Signs and diagnosis of a learning disability in adults

What can cause a learning disability?

Before a child is born, their development in the womb can be affected in a way that can cause a learning disability. A child can be born with a learning disability if the child develops certain genes, the mother has an accident or illness while pregnant, the unborn baby does not get enough oxygen during childbirth, the unborn child has trauma to the head, or is born too early.

After birth, a learning disability can be caused by early childhood illnesses, accidents and seizures.

Knowing what the signs of a learning disability in adults are is important as people can then get the support they need in life.

Sometimes, people’s learning disabilities can go undiagnosed during childhood which can cause a range of problems in adulthood, including preventing them from receiving the support they may need to live their lives to the full.

People diagnosed with a learning disability and their families will be aware of what support they may need to lead independent lives. Through getting a diagnosis they can also better understand why some things in life are more difficult or takes a little bit longer.

What is a learning disability?

Learning disabilities affect people’s ability to learn new skills, understand and process information and communicating with others. However, people with a learning disability could still be able to work and live on their own, depending on which type of learning disability they have.

It is estimated around 1.5 million people in the UK have a learning disability. Around 1.3 million of those are adults with a learning disability. This is believed to be approximately 2.16 per cent of the total UK population according to the charity Mencap.

How do you know if you have a learning disability?

As an adult, knowing or even considering that you have a learning disability can be difficult because living with it for years normalises the problems.

If they are mild, symptoms of learning disabilities can be subtle but here are some signs to look out for.

Signs of learning disabilities in adults

• Difficulties in understanding information
• Problems with maths, reading or writing
• Learning new skills at a slower pace
• Problems with memory
• Problems with communication, such as speaking slowly or having a small vocabulary
• Difficulties in understanding and following conversation
• Problems with coordination
• Finding it difficult to understand concepts such as time and direction

Why getting a learning disability diagnosis is important

Without a learning disability diagnosis, the adult may be largely unaware of their needs and blame their problems on their own lack of ability. This can affect career choice, lead to low self-esteem and feelings of low self-worth, which in turn can develop into emotional and psychological issues such as depression.

It may cause the person to stop trying and feel embarrassed, when in actual fact they could very well have succeeded to achieve their educational or other goals with the right support. Receiving a diagnosis will help someone with a learning disability to get the support they need to reach their potential, improve their social skills, find satisfying employment and live their life independently.

Without a diagnosis and the right support, a person may go through their life struggling with certain aspects of daily life and not understand why. For example, someone may be able to communicate well, work and live by themselves but struggle with learning new skills such as reading and writing, the ability to do maths or processing new information.

Although autism is not classed as a learning disability, around half of those on the autism spectrum have a learning disability. Autism can sometimes go undiagnosed, particularly in women as they are generally better at hiding their symptoms and may for this reason go through their lives without getting the support that would have made their lives easier.

Getting a learning disability diagnosis as an adult

If you have concerns that you or someone you know, such as a family member, may have a learning disability you should discuss this with your GP.

The GP will be able to make a first assessment and if they believe further examination is appropriate, they can refer you to a clinical psychologist. A clinical psychologist may be able to give a diagnosis by assessing your intellectual functioning and adaptive behaviour.

What is an Adaptive Behaviour Assessment?

An adaptive behaviour assessment (ABAS-3) is a behaviour rating scale used by a psychologist to help a determine whether a diagnosis of disabilities can be made. It can identify strengths and weaknesses. It is especially useful for identifying developmental delays, autism spectrum disorder, intellectual disability, learning disabilities, neuropsychological disorders, and sensory or physical impairments.

Adaptive behaviour involves an individual’s conceptual skills (reading, writing, numeracy), social skills (interpersonal skills, social responsibility, self-esteem) and practical skills (daily living activities, use of money, safety, routines).

Intellectual functioning refers to a person’s ability to reason, plan, problem-solve, learn and understand complex ideas.

In assessing an individual, gathering information of their history and behaviour provides vital information and can assist in determining whether the criteria for a learning disability have been met.

Assessing an adult for a learning disability

To reach a diagnosis, the GP or clinical psychologist may ask you about your:

• Family and social history
• Developmental history
• Health problems during childhood
• Educational history
• Medical history and current medication
• Mental health issues
• Family interpretations of the person’s difficulties
• Previous cognitive assessments
• Vision and hearing
• Motor difficulties
• Culture

Factors considered when conducting an assessment of intellectual behaviour include:

• The environment – testing for a learning disability should take place in a well-lit, quiet room that is free from distraction.
• Mental health – assessment should not take place if the individual is distressed.
• Medication – As medications (legal or illegal) may influence an individual’s performance and should be considered during the assessment.
• Fatigue – Fatigue reduces performance, meaning assessments should not take place when the individual is unduly fatigued.
• Motivation – For tests results to be considered valid, it is important that the individual gives their best throughout the process.
• Effort – The individual may deliberately under-perform during an assessment to gain access to benefits, services or activities, which should be taken into account.
• Language, culture and ethnicity – If English is not the individual’s first language, the psychologist should acknowledge any cultural differences, attempt to understand any relevant differences and be aware of difficulties in interpretations.
• Sensory and other impairments – A poor cognitive performance could be attributed to some form of physical, language and/or sensory difficulty.

Factors considered in the assessment of adaptive behaviour:

The aim of an adaptive behaviour assessment is to determine to what extent an individual can function independently.

This information should ideally come from people who know the person well and who are familiar with how they function in daily living.

Additionally, to test conceptual skills such as reading, spelling and numeracy, the individual may be assessed using specific tests of these skills.

How to make sure you get the healthcare you need

People with a learning disability are at high risk of missing out on the healthcare they need. To use healthcare services, someone with learning disabilities may need extra support from their GP surgery.

Every doctor’s surgery has their own learning disabilities register.

People with a learning disability should make sure they are on the register in order to get extra support at the doctors, longer appointments, invitations to visit the doctor’s each year for a health check and better access to vaccines and free flu vaccines.