scholarly journals OpenSAFELY: Risks of COVID-19 hospital admission and death for people with learning disabilities - a cohort study

2021 ◽  
Author(s):  
◽  
Elizabeth J Williamson ◽  
Helen I McDonald ◽  
Krishnan Bhaskaran ◽  
Alex J Walker ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Down Syndrome ◽  
Cerebral Palsy ◽  
Learning Disability ◽  
Hospital Admissions ◽  
Geographical Location ◽  
Hazard Ratios ◽  
Level Data ◽  
Related Hospitalisation ◽  
Adults And Children

AbstractObjectivesTo assess the association between learning disability and risk of hospitalisation and mortality from COVID-19 in England among adults and children.DesignWorking on behalf of NHS England, two cohort studies using patient-level data for >17 million people from primary care electronic health records were linked with death data from the Office for National Statistics and hospitalization data from NHS Secondary Uses Service using the OpenSAFELY platform.SettingGeneral practices in England which use TPP software.ParticipantsParticipants were males and females, aged up to 105 years, from two cohorts: (1) wave 1, registered with a TPP practice as of 1st March 2020 and followed until 31st August, 2020; (2) wave 2 registered 1st September 2020 and followed until 31st December 2020 (for admissions) or 8th February 2021 (for deaths). The main exposure group was people included on a general practice learning disability register (LDR), with a subgroup of people classified as having profound or severe learning disability. We also identified patients with Down syndrome and cerebral palsy (whether or not on the learning disability register).Main outcome measures(i) COVID-19 related death, (ii) COVID-19 related hospitalisation. Non-COVID-19 related death was also explored.ResultsIn wave 1, of 14,301,415 included individuals aged 16 and over, 90,095 (0.63%) were identified as being on the LDR. 30,173 COVID-related hospital admissions, 13,919 COVID-19 related deaths and 69,803 non-COVID deaths occurred; of which 538 (1.8%), 221 (1.6%) and 596 (0.85%) were among individuals on the LDR, respectively. In wave 2, 27,611 COVID-related hospital admissions, 17,933 COVID-19 related deaths and 54,171 non-COVID deaths occurred; of which 383 (1.4%), 260 (1.4%) and 470 (0.87%) were among individuals on the LDR. Wave 1 hazard ratios for individuals on the LDR, adjusted for age, sex, ethnicity and geographical location, were 5.3 (95% confidence interval (CI) 4.9, 5.8) for COVID-19 related hospital admissions and 8.2 (95% CI: 7.1, 9.4) for COVID-19 related death. Wave 2 produced similar estimates. Associations were stronger among those classed as severe-profound and among those in residential care. Down syndrome and cerebral palsy were associated with increased hazard of both events in both waves; Down syndrome to a much greater extent. Hazards of non-COVID-19 related death followed similar patterns with weaker associations.ConclusionsPeople with learning disabilities have markedly increased risks of hospitalisation and mortality from COVID-19. This raised risk is over and above that seen for non-COVID causes of death. Ensuring prompt access to Covid-19 testing and health care and consideration of prioritisation for COVID-19 vaccination and other targeted preventive measures are warranted.

scholarly journals Risks of covid-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform

BMJ ◽  
2021 ◽  
pp. n1592 ◽  
Author(s):  
Elizabeth J Williamson ◽  
Helen I McDonald ◽  
Krishnan Bhaskaran ◽  
Alex J Walker ◽  
Sebastian Bacon ◽  
...  
Keyword(s):  
General Practice ◽  
Cerebral Palsy ◽  
Cohort Study ◽  
Hospital Admission ◽  
Learning Disability ◽  
Hospital Admissions ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Population Based ◽  
Hazard Ratios

Abstract Objective To assess the association between learning disability and risk of hospital admission and death from covid-19 in England among adults and children. Design Population based cohort study on behalf of NHS England using the OpenSAFELY platform. Setting Patient level data were obtained for more than 17 million people registered with a general practice in England that uses TPP software. Electronic health records were linked with death data from the Office for National Statistics and hospital admission data from NHS Secondary Uses Service. Participants Adults (aged 16-105 years) and children (<16 years) from two cohorts: wave 1 (registered with a TPP practice as of 1 March 2020 and followed until 31 August 2020); and wave 2 (registered 1 September 2020 and followed until 8 February 2021). The main exposure group consisted of people on a general practice learning disability register; a subgroup was defined as those having profound or severe learning disability. People with Down’s syndrome and cerebral palsy were identified (whether or not they were on the learning disability register). Main outcome measure Covid-19 related hospital admission and covid-19 related death. Non-covid-19 deaths were also explored. Results For wave 1, 14 312 023 adults aged ≥16 years were included, and 90 307 (0.63%) were on the learning disability register. Among adults on the register, 538 (0.6%) had a covid-19 related hospital admission; there were 222 (0.25%) covid-19 related deaths and 602 (0.7%) non-covid deaths. Among adults not on the register, 29 781 (0.2%) had a covid-19 related hospital admission; there were 13 737 (0.1%) covid-19 related deaths and 69 837 (0.5%) non-covid deaths. Wave 1 hazard ratios for adults on the learning disability register (adjusted for age, sex, ethnicity, and geographical location) were 5.3 (95% confidence interval 4.9 to 5.8) for covid-19 related hospital admission and 8.2 (7.2 to 9.4) for covid-19 related death. Wave 2 produced similar estimates. Associations were stronger among those classified as having severe to profound learning disability, and among those in residential care. For both waves, Down’s syndrome and cerebral palsy were associated with increased hazards for both events; Down’s syndrome to a greater extent. Hazard ratios for non-covid deaths followed similar patterns with weaker associations. Similar patterns of increased relative risk were seen for children, but covid-19 related deaths and hospital admissions were rare, reflecting low event rates among children. Conclusions People with learning disability have markedly increased risks of hospital admission and death from covid-19, over and above the risks observed for non-covid causes of death. Prompt access to covid-19 testing and healthcare is warranted for this vulnerable group, and prioritisation for covid-19 vaccination and other targeted preventive measures should be considered.

