Defining learning disability: what place does intelligence testing have now?
In summary, therefore, when we endeavour to make any statements on the presence and/or degree of learning disability in children, we need to consider carefully how we define our population. Intelligence testing, or some similar psychometric procedures should be available, but with two substantial caveats. First, the results of the tests must be taken in the context of the respective test situations, and any relevant wider child/environmental factors. In practice, where testing is carried out by a chartered psychologist according to standard protocols, these considerations are dealt with, and will be cited in the commentary on the test results. Second, intelligence testing, while helpful, is not sufficient of itself for definition. There must be evidence for early onset in the developmental period. Here, it is surprising in clinical practice how often the evidence is far from clear; population migration and resultant variations in practice and documentation are contributory factors here. However, all indications are that evidence of early onset may become even more important in the near future, in the face of these latter secular trends. In addition to intelligence testing, therefore, some measure of social functioning should be made, such as a Vineland assessment. It should be noted, however, that many of the same provisos that apply to intelligence testing apply here. While the combination of the two is quite robust, just as intelligence assessment alone is insufficient, the same applies to assessment of social functioning. Furthermore, the complexities of definition by service received, for example by school attended, must be considered carefully. To ignore a child's reception into special education is to miss important information, whether in terms of the preceding background factors or the resultant impact of experience at the school. But to identify or classify a child according to type of special education received, and to then go on to make prognostic statements on that basis, is far from satisfactory. Finally, there is a need to be clear about what is meant by defining learning disability. Social context and obstacles to integration may in a sense 'define' the individual's situation. But an operationalized definition of learning disabity, including the consideration of intelligence, remains vital.
O'Brien
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Northgate Hospital, Morpeth, Northumberland, UK.
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D006801:Humans; D007223:Infant; D007361:Intelligence Tests; D007859:Learning Disabilities / Q000145:classification / Q000175:diagnosis*; D012919:Social Behavior