Oliver McGowan Awareness of Learning Disability and Autism Course

📚 Course Introduction – Understanding Learning Disabilities

This section sets the stage for the entire course, emphasizing the importance of informed, compassionate care. The primary goal is to shift the learner’s perspective from simply recognizing a diagnosis to truly understanding the individual experience of people with learning disabilities and autism. It introduces the course structure and highlights its foundational role in improving patient safety and quality of care.

🕊️ Oliver McGowan

This segment focuses on the person behind the mandatory training.

• The Story: It details the tragic and avoidable death of Oliver McGowan, a young man with a learning disability and autism, in an NHS hospital.

• The Impact: Oliver’s death highlighted systemic failures, including a lack of understanding among healthcare staff regarding how to appropriately meet the needs of people with learning disabilities and autism.

• The Legacy: The training is a direct response to this tragedy, making the need for better knowledge a statutory requirement to prevent future avoidable deaths.

🤔 What are Learning Disabilities

This point defines what a learning disability is, distinguishing it from general learning difficulties or mental health conditions.

• Definition: A learning disability involves a significant reduction in intellectual ability and difficulty with everyday activities (social and conceptual skills, practical skills) that started before adulthood.

• Key Criteria: The UK definition often relies on a triad of impairment: lower IQ, impaired social/adaptive functioning, and onset before age 18.

• Spectrum: Emphasizes that learning disabilities vary in severity, ranging from mild to profound.

📋 Signs of a Learning Disability

This section explores observable indicators that might suggest an individual has a learning disability, particularly relevant for staff who may encounter undiagnosed adults or children.

• Developmental Delays: Missing typical developmental milestones (e.g., speech, walking, toilet training).

• Difficulties with Communication: Struggling to express needs, feelings, or understand complex instructions.

• Challenges with Daily Living Skills: Trouble with money management, cooking, or personal hygiene without support.

🧩 Characteristics of Learning Disabilities

This expands on the signs by focusing on common features that can affect how an individual interacts with the world and with services.

• Slower Learning: Taking longer to learn new skills or information.

• Poor Concentration: Difficulty sustaining attention on tasks.

• Behavioural Challenges: May include frustration, anxiety, or behaviours that challenge due to difficulty communicating needs or sensory overload.

• Reliance on Routine: Often thrive with predictable structure and may struggle with change.

📝 Learning Difficulties

This segment is crucial for clarifying the difference between a learning disability and a learning difficulty.

• Learning Difficulty (e.g., Dyslexia, Dyspraxia): Affects specific areas of learning (e.g., reading, writing, coordination) but does not impact overall intellectual ability. A person with a learning difficulty typically has an average or above-average IQ.

• Learning Disability: Affects overall intellectual functioning and ability to manage daily life.

• Co-occurrence: Stress that a person can have both a learning disability and a learning difficulty.

✅ Knowledge Check – Characteristics

This interactive element, usually a short quiz or scenario, tests the learner’s ability to distinguish between the various characteristics and definitions covered so far (disability vs. difficulty, mild vs. severe impairment).

⚡ Attention Deficit Hyperactivity Disorder (ADHD)

This section provides an overview of ADHD, a neurodevelopmental condition often co-occurring with learning disabilities or autism.

• Core Symptoms: Persistent patterns of inattention (difficulty focusing) and/or hyperactivity and impulsivity.

• Impact on Care: Understanding ADHD is essential as it affects how a person receives and retains information, and their ability to remain still or wait their turn in a clinical setting.

• Adjustments: Staff must be prepared to offer short, clear instructions and flexible waiting arrangements.

♾️ Autism Spectrum Disorder (ASD)

A detailed exploration of Autism, emphasizing the concept of a spectrum.

• Spectrum: Highlights the wide variation in how autism presents, affecting individuals differently in terms of severity and specific traits.

• Key Areas of Difference (The Triad of Impairment/Dyad of Impairment): Focuses on persistent difficulties in two main areas:

  1. Social Communication and Interaction (e.g., non-literal language, understanding social cues).

  2. Restricted, Repetitive Patterns of Behaviour, Interests, or Activities (e.g., adherence to routine, sensory sensitivities).