scholarly journals ICTs and Music in Generic Learning Disabilities

2017 ◽  
Vol 12 (04) ◽  
pp. 101 ◽  
Author(s):  
Paraskevi Theodorou ◽  
Athanasios Drigas
Keyword(s):  
Learning Disabilities ◽  
Down Syndrome ◽  
Cerebral Palsy ◽  
Disruptive Behavior ◽  
Information And Communication Technologies ◽  
Communication Technologies ◽  
Digital Music ◽  
Information And Communication ◽  
Role Of Information

The purpose of this paper is to review the most representative studies of the last decade (2006-2015) which deal with the combination of technology and music and concern individuals with Generic learning disabilities. Particularly, the areas of needs in this paper are divided to the following categories: Depression/ disruptive behavior, Down syndrome, Intellectual disa¬bilities, Cerebral palsy and Severe/Profound disa-bilities. It is also underlined the important role of Information and Communication Technologies (ICTs) and digital music tools in promoting musical participation and as-sisting students with the pre-referred disa-bilities.

Commentary on: “Ordinary lives” means ordinary schools: towards a unitary 0-99 years policy for adults and children with learning disabilities

2020 ◽  
Vol 25 (1) ◽  
pp. 47-52
Author(s):  
Becky Hardiman
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Service Provision ◽  
Role Models ◽  
Design Methodology ◽  
Content Type ◽  
The Future ◽  
Adults And Children ◽  
Effective Inclusion ◽  
Future Of Education

Purpose The purpose of this study is to reflect on some of the challenges faced by caregivers when making decisions relating to school placements for their child with a learning disability. Design/methodology/approach Quotes from parents and caregivers, contacted via a national syndrome support charity, are shared, along with broader perspectives gained through the charity’s helpline service. Findings A number of themes are discussed, including friendships and role models; expectations and educational targets; training, speciality and capacity of staff and managing a widening gap. Originality/value When considering the future of education provision, it is important to consider some of the tensions between an ideology of inclusion and the current realities of service provision. To create effective solutions to achieving more effective inclusion, the concerns and experiences of families, as well as children, must be considered.

Adults with learning disabilities known to local authorities in Scotland: a national dataset

2015 ◽  
Vol 20 (1) ◽  
pp. 15-23
Author(s):  
Claire Stuart ◽  
Andrew McKeown ◽  
Angela Henderson ◽  
Chloe Trew
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Local Authority ◽  
Local Authorities ◽  
Data Set ◽  
Content Type ◽  
Individual Level ◽  
Level Data ◽  
Analytical Potential ◽  
Adults With Learning Disabilities

Purpose – Learning Disability Statistics Scotland collects information on adults with learning disabilities who are known to local authorities in Scotland and the services they use. The data collection supports national and local government policy making and is focused on monitoring the implementation of learning disability policy. The paper aims to discuss these issues. Design/methodology/approach – Individual level data are requested from all 32 local authorities on adults aged 16-17 who are not in full-time education and those aged 18 and over. Annual data guidance is developed in conjunction with local authorities prior to the collection and is issued to standardise the process and manage avoidable error. The collated data are extracted from local authority administrative data and records are provided on each adult regardless of whether they are currently receiving a service. Anonymisation takes place prior to upload and strict guidelines are followed to ensure it is not possible to identify individuals. Findings – The paper provides insights to the project's processes, uses, challenges and future plans. It details the position of the data outputs within a policy context and the role these might play within a broader research agenda. Research limitations/implications – This data includes only adults known to local authority services. Originality/value – The value of the project lies in its strength as a national social care data set comprised of individual level data. This methodology increases the analytical potential of the data set. This paper will be of interest to those interested in data on learning disability and those with an interest in the analytical potential of an individual level national data set.

