Learning difficulties

Learning disability is not a mental illness (Mencap 2010b). This term can cover a broad range of disabilities or difficulties with which a person may present (BILD 2007). Founded on the belief that people with learning difficulties are people first, learning difficulty can be defined as a significantly reduced ability to understand new or complex information or to learn new skills (impaired intelligence), with a reduced ability to cope independently (impaired social functioning) and which started before adulthood with a lasting effect on development (Department of Health (DH) DoH 2001).

People with learning difficulties have poorer health and are more likely to die prematurely than the rest of the population (DH DoH 2008). Health-related conditions that may coexist with the diagnosis of learning disability include Down’s syndrome (a lifelong genetic disorder that causes delays in development and learning (Mills 2007)), cerebral palsy, epilepsy, autism and Asperger syndrome (Mencap 2010c).

Asperger syndrome

The National Autistic Society (NAS) 2009a explains Asperger syndrome (AS) as a form of autism (see below). Although there are similarities with autism, people with Asperger syndrome have fewer problems with speaking and are often of average, or above average, intelligence. They do not usually have the accompanying learning disabilities associated with autism, but may have specific learning difficulties including dyslexia and dyspraxia, or other conditions such as attention deficit hyperactivity disorder (ADHD) and epilepsy. People with AS can find it harder to read signals such as facial expressions and body language which most of us take for granted. Thus they find it more difficult to communicate and interact with others, which can lead to high levels of anxiety and confusion, frustration, anger, depression and a lack of self-esteem.

Autism (ASD)

Autism is a lifelong developmental disorder characterized by impaired social interaction and communication, severely restricted interests and highly repetitive behaviour (Brugha et al. 2009). ‘Spectrum disorders’ is the collective term used, as the symptoms can present with varying degrees of severity (Autism Society of America 2006). Further classifications used are high-functioning autism, low-functioning autism, mild, moderate, severe and autistic traits or tendencies (Bogdashina 2006).

Autism can also occur in association with other conditions such as metabolic disturbances, epilepsy, visual or hearing impairments, Down’s syndrome, dyslexia, cerebral palsy, attention deficient disorder and ADHD (Bogdashina 2006). Other health problems that may be experienced by children with autism include sleep problems, eating difficulties, bowel problems, and difficulties developing motor skills such as holding a pencil (NAS 2009b).

Some people with autism have severe learning disabilities, and some are non-verbal. They may also have abnormal sensory perceptions, for example being hypo- or hypersensitive to tastes, smells and sounds (NAS 2009c, Royal College of Psychiatrists 2004), each altered perception possibly fluctuating between hypo- and hypersensitivity (Autism & Practice Group (APG) 2007).

However, some people with autistic tendencies are very high achievers and their oddness may show up only in their preference for being alone, lack of empathy and single-minded pursuit of their own interests (Wing 1997). Many very successful academics are thought to fall into this category (Carter 1998).

Altered sensory perception in autism

Touching, tasting and smelling – everyday experiences – inform us about the world we live in, each experience leading on to the next, assisting in learning and development. Those with autism may not be able to process the information in the same way, leading to ‘abnormal’ behaviour as the affected individual struggles to cope with altered perceptions (Table 13.1).

Table 13.1 Examples of behaviours that might result from the altered sensory perception of autism

(Autism and Practice Group 2007, Sensory Issues in Autism, p. 8)

People with autism might display what are known as autistic traits, e.g. rocking, flapping hands, or pressing fists into their eyes when experiencing a hypersensitive reaction to a sensory stimulus. This is because they are trying to induce different sensations in an attempt to block out the pain or calm themselves down. When autism causes hyposensitive sensory perception, the affected individual might bang objects/doors, seek out noises such as the vacuum cleaner, prefer tight clothing or self-injure in an attempt to cause sensations to help their brain get more information from the outside world. Aromas can be overpowering, so can background noise, and touch can be excruciating;

Contending with smell, noise and touch can cause a person to go into hypersensitive overload, leading to sensory shutdown (APG 2007). Although aromatherapy might not seem to be the obvious therapy choice for anyone with ASD, when used with discernment and care by a responsible, professional therapist, it can provide valuable support.