Global Developmental Delay and Learning Disabilities


Global Development Delay / Learning disabilities

Overview:

The Department of Health has described a Learning Disability (LD) as a “significant reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with a reduced ability to cope independently (impaired social functioning), which started before adulthood”. This diagnosis is often given when young child has not reached development milestones in two or more areas of development: motor skills, speech and language, cognitive skills, social and emotional skills. Every child presents differently in terms of their difficulties. Research suggests it is said to affect 1-3% of the population.  Often the term ‘Global Developmental Delay’ (GDD) is used to describe a learning disability. GDD occurs between birth and the age of 18 and diagnosed because a child has not reached fundamental milestones of development that includes communication skills, processing information, and executive functioning skills.

The causes of learning disabilities are varied and complex. Below are a few:

  • Chromosome abnormalities such as Down’s syndrome.
  • Complications during birth resulting in a lack of oxygen to the brain or  very premature birth.
  • An inherited condition, for example Fragile X.
  • A debilitating illness or injury in early childhood affecting brain development, for example a road traffic accident or child abuse.
  • Neglect, and/or a lack of mental stimulation early in life.
  • Often other disorders can co-occur, for instance a child with GDD/LD may also have physical disabilities, epilepsy, food intolerance.  

How it affects individuals:

  • Children are behind peer-levels, which can create complex challenges in school.
  • Varying muscle tone
  • Fine and Gross motor difficulties
  • Difficulties in acquiring new skills
  • Delayed communication skills
  • Behaviours that challenge
  • Multi-sensory impairments
  • Motivation/confidence to initiate activities

Therapies:

With the right support and early intervention individuals with LD can lead a full and purposeful life. However with support they may have difficulties gaining independence, having a good quality of life, may find it difficult to develop and maintain appropriate peer relationships and may find it hard to suitable employment. The following therapies have research evidence to support their efficacy in enabling individuals with LD to have greater independence in life.

  • Positive Behaviour Support/Verbal Behaviour (PBS/VB)
  • Salt and language therapy (SALT)
  • Occupational therapy (OT)
  • Physiotherapy

PBS/VB approach to the disorder:

PBS/VB has been shown to support children with LD/GDD. The principles of PBS can help teach children with LD/GDD in all areas of development by designing individualised intervention to teach specific skill areas such language, communication, play, social skills daily living and functional skills and academic skills.

All Behaviour Consultancy Approach:

At ABC we use the following PBS/VB principles to support children with LD/GDD:

  • We teach communication using the principles of Verbal Behaviour ensuring communication is functional age appropriate and taught through play.  
  • We devise programs to increase the individual’s motivation to initiate and reciprocate communication.
  • We work on improving joint and play skills attention skills
  • We teach academic skills by breaking down complex task into discrete components and ensure a highly level of repetition to support acquisition of skills.
  • We provide individualised parent training programs that aim to teach parents and carers about positive behaviour support strategies while increasing confidence in their ability to help the child and improve relationship  
  • We run social skills groups. Our social skills groups meet weekly term time only. Our aim is to support children to interact and use functional communication skills in situations by learning how their behaviour affects others.

For individuals with LD/GDD who engage in behaviours that challenge we use positive behaviour support framework to decrease such behaviours.

Positive Behaviour Support is a person centered approach to supporting individuals whom as a result of the impact of their disorder may present with behaviours that challenge.

The aim of PBS is to understand the person as a whole – medical, physical, mental and environmental history in trying to establish the reasons why he/she is engaging in behaviours that challenge.

Behaviours that challenge are extremely complex and often require an assessment to understand the triggers and consequences that maintain the behaviours. For some individuals, one behaviour can occur for multiple reasons and for others several different behaviours can occur for the same reason.

By understanding the reasons people with LD/GDD display behaviours that challenge we can start to develop evidence based behaviour intervention plans to support the individual to have alternative means of communication.

There are many different causes of behaviour that challenge; and these vary widely between individuals. The person’s unique circumstances and history (in particular where trauma, abuse or neglect have been experienced) must be considered to fully understand the behaviour that is challenging.

At All Behaviour Consultancy, we begin by conducting a comprehensive functional behaviour assessment followed by an individualised Behaviour Support Plan based on the results of a functional assessment.

Our support plans tie in strategies that match the reason for the behaviour that challenge.  We provide high quality training for staff and support for people with LD and/or ASD who display behaviours that challenge.

We offer a flexible needs based model of training for local staff teams an we are currently offering services to schools, families CCGs, Independent care providers and charities which support children with ASD.