Adolescence in DD/LD Flashcards
Describe adolescence in DD/LD (2)
- A time of rapid physical, emotional and sexual development
- Most experience a physically ‘typical’ puberty
What are the emotional aspects of puberty that can be challenging for people with DD/LD? (2)
- Starting to look different from their peers
2. Understanding the processes of sexuality and bodily changes
Summarise the challenges for an individual who does not experience adolescence in the typical way
- Cognitive ability to manage changes
- The internal and external changes may have different consequences
- Additional changes/challenges for specific populations
- Demands vs capacities
- Language
What are 2 difficulties that people with DD/LD may have in understanding developmental changes?
- Understanding physical changes
2. Understanding and acting upon sexual thoughts and feelings
Give an example of a difficulty in understanding/adjusting to physical changes
Fairbairn et al (1995)
Female clients with MLD - menstruation demands a lot of independence and understand as a normal process
Give examples of difficulties in understanding sexual feelings/thoughts
- “Social communication” difficulties and differences in self-perception in ASD
- Sexual behaviour in “public” eg. posting pictures online
Summarise the internal factors of adolescence in people with LD/DD (3)
- Most experience biological process of puberty
- Some populations - specific changes in “symptomatology”
- Some populations - new difficulties arising from developmental delay
Give examples of syndromes which do not experience the typical process of puberty
- Turner syndrome
- Noonan syndrome
- Klinefelter’s
What is Turner syndrome?
- A chromosomal disorder affecting females
2. May not experience puberty at same rate and onset as others
Give examples of populations that experience specific changes in symptomatology
- Fragile X
- Tourette’s
- ADHD
Describe the changes in symptomatology of Fragile X
Characteristic physical phenotype becomes more apparent (Rittey, 2003)
Describe the changes in symptomatology of Tourette’s
Lessening of symptoms in some following puberty (Walker, 2002) thought to be due to hormonal changes
Describe the changes in symptomatology of ADHD (3)
- Less hyperactivity
- Continued difficulties with inattentiveness and impulsivity (Barkley, 1998)
- Increases likelihood of engaging in risky behaviour eg. drugs, crime
What new difficulties may be experienced by some populations? (2)
- General moderate learning difficulties - display lack of pragmatic/social competence towards peers (Dudley-Marling, 1985)
- Down’s syndrome: over-friendliness can increase vulnerability, language development plateaus towards late childhood (Carr, 2001)
Summarise the external factors of adolescence in DD/LD (4)
- School system eg. mainstream/special school and related social issues
- Fewer friends
- More contact with progressionals
- Symbologically stigmatised by medical model
What are the social issues created by school?
- Transition from primary to secondary
- Differences in peer groups - varied and multiple
- Transition out of school into the community
- Learned helplessness and paternalism
- Expectation of independence and self-organisation
- Increased complexity of timetabling
What factors make transitions difficult for an adolescent with DD or LD during adolescence? (2)
- Transition to secondary: differences in institutional philosophy, teaching style, staff attitudes/expectations and less support.
- Increased complexity of timetabling - difficult to schedule lessons for group/individual support (Starling, Munro, Toger & Arciuli, 2012)
- Transition to community: availability of provision, individual and family expectations vs reality
What did Zetlin and Murtaugh (1988) find about the peer groups of those with learning disabilities? (2)
- Fewer friends
2. Tended to have more relatives in their friendship group
Explain the external factor of receiving more contact with professionals in DD/LD (4)
- Understanding diagnosis - some may understand it and the reasons, welcome it, others may not understand or want additional support
- Psychosocial impact of diagnoses and medical treatment
- Functional and social consequences of diagnosis
- More time away from the classroom
Explain the role of demands vs capacities in the adolescence of LD/DD (3)
- Interplay between internal and external factors may cause particular problems for adolescents
- Capacity: the internal changes
- Demands: external changes and how you adjust
What is the role of the dynamic perspective in adolescence of LD/DD? (2)
- Biopsychosocial framework identifies the role of within child (biological), interpersonal (psychological) and environmental (social) factors and emphasis how these factors interact at multiple levels through development
- The dynamic interplay may cause issues for young people with LD/DD where the demands of adolescence exceed their capacities to manage the transition period
What is the role of language in this dynamic perspective? (3)
- SLC development is an internal factor but also external factor in terms of communciation demands
- May be involved in the onset and maintenance of mental health difficulties in adolescence and adult life (Conti-Ramsden & Botting, 2008)
- SLCN can prevent emotional wellbeing and effective psychosocial adjustment (Clegg et al., 2012)
Why is the link between SLCN and mental health criticised?
- The relationship is complex and there is no linear causal relationship
What is the relationship between adolescence and mental health? (4)
- Associated with onset of MHD
- Prodromal
- Adolescents with DD may be at particular risk of MHD
- Convictions of criminal behaviour increase in adolescence
Explain why adolescents with DD may be at a particular risk of mental health difficulties?
- Genetic/biological links between developmental and psychiatric disorders (controversial)
- Internal response to their disorder eg. anxiety in ASD (Tantum, 2004)
- Higher frequency of traumatic life events
- Consequence of structural and social limitations - “neglect of emotional lives” (Dowling, 2003)
- Medical over-diagnosis or misdiagnosis of comorbid difficulties
Provide evidence of traumatic life events in LD
People with LD are more likely to experience deprivation, poverty, ‘looked after’ provision, emotional, physical, social abuse and neglect (Emerson and Hatton, 2007)
Explain the idea of “over-diagnosis”
- Diagnosing more difficulties rather than managing the typical process of adolescence in a more supportive way
Eg. ADHD rather than understanding their needs
Why is adolescence associated with onset of mental health difficulties?
Walker (2002) suggests neurobiological changes are a factor in the onset of MHD
Define prodromal
Precursor stage of serious mental illness
What are some of the challenges of working with LD/DD group?
- Mental health difficulties
2. Behavioural difficulties
Give examples of behavioural problems which may impact working with LD/DD group
- Prader-Willi: hyperphagia (overeating)
- Prevalence of 40% of behavioural problems in children and adolescents with DD (Stromme & Diseth, 2000), which is significantly higher for the typical popualtion of adolescents
- Down syndrome: fewer difficulties with mental health when compared to other LDs (Mantry et al., 2007)
