Learning Disability Is a Growing Problem in the UK - Essay Example

Running Head: CRITICALLY EVALUATE APPLIED BEHAVIOUR ANALYSIS AS A Critically evaluate applied behaviour analysis as a method of reducing behaviour analysis in people with learning disabilities [Writer's Name] [Institution's Name] Critically evaluate applied behaviour analysis as a method of reducing behaviour analysis in people with learning disabilities Introduction This paper shall analyze and discuss learning disability in the UK and how applied behaviour analysis helps in reducing such behavioural problems. Behaviour analysis (behaviour difficulties) represents a problem of considerable clinical significance for learning disability people, and a source of much human distress in the United Kingdom (UK). Of the 97 000 children in the UK under the age of 16 with learning disabilities (Office of Population 64 Census Surveys (OPCS) 2004), the proportion with behaviour difficulties is estimated to be higher than in the rest of the population (Saxby & Morgan 2000). Quine (2003) studied a sample of 200 five to 18-year-olds with learning disabilities and identified a range of behaviour difficulties such as: attention seeking (29%), over activity (21%), temper tantrums (25%), aggressiveness (21%), screaming (22%), wandering off (18%), destructiveness (14%) and self-injurious behaviour (12%). Kiernan and Kiernan (2000) found that in a study of 68 schools for children with severe learning disabilities, 8% were thought to have extremely difficult or very difficult behaviour and a further 14% who were thought to have behavioural difficulties of a lesser nature. They calculated that somewhere in the region of 2000 children in England and Wales alone will present with severe difficulties, and that a further 3400 will present with difficulties of a lesser nature. Discussion As introduced above, the determining, the prevalence of behaviour analysis is difficult, in part because of inadequate operationalization of the term. The preferred term, behaviour analysis, is regarded by a number of commentators as problematic, because of its tendency to be used over-inclusively for a range of other conditions (Slevin 2000, Gates 2002). Consequently, in the current study, to achieve conceptual clarity the term was operational zed to refer exclusively to children with learning disabilities who predominantly demonstrated behavioural difficulties. Nihira (2000) has divided behavioural difficulties into six subcategories: violent and antisocial behaviour, rebellious behaviour, untrustworthy behaviour, destructive behaviour towards property or self, stereotyped and hyperactive behaviour and inappropriate body exposure. These six subcategories have been developed into an eight category scale: The British Association on Learning Disabilities, Adaptive Behaviour Scale-Residential and Community 2nd Edition (UKLD ABS: RC: 2) (Nihira et al. 2000). The manifestation of any behaviour that fell into any of these eight subcategories, at a level that caused parental distress, was used in this study as evidence of behaviour difficulties. Learning Disabilities and Developmental Disabilities. A relatively unexplored conceptual issue is the relationship between learning disabilities and developmental disabilities. This relationship is important to the topic of this article because the emphasis on functionality in the recent UKLD definition (Luckasson et al., 2001) is conceptually similar to that found in the definition of developmental disabilities (Beirne-Smith et al., 2000). Furthermore, Learning Disabilities have always been considered the most common type of developmental disability. As defined in the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (P.L. 98-527), a developmental disability refers to a severe, chronic condition that causes substantial functional limitations in three or more major life activities. This primary component of the definition is very similar to the UKLD definition's specification of limitations in two or more applicable adaptive skill areas. For a comparison among the major life activities from the developmental disabilities definition, the adaptive skills areas from the UKLD definition, and the areas of significant difficulty from the NJCLD definition. As can be seen, these lists are quite similar. However, Mudford (2000) has stated that before any further replication of study into the therapeutic benefits of gentle teaching, minimum requirements are required. These include, supervision by a teacher or therapist approved by McGee (2001), empirical evaluation to be supervised by a behaviour analyst, the use of a multiple across-subjects experimental design, observation to be conducted when subjects are with therapists in order to describe the independent variables of gentle teaching and finally that observations should be undertaken over a long period of time. Three issues are important to the relationship between learning disabilities and developmental disabilities. First, the definition of developmental disabilities states that they can be attributed to a mental or physical impairment or to a combination of mental and physical impairments, without regard to limited intellectual functioning. Interestingly, this differs from the definition of Learning Disabilities, which clearly specifies that "sub average intellectual functioning" must exist. Second, the list of major life activities can apply easily to individuals with learning disabilities. The point was made earlier that the adaptive skill areas identified in the UKLD definition are not specific to individuals with Learning Disabilities. Third, developmental disabilities must be manifested before the age of 22. Although there are cases, in which a learning disability may not have been recognized until a person was well into adulthood, the condition itself manifests during the developmental period. The fact that the concept of developmental disabilities requires that the condition be severe but does not explicitly require that a person have sub-average intellectual functioning focuses attention on whether a person who has a learning disability can be considered developmentally disabled. Little professional attention has been paid to this issue, although the two disabilities have periodically been linked in the literature (e.g., McLaughlin & Wehman, 2001). Nevertheless, it is theoretically possible for a person with a learning disability to meet the criteria of a developmental disability. Behavioural difficulties are a major source of parental stress (Quine & Pahl 2002), with parents often reporting a sense of powerlessness and lack of support in the problems they encounter. A recent report identified difficulties that parents encounter on a day-to-day basis in the management of their child at home (Mental Health Foundation 2004). Two frequently used approaches of therapeutic intervention with behavioural difficulties are behaviour modification and gentle teaching. Behaviour modification is a collection of therapeutic techniques derived principally from behavioural learning theories (Yule & Carr 2003), during which behaviour is modified through the systematic, contingent application of negative or positive reinforcement. A recent met analytic study on treatment effectiveness on behavioural difficulties in people with