Ordinary lives means ordinary schools: towards a unitary 0-99 years policy for adults and children with learning disabilities

2020 ◽  
Vol 25 (1) ◽  
pp. 40-46
Author(s):  
Christopher Goodey
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Design Methodology ◽  
Adult Life ◽  
Learning Disabled ◽  
General Sense ◽  
Content Type ◽  
Adults With Learning Disabilities ◽  
Adults And Children ◽  
Adult Lives

Purpose This paper aims to look forward to the next generation of policymaking on learning disability and recommends a unitary strategy covering all phases of life including childhood. Design/methodology/approach In this paper, the author addresses the policy gap between inclusion in ordinary (“mainstream”) schools and inclusion in ordinary adult life. The author asks why what has been accepted, at least in principle, for the adult two-thirds of the learning disabled population is still contested for the other, younger third. In the following sections, the author summarises the present discrepancy, compares the rights of children in general with those of people with learning disabilities and outlines the rationale for a 0-99 years focus in research and practice on learning disability, and for future government strategy to establish a 0-99 policy. Findings It is in the broad context of a unitary 0-99 years approach that policymaking must in future be addressed. The education of children is key to the success of their adult lives, and makes the policy of educating them together in ordinary schools (i.e. giving them from the start the “ordinary lives” that are the main goal of adult policy) an imperative. Originality/value The need to consider children’s rights in a general sense has not previously been applied to the field of policymaking for adults with learning disabilities.

scholarly journals Abuse of people with learning disabilities and other vulnerable adults

1998 ◽  
Vol 4 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Leila B. Cooke ◽  
Valerie Sinason
Keyword(s):  
Sexual Abuse ◽  
Learning Disabilities ◽  
Learning Disability ◽  
Residential Care ◽  
Learning Disabled ◽  
British Society ◽  
Disabled Children ◽  
Adults And Children ◽  
Vulnerable Adults ◽  
Voluntary Organisations

Workers in the field of learning disability drew attention to the problem of sexual abuse and learning-disabled children and adults only a decade ago (Sinason, 1986; Cooke, 1989), at the same time that British society first tolerated the knowledge that non-disabled children were being abused. Although guidelines have been produced and voluntary organisations such as the National Association for the Protection from Sexual Abuse of Adults and Children with Learning Disabilies (NAPSAC), the Association for Residential Care (ARC) and Voice UK have made vital contributions, psychiatric involvement and provision is uneven (ARC & NAPSAC, 1993).

Specific Learning Disabilities

2018 ◽  
Author(s):  
Christopher J. Lonigan
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Language Proficiency ◽  
Medical Condition ◽  
Neurodevelopmental Disorder ◽  
Opportunity To Learn ◽  
Specific Learning Disability ◽  
Specific Learning Disabilities ◽  
Low Achievement ◽  
Specific Learning

Specific learning disability is a common neurodevelopmental disorder affecting about 5–8% of the school-aged population. A key concept in specific learning disabilities is unexpected low achievement. An individual whose achievement in reading, math, or writing is both low and less than what would be expected based on developmental capacity and opportunity to learn and whose low achievement cannot be explained by a sensory impairment, limited language proficiency, or other impairing medical condition is considered to have a specific learning disability. This chapter provides an overview of issues and challenges involved in the identification and diagnosis of a specific learning disability, and it provides information on prevalence, epidemiology, and interventions for specific learning disabilities. Response-to-instruction models of identification hold promise for the identification of individuals with a specific learning disability, and they provide a means for the identification of false positives while enhancing the instructional context for children at risk.

Deficits in musical rhythm perception in children with specific learning disabilities

2021 ◽  
pp. 1-7
Author(s):  
Vasudha Hande ◽  
Shantala Hegde
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Language Processing ◽  
Phonological Processing ◽  
Specific Learning Disability ◽  
Specific Learning Disabilities ◽  
Target Language ◽  
Rhythm Perception ◽  
Musical Rhythm ◽  
Specific Learning

BACKGROUND: A specific learning disability comes with a cluster of deficits in the neurocognitive domain. Phonological processing deficits have been the core of different types of specific learning disabilities. In addition to difficulties in phonological processing and cognitive deficits, children with specific learning disability (SLD) are known to also found have deficits in more innate non-language-based skills like musical rhythm processing. OBJECTIVES: This paper reviews studies in the area of musical rhythm perception in children with SLD. An attempt was made to throw light on beneficial effects of music and rhythm-based intervention and their underlying mechanism. METHODS: A hypothesis-driven review of research in the domain of rhythm deficits and rhythm-based intervention in children with SLD was carried out. RESULTS: A summary of the reviewed literature highlights that music and language processing have shared neural underpinnings. Children with SLD in addition to difficulties in language processing and other neurocognitive deficits are known to have deficits in music and rhythm perception. This is explained in the background of deficits in auditory skills, perceptuo-motor skills and timing skills. Attempt has been made in the field to understand the effect of music training on the children’s auditory processing and language development. Music and rhythm-based intervention emerges as a powerful intervention method to target language processing and other neurocognitive functions. Future studies in this direction are highly underscored. CONCLUSIONS: Suggestions for future research on music-based interventions have been discussed.

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