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Learning disability profiles
This page is still being developed as a resource for therapists.
Profiles on specific conditions that Complementary Therapists are most likely to encounter while working in special needs.
 | Fragile X Syndrome |
| Down's Syndrome |
| Autism |
| Attention Deficit |
| Epilepsy |
| Cerebral Palsy |
| Links to resources and more information |
Fragile X Syndrome
Fragile X is the most common hereditary condition causing mild learning problems to more severe learning disabilities. It is also characterised by specific physical and behavioural features. It affects mostly males, with females more likely to have milder symptoms, or be a carrier without symptoms. A simple blood test can show if a woman is a carrier of the Fragile X gene.
While Fragile X may not be immediately apparent in early childhood, the symptoms become more marked as the child grows older. Typical physical features include:
| Enlarged ears |
| Prominent chin |
| Elongated face |
| Behavioural problems include: |
| Attention Deficit |
| Speech difficulties |
| Autistic-like behaviours |
| Hand biting |
| Aversion to touch and noise |
| Poor eye contact |
| Common physiological problems include: |
| Muscular-skeletal and connective tissue abnormalities |
| Flat feet |
| Frequent ear infections |
(Fragile X Society 2002)
People with Fragile X Syndrome experience very similar problems to those encountered in Autism and Attention Deficit Disorder: a strong resistance to change; hypersensitivities to their environment; with frequent outburst, tantrums and frustrated behaviour.
Down's Syndrome
Down's Syndrome is one of the commonest chromosomal disorders affecting approximately 1 in every 600-700 births (Clark 1982). It carries certain typical physical features:
| Short stature |
| Smaller head and shorter neck |
| Small mouth where tongue appears larger |
| Delayed or abnormal dental development |
| Dry skin |
| Alopecia in adulthood |
| Frequent eye infections due to lack of enzyme lysozyme in the tears |
| Frequent colds and respiratory infections due to mouth breathing |
| Cardiac abnormalities |
| Hearing problems |
| Umbilical hernia is common |
| Poor peripheral circulation in hands and feet |
| Tendency to be overweight |
| Cerebral Palsy and Epilepsy is rare |
You will encounter varying degrees of learning disability with Down's Syndrome; some can be very able, other much more handicapped. Unfortunately as improved healthcare enables people with this condition to live much longer, we are seeing a greater proportion with the onset of Dementia in middle age.
Some people with Down's Syndrome can be very sociable and extrovert. They may thrive on attention, be over-trusting and uninhibited in their social (and sometimes sexual) behaviour. You may need to agree clear boundaries of what is acceptable and what is not as they will carry their experiences with you into other relationships where touch and trust may not be so appropriate.
Autism
Autism affects 500,000 people in the UK. It affects the way they learn, communicate, and affects their understanding of social situations and behaviour.
People with autism often have very restricted interests, which can be ritualistic and obsessive. They will not actively seek interaction and have a very different view of the world.
Autism can affect people in varying degrees.
Receiving and processing sensory information can be particularly difficult with too much at once being overpowering and confusing. The man features relevant to the therapist are:
| Communication and understanding difficulties |
| Inability to read body language and facial expressions |
| Unable to pick up on social cues as to what is acceptable and what is not |
| May be hypersensitive to certain sensory stimuli |
| Protective of their own personal space |
| Resistant to change and new routines |
| Obsessive interests |
| Fascination with objects or parts of objects |
| May seek self stimulation such as hand flapping or spinning |
Attention Deficit Disorder or Hyperactivity
Sometimes called ADD, or ADHD if hyperactivity is also involved (AD/HD).
AD/Hd is a common feature accompanying other disorders such as Autism or Fragile-X Syndrome. It can also occur with specific learning disabilities such as dyslexia. Typical features are:
| Distractibility |
| Excitability |
| Lack of concentration |
| Disruptive |
| Easily angered or aggressive |
| Tantrums |
| Impulsive |
| Obsessive |
Work within their attention span and always end your sessions on a positive note. Massage can also be taught as a useful part of a relaxation routine or to gain their attention for important tasks such as washing or cutting nails and hair.
Epilepsy
Although not a cause of learning disabilities, epilepsy affects a greater proportion of this client group.
There is a lot of incorrect information regarding the use of essential oils and epilepsy. Some publications recommend avoiding Aniseed, Dill, Rosemary, Fennel, Hyssop, Sage, and more recently, even Evening Primrose has been reported to be linked to seizures. However, in the sort of dilutions used for massage, epileptics are probably at more risk from the strong smell triggering a seizure than any adverse effect of the essential oil through absorption via the skin. As strong smells can trigger seizures, it would be wise to avoid strong overpowering fragrances.
Many publications list Rosemary and other camphor containing oils as contraindicative to epilepsy, while some maintain that it is a useful anticonvulsant when used in low dilution (2%) (Price et al. 1995). Epilepsy can result in frequent injuries from the seizures.
Calming essential oils with established relaxation techniques have recently proved very effective in controlling anxiety-induced seizures (Betts, 2002)
Know what to do in the event of a seizure and plan the massage position carefully to minimise risk from falling.
Cerebral Palsy
Like epilepsy, not everyone with this condition has a learning disability although the two do often accompany each other.
Cerebral Palsy is due to motor nerve damage due to congenital problems, physical trauma before or during birth, prematurity or low birth weight, or as in many cases, the cause may be unknown.
Cerebral Palsy can affect people in varying degrees of severity from mild which may only slightly affect posture and small motor control, to severe symptoms which can affect both limbs down one side (hemiplegic) or all four limbs (quadriplegic), or the lower limbs only (diplegia) affecting the larger motor movements, coordination and speech.
Severe cerebral Palsy can also affect swallowing action. It can also result in deformation of muscles around joints and can cause curvature of the spine. Hip dislocation is also a common complication in Cerebral Palsy particularly in quadriplegia.
Therapists need to be working towards maintaining skin integrity, motor and muscle control with various neural stimulation and remedial massage techniques.
More information on Cerebral Palsy from http://www.about-cerebral-palsy.org/
References and information
Betts T(2002) Using smell as a countermeasure against epilepsy: Why is it so successful? Report to the IFPA Conference 12 October, Harrogate
British Institute of Learning
Disabilities (BILD) Fact sheets and publications
Campion House
Green Street
Kidderminster,
Worcestershire, UK. DY10 1JL
Phone: 01562 723010
http://www.bild.org.uk/index.htm
Clark, D. (1982) Mentally Handicapped People: Living
and Learning. Bailliere Tindall
The Fragile X Society. (2002) 53 Winchelsea Lane, Hastings, East Sussex, TN35 4LG. Tel: 01424 813147
MENCAP
123 Golden Lane, London EC1Y 0RT
Tel: 020 7454 0454
http://www.mencap.org.uk/index.htm
Mencap works with children and adults with a learning disability and their
families and carers to improve their lives and opportunities.
National Autistic Society (2002) at http://www.nas.org.uk/index.html
Price, S., Price L. (1999) Aromatherapy for Health Professionals. London: Churchill Livingstone
The UK Learning Disabilities
Website at http://www.uklearningdisabilities.co.uk/
Offers information and links to
most of the information you will need about legislation, services and
conditions.
Royal National Institute for the
Blind (RNIB) Fact sheets including sensory and multiple
disabilities.
PO Box 173
Peterborough PE2 6WS
Tel: 0845 702 3153
http://www.rnib.org.uk
© Jane Ellwood 2002