Emotional Problems In Adults with Learning Disabilities

The daily demands and forces that affect adults, though different from those affecting children, are nonetheless significant. From the perspective of learning disabilities we all agree that children with learning disabilities grow up to be adults with learning disabilities. The consequences of their learning disability, however, change. The arena shifts from school to work and community. The implications become more significant. The child with learning disabilities may rely on family and school for support. The adult with learning disabilities, however, often struggles to find a support system. Therefore, adults with learning disabilities may be at increased risk to develop emotional problems and specific psychiatric disorders as a consequence of their learning disability in the adult years.

Professionals need to recognize the logical consequence of increased feelings of helplessness, hopelessness, lower self-esteem and lack of assertive skills that arise as the result of living day in and day out with a handicapping disability, particularly one that for many adults with learning disabilities, was either inadequately identified or not identified, and was even less likely to have been treated. I urge my fellow mental health clinicians, counselors and advocates to do the following:

1. Recognize and accept that a child with a learning disability grows up to become an adult with a learning disability. 2. Listen carefully to what our clients and patients say. 3. Obtain careful childhood histories, as those individuals with learning disabilities and psychiatric problems in childhood likely continue to have both problems in adulthood. 4. Do not assume that all individuals with histories of learning disabilities will experience emotional problems but recognize that all will be affected to some extent. 5. Reasonably assume that most individuals with learning disabilities have had a much more difficult life course emotionally and are more likely to experience feelings of low self-esteem. 6. Adults with learning disabilities can and do experience more life and vocational problems than others. For some, these problems are invasive and intrusive. For others, they are fairly subtle. 7. Many individuals with learning disabilities use other strengths to compensate for their disabilities and develop a variety of coping strategies, allowing them to function well in every day life. 8. Listen carefully when taking a history. An undiagnosed learning disability may, in some individuals, represent a significant variable to explain the course of reported emotional problems. 9. With increased community acceptance and recognition that learning disabilities represent a life time phenomenon, medical, mental health and educational professionals are going to find themselves supporting and treating more and more of these individuals. As adult learning disabilities become popular, these individuals are also excellent targets for the marketing of all kinds of fads, mythical treatments, and unproven remedies. Knowledge professionals can offer their patients and clients a powerful sense of hope by being available and providing accurate information, understanding, and support. Although much of the science in adult learning disabilities remains in the future, common sense and clinical judgment can offer great help today.

To avoid the tendency to blame the person for their lack of flexibility, it is important to understand the neurological basis for this difficulty with adjusting to change. With this said, through social skills practice, adults with learning disabilities can improve their ability to tolerate change. In addition, parents, instructors, and other professionals can help adults with learning disabilities by making transition processes easier through understanding and accommodating the adults' needs.

Some warning signs of psychological difficulties

Low self-esteem is a common issue for kids with LD. Dr. Robert Brooks, a psychologist, Harvard Medical School professor, and expert on self-esteem, categorizes the signs of low self-esteem in kids as either "direct" or "indirect." Direct indicators include words or actions that suggest that a child lacks self-confidence, is overwhelmed by challenges facing him, or has little hope for future success. At times, however, according to Dr. Brooks, signs of low self-esteem may be masked by a variety of self-defeating coping strategies, such as: Quitting, when tasks become difficult or frustrating; Avoiding a task or activity for fear of failing; Clowning, to hide lack of confidence or to relieve pressure; Controlling, to counteract a sense of helplessness; Being aggressive and bullying, to fend off feelings of vulnerability; Denying, in order to manage the pain they would feel if insecurities were acknowledged; Being impulsive, finishing tasks as quickly as possible "just to get it over with."

Occasional and short-term use of these unproductive coping strategies is probably not a cause for concern. But when they become the habitual way a child approaches daily tasks, interfering with learning, growing, and enjoying life, it's time to look at the feelings behind the behavior. Some kids with learning difficulties may become either anxious or depressed as a result of ongoing academic and non-academic struggles related to their LD. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), which is used by physicians to diagnose psychological problems, a child who is anxious may seem worried most of the time; may act nervous in certain settings, such as in crowds of people, at school, or when expected to perform; or may fear being separated from home or from parents or other adults to whom he's attached.A child who is depressed, according to DSMIV criteria, seems sad or irritable most of the time; loses interest and pleasure in many activities she used to enjoy; over-eats or loses her appetite; feels inappropriate guilt; has trouble thinking, concentrating, and making decisions; feels worthless or hopeless. (Note: These are not complete lists of symptoms; only a qualified professional can diagnose anxiety or depression in your child.) If you are worried that your child may be experiencing psychological difficulties, discuss your concerns right away with your pediatrician, family physician, or a mental health professional. As an expert on your child's personality and typical behavior, you play a critical role in identifying early signs of possible problems. By taking action when you first notice that your child is having problems, you can begin to support her to regain her self-esteem, motivation, and the pleasure she gets from friends, family, and daily activities.In the next few months, upcoming articles in this series will focus on particular psychological difficulties that can affect children with LD, such as anxiety, depression, or loneliness, and what research shows about effective approaches for coping with these challenges

Adults with Learning Disabilities: A Call to Action

In a 1985 paper titled "Adults with Learning Disabilities: A Call to Action," the National Joint Committee on Learning Disabilities articulated the following concerns about the issues faced by adults with LD, all of which unfortunately still hold true today: Learning disabilities are both persistent and pervasive throughout an individual's life. The manifestations of the learning disability can be expected to change throughout the life span of the individual. At present there is a paucity of appropriate diagnostic procedures for assessing and determining the status and needs of adults with learning disabilities. This situation has resulted in the misuse and misinterpretation of tests that have been designed for and standardized on younger people. Older adolescents and adults with learning disabilities frequently are denied access to appropriate academic instruction, prevocational preparation, and career counseling necessary for the development of adult abilities and skills. Few professionals have been prepared adequately to work with adults who demonstrate learning disabilities. Employers frequently do not have the awareness, knowledge of, or sensitivity to the needs of adults with learning disabilities. Corporate as well as public and private agencies have been unaware and therefore have failed to accept their responsibility to develop and implement programs for adults with learning disabilities. Adults with learning disabilities may experience personal, social, and emotional difficulties that may affect their adaptation to life tasks. These difficulties may be an integral aspect of the learning disability or may have resulted from past experiences with others who were unable or unwilling to accept, understand, or cope with the persons' disabilities. Advocacy efforts on behalf of adults with learning disabilities currently are inadequate. Federal, state, and private funding agencies concerned with learning disabilities have not supported program development initiatives for adults with learning disabilities.While much progress has been made in many of these areas, coordinating services and supports for adults with LD and finding ways to support this population with essential information and effective resources remains an enormous challenge.