Learning / Intellectual Disability

Pakistan Institute of Living and Learning

Issue #: 4 Learning / Intellectual Disability

Learning disability is not

A mental illness, physical or medical illness

Dyslexia or Dyspraxia ADHD, Asperger’s syndrome

Learning/intellectual disability involves difficulty in understanding, learning of daily life tasks and maintaining relation-

ships. The worldwide prevalence of learning/intellectual disability is approximately 1%, however, the majority of the peo-

ple with learning/intellectual disabilities remain undiagnosed and don’t receive any specific help. Evidence suggests that

specialized care and training can bring significant improvement in their ability to learn. We must ensure that every person

receives effective support and care so that they can achieve their maximum potential.

How to support someone with Learning

Disability:

1. Take charge of your child’s education

2. Understand how your child learns (visual learn-

er, auditory learner, kinesthetic learner)

3. Help them to develop and maintain good rela-

tionships

4. Encourage them to participate in activities they

enjoy.

5. Give frequent feedback

6. Teach them in small and short steps

7. Help them to learn different problem solving skills

8. Focus on what they are best at and help them to

master those skills

9. Focus on maintaining a healthy life style

A person with a learning disability

might face difficulty in:

Thinking, understanding and learning new

information

Planning and taking decisions

Doing daily tasks (e.g. Using money)


Prof. Nasim Chaudhry,

CEO

Our Mission

The mission of Pakistan Institute of Living and Learning (PILL) is to improve the

health and well being of people with an emphasis on mental health difficulties.

Our focus is on gathering evidence to inform health and social care policy. We

want to develop and test culturally appropriate treatments and if effective

contribute to the implementation into the health infrastructure.

“People with learning disability should be able to lead fulfilling lives and be valued. We as a

society should learn to accept, understand and help them achieve their true potentials”

Some reasons of learning disability are:

Individual can be born with learning

disability due to any complication

before or during birth.

Anything happened when the indi-

vidual was young

Sometimes we don’t know the rea-

son why someone has a learning

disability.

What changes if an individual hasa learning

disability?

A learning disability does not change who you are,

what you like, or who you are friends with.

Individual with Learning Disability might need support

with:

Managing money

Doing recreational activities

Attending school and college

Look after themselves

Go to groups or activities

Activities during workshop at NPLC

learning disability is

having difficulty in under-standing information.

need support and help in doing

day to day task. These problems start before

the age of 18.

Dr. Nasim’s Workshop on Learning Disability

in Jinnah Medical College, Karachi


My Life with Haani

I was pretty ashamed to be Haani’s mother. I would constantly com-

pare my child to others. There were days I thought she was acting and

just trying to annoy us. I thought she was pretending to get attention.

“I don’t know” was something she started using too often for almost

everything she was asked about. The outcome would always be the

same. I would end up beating her up with almost anything and every-

thing I could get my hands on. Separate beatings would follow by my

husband if she made any mistakes with him. “I was exhausted being

called twice a month to discuss my child’s performance.” Each time I

went, the performance got worse. My husband and I did everything we

could. We put her in the best of tuitions, I sat with her after tuitions

then my husband would sit with her after work. “It came to such a

point that we only felt frustrated and hopeless especially when it came

to her”. One morning, I had gone for my child’s performance meeting

with the headmistress. She stated that my child is not normal. There

are some issue with her. She should be removed from school and be-

cause she is pretty, I should get her married off as soon as possible.

Outraged by this remark, my husband and I came across a psycholo-

gist who recommended a special education school to us. When Haani

started going there, things slowly started to change. “We were psycho-

educated on how to handle Haani.” I will never forget the dedication

and softness that teacher had with my child. The teacher made sure

she was taught at her own pace and wasn’t rushed into new topics. She

broke information down so beautifully. She started understanding

things better. At school too she started improving. Luckily she did not

get expelled from school. Even though my child kept improving, I will

never forget the harsh words I had to hear from other parents.

“Suggestions like my child is abnormal or laughing at the mistakes she

would make.” Calling her names. There was constant comparison be-

tween my child and theirs. They would not only criticize my child but

give me tips to be a better parent. It has been an emotional rollercoast-

er. No matter how much I try to forget, some things haunt you still.

Haani’s own story; Living with Learning Disabilities

Stupid! Moron! Idiot! Dumb! Fool! Are you retarded?

These are the words I grew up with. No one understood me. I was iso-lated to such a great extent. At school, teachers would constantly yell at me and remove me from the class. At home, any mistake I would make, I would end up being beaten up black and blue to the point I couldn’t move. I had no friends because of the labels that were at-tached to me. I was alone, confused, hopeless and majorly damaged. I felt that something is wrong with me and I would pray and wish to be normal like everyone else. Every avenue was another nightmare for me on its own. Each treating me worse than the previous ones. Through all this, one thing I am utterly proud about, my walls got higher, my pain grew weaker and I grew stronger.

Mindfulness Training at

Dar-ul-Sakoon

PILL Awareness Campaign on Learning Disability in

Karachi

Mindfulness Training at

Dar-ul-Sakoon


How can I not be stressed? Com-

pared to the other children, he is

physically and mentally lagging

behind.

Do not worry. Consult

a good psychologist.

Nida mentioned today that we

should take Kamal to a

psychologist? Okay Zeenat, it is not a problem. We will take him.

