ of 50 to 70 and are usually able to hold a conversation and communicate most of their needs and wishes. They may need some support to understand abstract or complex ideas. People are often independent in caring for themselves and doing many everyday tasks. They usually have some basic reading and writing skills. People with a mild learning disability quite often go undiagnosed.