ASD and learning difficulties

Question 1

what is asd?

Answer 1

Autism spectrum disorder (ASD) is the name for a group of developmental disorders that display autistic style symptoms across a wide range of severity and disability (NAS, 2016).

Question 2

what are the two main impairments of autism?

Answer 2

1. Persistent deficits in social communication and social interaction
2. Restricted, repetitive patterns of behaviour, interests, or activities.

Question 3

What is a learning disability?

Answer 3

A condition arising during the developmental period resulting in the arrested or incomplete development of the mind. It is characterised by an intellectual fuctioning that is lower than the normal population in terms of cognitive abilities, language, motor skills and social abilities. A typical IQ would be less than 70 (Bouras and Holt, 2009)

Question 4

what is the prevalence of mental health in ASD?

Answer 4

According to Simonoff (2008) study 70% of participants had at least one comorbid disorder and 41% had two or more.

Question 5

what is the prevelance of mental health disorders in learning disabilities?

Answer 5

Corbett (1979) found a total prevalence of ICD 8 mental health problems of 46%. This rate includes problem behaviour and past psychiatric disorder but not dementia. Prevalence of schizophrenia is 3%, whereas for the general population it is less than 1%

Question 6

What are the biological reasons why people with ASD are more likley to develop mental health problems?

Answer 6

1. shared underlying cognitive deficits
2. SLCN
3. Problems with diagnosis

Question 7

What are the social reasons why people with ASD are more likley to develop mental health problems?

Answer 7

1. vulnerable to family breakdown
2. vulnerable to adverse life events
3. Less likley to have strong relationships
4. Higher risk of unemployment and social deprivation

Question 8

What are the psychological reasons why people with ASD are more likley to develop mental health problems?

Answer 8

1. poorer coping strategies
2. less likley to be forward thinking
3. Awarness of differnce

Question 9

Why do the SLCN of ASD increase vulnerability for developing mental ilness?

Answer 9

Snow & Powell (2005) speculate the poor communication skills could lead to deficits in social cognition and difficulty establishing relationships, which would increase the tendency to hostile attribution and violence. More generally, it is known that children with pragmatic deficits are at risk of isolation or bullying (Bolting & Conti-Ramsden, 2000) and later have difficulty establishing long-term relationships.

Question 10

Why are people with ASD more vulnerable to family breakdowns?

Answer 10

Many families experience the task of bringing up someone with asperger syndrome as being particularly challenging. Which can cause family tensions. Family tension or breakdown is not the cause of autism or asperger syndrome, but clinical experience suggest that it may lead to emotional problems in a person with ASD. This can lead to short and long term emotional difficulties

Question 11

why are people with ASD more vulneable to adverse life events?

Answer 11

Many people with asperger syndrome attend mainstream schools and their special educational need may not be recognised. Victimization, teasing or physically bullying commonly occurs and may lead to a long standing frustrations, poor self esteem and suspiciousness of other. On the other hand, some can be ‘over sensitive’ to slight in-justifications in the past resulting in unnecessary emotional difficulties (digby, 2000)

Question 12

why are people with ASD less likley to form strong relationships?

Answer 12

DIGBY (2000)

1. Sometimes they cut themselves off - some people with asperger’s syndrome seem to cut themselves off from others, taking refuge in a special world of idiosyncratic interests routines and private preoccupations. For those who cope in this way, close friendships or sexual relations hold little attraction.
2. Sometimes other people cut them off-However other people with asperger’s syndrome are all too painfully aware of their desire for closeness and may succeed in making friendships with people of their own sex who often have some social difficulties themselves. Sexual relationships are much harder to achieve and many people with asperger’s syndrome find their self-esteem further eroded by rejections. Sometimes, when relationships do develop it is on a basis of exploitations of the person with asperger syndrome and the effect is undermining rather than rewarding. This can affect their self esteem and confidence, social difficulties tend to be ongoing throughout life, causing ongoing perpetuating distress and anxiety.

Question 13

What are the biological resons why people with a learning disability are more vulnerable to developing mental health difficulties?

Answer 13

1. shared underlying cognitive deficit
2. SLCN
3. Physical health problems
4. problems with diagnosis and treatment

Question 14

What are the psychological resons why people with a learning disability are more vulnerable to developing mental health difficulties?

