The adult outcome of child learning disability : a study of the psychosocial functioning of young adults with a history of childhood learning disability carried out in the Cambridge area
Psychiatric and behaviour disorder is common among people with learning disabilities. Young people at the transition stage between child and adult services are at especially high risk. Commentators on recent innovations in community-based service delivery have highlighted the need for further study of the psychosocial situation of this group. Also, the extent to which learning disability recognised in childhood has long-term consequences, in terms of both psychosocial functioning and service outcome, is as yet unclear. The present study was carried out in Cambridge Health District, between 1987 and 1992. The Health Authority School Health case notes of all children born in that district between 1967 and 1973 (N=33,800) were scrutinised to identify those who had received special education on the basis of learning disability (IQ under 80). These individuals, (aged 18-22 years at time of study) were contacted as young adults, 45% (N=149) agreeing to participate in the study. Two interviews were carried out, blind to each other: (i) psychiatric diagnosis and adaptive functioning; (ii) behaviour disorder and service contact. The cohort identified appears to have included the great majority of moderately to severely learning disabled children, on epidemiological considerations. The prevalence of psychiatric disorders found was high, but in agreement with previous studies. Much of the variance in behaviour disorder appears to be due to factors other than psychiatric diagnoses. There was a strong association between the severity of learning disability in childhood and both the subsequent capacity for independent functioning in adulthood, and also the pattern of day service/occupation in adulthood. The findings suggest that the detection of learning disability in childhood should lead to pro-active follow-up into adulthood, in order to maximise or support independent social functioning, and to detect and treat emerging psychiatric and behavioural problems.