learning disabilities continues to point to the superiority of these response contingent procedures (Didden et al. 2004). Gentle teaching is a relatively new approach to dealing with behavioural difficulties, whose focus is the promotion of meaningful complex dyadic interactions' between the person exhibiting behavioural difficulties and the carers. Critics of gentle teaching have argued that as most contemporary behaviour therapists attempt to minimize, or reject the use of aversive techniques, it appears difficult to define the difference between behaviour modification and gentle teaching (Linscheid et al. 2003). Positive findings regarding the efficacy of gentle teaching have been confined mainly to case studies and other anecdotal accounts. Jordan et al. (2004) undertook a study that found that visual screening and gentle teaching were more effective than task training and the no treatment condition in reducing stereotypical behaviour. In addition, visual screening was found to be more effective than gentle teaching. Barrera and Teodoro (2003) found that self-injury did not decrease significantly with the use of gentle teaching and was reduced to its lowest levels only when restraints, edible reinforces and isolation between sessions were used in one of the experimental conditions. By way of contrast, Jones and McCaughey (2001) found that gentle teaching was the more successful intervention with one particular person in their study. Emerson (2003) has noted that gentle teaching increased the self-injurious behaviour of some of the people in their study, and stated it to be: "Highly aversive to people whose self-injury is motivated by a desire to escape others". (Emerson 2003, p. 94) The ambiguous nature of the experimental effect found in these studies perhaps supports a view that gentle teaching is not universally effective; as proponents of this approach have claimed. Thus, although there is considerable evidence of the benefit of training caregivers in the use of behavioural techniques, the literature on gentle teaching is equivocal in its conclusions, despite its widespread use within learning disability settings. For example, Mudford (2000) has undertaken a review of the gentle teaching data. He has questioned the empirical basis for the claims made by proponents of gentle teaching. He has asserted that those who are favourably disposed' to gentle teaching should be aware that embracing its use might: - Increase or maintain levels of behaviour difficulty; - Result in teachers using inappropriate alternatives when gentle teaching fails to work; - Result in possible injury to therapists; - Result in disillusionment amongst caregivers if, and or when gentle teaching fails to fulfil the promises it makes (Mudford 2000, p. 353). Therefore, the importance of establishing empirical evidence to support the use, or not, of gentle teaching for learning disability people, and other members of the multidisciplinary team was seen by the researchers as important. Recent narrative reviews of instructional research and learning disabilities, although of theoretical and practical import, have been limited by their reliance on a narrow sample of interventions, domains (e.g., perceptual processing, social skills), and/or techniques to analyze studies. The present review uses meta-analytic techniques to aggregate the research literature on intervention. (Meta-analysis is a statistical review technique that provides a quantitative summary of findings across an entire body of research; Cooper & Hedges, 2000; Hedges & Olkin, 2003). Of interest in this article is the meta-analysis of research on the effects of treatments that are based on the manipulation of instructional variables intended to induce educational change, whether in academic (e.g., reading, mathematics), cognitive (e.g., problem solving), or behavioural domains (e.g., social skills). Because of the vastness of the topic, some boundaries in our analysis were necessary. The intervention literature that focuses on administrative decisions and does not reflect a manipulation of treatment conditions (e.g., educational placement -- resource room), falls outside the boundaries. Educational research based on intervention, which occurs as an extension of the educational placement of children and adolescents with LD within various classroom placements, is included. Moreover, attention is directed to those instructional interventions only geared to students with LD. Excluded from the analysis, therefore, are interventions in which the effects of intervention on students with LD cannot be directly analyzed or parcelled out in the analysis. In addition, within the area of educational intervention, it was necessary to place parameters on the level or scope of intervention. At one end of a rough continuum we distinguished between treatment techniques that include separable elements, but that do not, by themselves, reflect a freestanding treatment (e.g., teacher presents advanced organizers). At the other end of this continuum are broad approaches that reflect policies and organizational arrangements (e.g., consulting teacher model that provides help to a student with LD in a regular classroom). We excluded those treatments that were at the top of the continuum. Although there are some grey areas in our selection, we have found it possible to identify instructional programs that are added to the typical instructional routine. Conclusion Learning disability is a growing problem in the UK, and applied behaviour analysis seems to be the most feasible and effective method of reducing behaviour analysis. The number of children classified as learning disabled (LD) has increased substantially over the last 20 years. For example, 783,000 children were identified with learning disabilities in 2000, but by 2001-04, the LD population was about 2.3 million. These children currently comprise almost 50% of all placements into special education. Although learning disability as a diagnostic entity is the largest single category of students receiving special education, simple questions such as, "Which intervention is best suited for students with learning disabilities" or more appropriately, "Which intervention works best for which subgroup of students with learning disabilities" cannot be answered. This is unfortunate because policy issues (such as "where" or "how" it should occur) related to effective instruction for students with learning disabilities will not be resolved without a clear understanding of intervention research (Martin, 2002; Bateman, 2001; graham & Harris, 2000; Hallahan, 2001; Scruggs & Mastropieri, 2000). Individuals with Learning Disabilities and those with learning disabilities both have been included in the recent debates concerning the most appropriate placements for students with special needs. Traditionally, students with Learning Disabilities most often have been served in self-contained settings designed specifically for students with that label (Polloway, 2000). Although educational services for students with learning disabilities began later than those for students with Learning Disabilities, self-contained classrooms initially were also the norm (T. Smith, Polloway, Patton, & Dowdy, 2000). References Barrera F.J. & Teodoro G.M. 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