Answer 14

1. poorer coping stategies
2. negative thoughts
3. less insight

Question 15

What are the social resons why people with a learning disability are more vulnerable to developing mental health difficulties?

Answer 15

1. Social deprevation
2. treatmnet from other people
3. fewer social protective factors
4. trauma

Question 16

why might there be a shared cognitive association between mental health and learning disability.

Answer 16

a. A learning disability is caused by the way the brain develops. This in itself may increase vulnerability to mental health problems, although this interaction is unclear.
b. When one considers the aetiology of depression, it is evident that people with learning disabilities are at an increased risk. There may be biological or genetic factors related to those which caused the learning disability; some conditions are associated with an increased risk of mental illness (Emerson and Hatton, 2007)

Question 17

why can physical disabilities increase the risk of mental illness?

Answer 17

a. The long term health problems can cause long-term pain which may lead to distress, irritability and anger, especially if not properly treated (Royal College of Nursing 2010).
b. Croker et al. (2013) argue that some physical health problems may lower an individual’s self-esteem, which in turn can exacerbate other problems such as challenging behaviour, e.g epilepsy and urinary incontinence in people with a learning disability have been linked to increased prevalence of mental health problems (Varghese and Banerjee 2011; Cooper et al. 2007).

Question 18

Why is mental health disorders in ASD often harder to diagnose and treat?

Answer 18

• the mood disorder might have overlapping symptoms with ASD e.g higher trait anxiety (Digby, 200)
• might be less likely to cooperate in therapy (digby, 2000)

Question 19

why do people with ASD they have a higher risk of unemployment and social deprivation ?

Answer 19

• less likely to get a job because of deficits in social communication and interaction, this can exacerbate the risk factors associated with mental illness

Question 20

How can the trait of ‘less likely to be forward thinking’ in ASD affect their mental health

Answer 20

• less likely to seek emotional support (bouras and Holt, 2009)

Question 21

Explain the awareness of difference in individuals with ASD.

Answer 21

Some children with ASD, particularly those with high-functioning ASD can become very aware of there differences. Paradoxically people with ASD become more distressed by their condition as they get older and less disabled by it, This can lead to lower self-esteem, social-isolation and so increase the chances of them developing mental illness!

Question 22

who said that social deprivation was a risk factor for mental illness?

Answer 22

Emmerson and hatton (2007)

Question 23

why are people with learning disability more at risk fro trauma/ negative life events?

Answer 23

They often have to move house into a residency, they might have had a serious injury, experienced abuse and neglect or unemployment and finial difficulties(Hastings et al 2004). Major transitions for example can be particularly stressful (kaehne, 2011)

Question 24

Why do people with learning disabilities have fewer social protective factors? and how can this lead to mental helath problems?

Answer 24

people with learning disabilities have smaller social networks. This means they have less social support and are at a higher risk of social exclusion and loneliness (stacey and Edward, 2013). Social support is an established proteting factor form mental health problems, and loneliness is a precursor to many psychological difficulties (hagerty and Williams, 1999)

Question 25

Explain how the way people treat people with a learning disability can contribute to developing mental health problems?

Answer 25

Mchale and Carey (2002)- when somebody within the family of a person with learning difficulties died, support workers often saw their grief as behaviour problems. If families, carers and professionals do not correctly identify the reason for their behaviour of a person with a learning disability, this might mean that they are not provided with the appropriate support or service provision, which might lead to mental health problems developing or worsening

Question 26

explain the poorer coping mechanisms in people with learning difficulties.

Answer 26

Emerson and Hatton (2007) recognise that difficulties in problem solving associated with some conditions contribute to increasing the likelihood of mental ill health
Zigler (2002) similarly notes increased dependency on others for decision-making

Question 27

negative thoughts in people with learning difficulties

Answer 27

People with learning disabilities are more likely to have negative perceptions of the self, their environment and the future (Sikabofori and Anupama, 2012).
Children with learning disabilities are both less optimistic about success when faced with new challenges and find less satisfaction in problem solving (Zigler, 2002 in Alim, 2012).
Many studies have demonstrated that people with learning disabilities are more likely to experience negative self-esteem (LaBarbera, 2008).
In turn, low-self esteem is a predictor for depression and related disorders such as anti-social behaviour, eating disorders and suicidal thoughts (Erol and Orth, 2011).