Yes, I have noticed Kamal is improving

Thanks to you. There would not be any

change, if you did not made me under-

stand. We have been so scared to take

him to a psychologist.

Mirza & Family

I spent half a day on increasing the team’s ability to assess learning disabilities;

half a day on adapting CBT therapy for people with an LD, visited a village on

the outskirts of the city to see LTP Plus in action and then discussed the neces-

sary adaptations for mum’s of down syndrome children; we visited several units

and day centres in the city and discussed how Karachi has many pockets of ex-

cellent practice especially for autism. In the gaps we looked at developing re-

search projects and I outlined what needs to be focussed on in a mindfulness

course for people with LD at day centres. Then as the evenings approached

PILL’s generosity and enthusiasm for life generally emerged and they shared

amazing locations, delicious dishes and beautiful views with me. Thanks so

much for a week that I will never forget and hopefully this is just the start of an

international endeavour to collaborate on many LD projects.

Dr. Jill Along with CEO Pill Professor. Nasim CH at Gadap Town

Dr. Jill MacGarry’s trip to Pakistan and her comments

In February this year I embarked on the most amazing adventure of my clinical

psychology career. I was invited to Pakistan to run a workshop for PILL in Karachi

at Dow University’s psychiatry department. This trip was only possible because of

the financial support of the SASHI project and the good advice, support, guidance

and welcoming approach from my long term colleague, Professor Nasim

Chaudhry.

The Understanding Learning Disability workshop was planned for 20 psychiatrists

but as the word spread the numbers grew and on the day we taught over forty

professionals. However this was only one day and I’d decided to come for seven

so my days were filled with great learning, sharing and action, thanks to the dedi-

cated team at PILL. Dr. Jill at Dow University, Karachi


Developing Low Cost Culturally Adapted Mindfulness Based Intervention For People with Intellec-tual Disabilities In a Low Income Country

(MINDFULNESS)

This project is to develop a low cost culturally adapted mindfulness based intervention and assess its ac-ceptability and feasibility for people with intellectual disabilities (ID) in a low income setting. This Inter-vention comprises of 12 weekly sessions of simple mindfulness based exercises like breathing, body scan, guided meditation, mindful stretching and walking.

Feasibility trial of learning through play (LTP) in my own way Plus Cognitive behavior therapy (CBT) as parent based intervention for distressed mothers with Down syndrome children

(UMEED)

The objective of this study is to assess acceptance of ‘LTP in My Own Way Plus’ intervention for depressed mothers of Down syndrome children. All mothers will receive 12 sessions of LTP in my own way Plus. We are hoping that these sessions will help mothers to improve their knowledge about child development and also to improve their interaction with child.

PILL Projects

Intellectual Disability and Self Harm

Individuals with intellectual disability (ID) have significant limitations in their intellectual functioning i.e. reasoning, learning, problem solving, abstract thinking, judgment, planning and learning from experience. They also have difficulties with everyday living such as, communication, social and practical skills e.g. getting dressed and using the restroom without help. These limitations hinder these people to adequately adjust in their environment. Further, lack of support from family and rejection increases the intensity of their disability, that eventually causes other mental problems such as depression and behavioural problems.

Intellectual disabilities often co-exist with other neurological, psychological or sensory problems, including sei-zures, vision problems, hearing problems, and psychological disorders.

It’s very important to understand why a person with ID is self-harming and what has changed for them rather than just focusing on the self-harm behaviour itself. To help reduce self-harm among individuals with ID, it is necessary to work on preventive measures. Keeping close contact, sharing their ideas, exploring their thinking patterns, enhancing problem solving skills and stress management would greatly benefit these individuals. Distrac-tion, socialization, decrease in substance use and finding alternative ways of expression are often effective ways to reduce self-harm. Appropriate referral for medical help in case of neurological, biological or sensory problems and psychiatric help for psychological problems is necessary. A psychologist can help with analysing the behaviour and occupational therapists can help understand the sensory needs and problems of an individual. Rehabilitation ser-vices also enhance their adjustment, social interaction and problem-solving skills. Maintaining a safe environment where access to dangerous material like knife, scissors, or any other tools may be essential. Constant supervision is needed if anyone with ID has attempted suicidal act or talking about it, and hospitalization should be considered if needed.

Why people with ID self-harm?

Pain/discomfort and physical health problems Learned behaviour Communicate emotions or need for response Low level of educational attainment Low income or unemployment Being unmarried Adverse childhood experience or trauma Lack of social support

Isolation and withdrawal Coping deficits Rejection from social environment Lack of control over their lives Block out feelings Mental illness Lack of meaningful activities Disturbance in sensory stimulation Deprived environment


Lahore 042-35912278 Peshawar 0348-0889909

Quetta 0308-3869545 Hyderabad 0333-2837134

KARACHI (Head Office) Address: 11-C, 6th Commercial

Lane Zamzama,

Phase-5, Karachi

021 -36703712, 0335-1024935

Editorial Board

Mrs. Afshan Qureshi, Mrs. Rakhshi Memon, Usman Arshad, Arqum Ali, Uzma Omer, Sameen Ali, Marvi Channah, Farhat-ul-ain, Zunairah Fawad and PILL team

Learning / Intellectual Disability

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Transcript of Learning / Intellectual Disability