🔍 Asperger’s Syndrome (Historical Context)

While no longer a formal diagnosis in modern diagnostic manuals (it is now included under ASD), this point explains its relevance.

• Definition: Historically referred to individuals with autistic characteristics who did not have a general delay in language or cognitive development.

• Present Day: People who were diagnosed with Asperger’s may still use the term to describe themselves, and it often implies higher support needs related to social communication but preserved intellectual ability.

🔄 Learning Disability and Disorder Overlap

This crucial section addresses the high rate of co-occurrence (comorbidity) between these conditions.

• High Incidence: Explains that a significant percentage of people with learning disabilities also have ASD and/or ADHD, and vice versa.

• Compounding Needs: Staff must recognise that the presence of multiple conditions often increases the complexity of care needs and sensory sensitivities.

• Holistic View: Stresses the need to treat the whole person, not just one diagnosis.

🔬 Causes of Learning Disabilities

This provides a brief overview of the diverse factors that can lead to a learning disability.

• Genetic Conditions: Down’s syndrome, Fragile X syndrome.

• Complications During Birth: Lack of oxygen, prematurity.

• Illness or Injury in Early Childhood: Meningitis, severe head injury.

• Environmental Factors: Exposure to toxins or severe deprivation.

• Idiopathic: Stress that for many, the cause remains unknown.

✅ Knowledge Check – Disorders

Another interactive element to ensure the learner can differentiate between ASD, ADHD, and Learning Disability and understand the significance of their overlap in a care setting.

🛑 Core Difficulties (The ‘What Goes Wrong’)

This section focuses on the practical consequences of a lack of understanding in a health or social care setting.

• Communication Barriers: Staff misunderstanding or ignoring non-verbal cues or behaviour as communication.

• Diagnostic Overshadowing: Attributing a new medical symptom (e.g., chest pain) to the individual’s learning disability or autism, leading to missed or delayed diagnoses.

• Sensory Overload: Failing to adjust the environment (bright lights, noise, busy waiting rooms), leading to distress, meltdown, and inability to cooperate with treatment.

👶 Early Detection

This emphasizes the critical value of identifying learning disabilities and autism early in life.

• • Maximizing Potential: Early diagnosis allows access to therapies, educational support, and interventions that can significantly improve long-term outcomes, independence, and quality of life.

  • Family Support: Provides families with the resources and understanding necessary to support their child’s development from a foundational stage.

🗣️ Communication

This section emphasizes that communication is a two-way process and that behaviour is communication. Staff are responsible for making their communication clear and accessible.

• Types of Communication: Covers verbal, non-verbal (body language), and Augmented and Alternative Communication (AAC) methods like PECS and communication boards.

• Adapting Communication: Strategies include using simple, concrete language, allowing extra processing time, and utilizing visual aids .

• Good Practices: Highlights being person-centred, creating a calm environment, and consistently using the person’s preferred method.

• Poor Practices: Focuses on harmful errors like Diagnostic Overshadowing and ignoring non-verbal signs of distress or pain.

⚖️ Rights and Adjustments

Reasonable Adjustments

These are legally mandated changes to services, policies, or environments to ensure equal access to care. Examples include offering quiet waiting areas or scheduling longer appointments.

Legislation

Staff must understand the legal duties:

• Equality Act 2010: Enforces the duty to make Reasonable Adjustments.

• Health and Care Act 2022: Makes the Oliver McGowan Training statutory.

• Mental Capacity Act 2005 (MCA): Framework for supported decision-making and capacity assessments.

🍎 Dysphagia

Dysphagia

Defined as difficulty swallowing, it is a significant risk for individuals with learning disabilities due to the high risk of aspiration pneumonia.

Learning Disabilities and Dysphagia

Staff must be trained to recognize signs of swallowing difficulty (e.g., coughing, wet voice) and strictly adhere to Speech and Language Therapy (SALT) recommendations for modified diets and fluids .

⚠️ Safety and Reporting

Scenario – Managing Stressful Situations

Practical training on de-escalation techniques, focusing on identifying triggers, using calm language, offering choices, and providing a safe, quiet space. It stresses that physical restraint must be an absolute last resort.

Reporting Concerns

Details the duty to report suspected abuse, neglect, or poor practice immediately, following both internal and external safeguarding procedures.