(Gilbert, 2009). ‘Mental handicap’ becomes ‘learning disability’. The old hospitals closed and care was (and is) provided in much smaller community-based homes. Many of those with a learning disability were encouraged to live semi-independently in their own homes with multi-agency support.
Hanif: I understand that there has also been some anti-discriminatory legislation during this time?
Ziva: Yes, Hanif. There was the Disability Discriminatory Act in 1995, the ‘Valuing People’ White Paper in 2001 and the Equality Act in 2010. All of these had an impact upon those with a learning disability and will be discussed further in Chapter 4.
WHAT IT MEANS TO HAVE A LEARNING DISABILITY
PAUSE FOR THOUGHT 2.4
Marcel has Down’s syndrome. Is he ‘learning disabled’ or does he have a ‘learning disability’? To put this question another way: is Marcel disabled or does he have a disability?
Ziva: This question may not be either as simple or as rhetorical as it may at first seem. After all, in the previous section one can see how the use of language such as ‘idiots’, ‘lunacy’, ‘mentally subnormal’, ‘mental handicap’ and ‘learning disability’ changed over time and helped frame how those with a learning disability were viewed and treated.
PAUSE FOR THOUGHT 2.5
A sign noticed in a church: ‘INVALID TOILET’. Does this mean that this toilet is in-valid, not/non-valid? Or does it mean that those who use it are somehow in-valid, not valid?
Ziva: In one way, we can never really understand and appreciate what it really means to my brother Marcel to have a learning disability as such meanings are often ‘value-laden’, subjective and personal to every person who has a disability. After all, it is often claimed by those on the autism spectrum such as me, for example, that if you meet one person with autism then you have met one person with autism! However, many are likely to experience discrimination, hate-motivated crime, infantilising attitudes, a lack of understanding and poor care on the part of some (but by no means all) care professionals. It could be suggested that one of the reasons for such experiences is the nature of the disability model that has been used in order to engage with those with a learning disability. There have been two main theoretical models that have sought to explain disability: the bio-medical model of disability and the social model of disability.
Bio-medical model (Hallawell, 2009)
The person with a learning disability is seen, addressed and treated as a patient
The role of the patient is to comply with medical, nursing and social ‘treatment’
The focus is on the disability: the individual is considered to be disabled due to his or her impairment
The person is defined by his or her disability
The language around disability is one of negative terms, of deviance, lacking normality
The disability prevents the person from fully engaging within society
The person with disability has to change in order to fit into society.
Social model (Hallawell, 2009)
Although originating in the mid-1970s, the social model came to prominence in the 1990s
Has been described as being vaguely ‘Marxist’ in orientation
Suggests that there is a difference between ‘impairment’ (such as sensory or physical impairment or learning disability) and ‘disability’
Looks beyond the individual impairment or disability to examine the social, political, educational and environmental causes of disability
It is society that causes and imposes disability on the individual due to its ignorance, stereotyping and the erection of structural, physical, environmental and attitudinal barriers that prevent full engagement, inclusion and participation of the individual with a disability or impairment within society
A positive disability identity and a pride in having a disability develops out of a greater control by those with a disability of both their own lives and the services that are provided for them
An aspect of this greater control by those with a disability is independent living supported with assistance when needed, rather than communal and dependent living.
CONCLUSION
Hanif has been exposed to a number of different meanings and perspectives of learning disability. As a result, he has acquired a basic understanding of what learning disability is. The meaning and understanding of learning disability is very much multi-dimensional in nature; differences in meaning and hence understanding arise from light being shone on learning disability from a variety of different angles, from a variety of different perspectives. Again, the meaning and understanding of learning disability has changed over time and will continue to do so. This is normal!
KEY POINTS
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There is no single definition of ‘learning disability’. |
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The ways in which learning disability and its attendant health issues can affect a person are manifold. |
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It is important to know a basic history of learning disability before the current situation can be understood and to prevent historical mistakes being repeated. |
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There are different theoretical models of care, the main ones being ‘social’ and ‘bio-medical’. |
REFERENCES
Barber, C. (2011) Understanding learning disabilities: an introduction. British Journal of Health Care Assistants, 05:04; 169–170.
British Dyslexia Association (2012) What are Specific Learning Difficulties? Available at: www.bdadyslexia.org.uk/about-dyslexia/schools-colleges-and-universities/what-are-specific-learning-difficulties.html (last accessed 16 October 2014)
Department of Health (DH) (2001) Valuing People: a new strategy for learning disabilities for the 21st Century. HMSO, London.
Garvey, F. & Vincent, J. (2006) The bio-physical aspects of learning disabilities. In Peate, I. & Fearns, D. (2006) Caring for People with Learning Disabilities. Chichester, Wiley.
Gilbert, T. (2009) From the workhouse to citizenship: four ages of learning disability. In Jukes, M. (ed.) (2009) Learning Disability Nursing Practice. London, Quay Books.
Hallawell, B. (2009) Challenges for the curriculum in learning disability
