Literature Review on Learning Disabilities

This assignment requires a thorough review of literature related to learning disabilities, covering topics such as reading acquisition, mathematics learning, writing interventions, language-based learning disabilities, specific learning disability, and response to intervention. The selected papers from the list provide insights into various aspects of learning disabilities, including subtyping, neuropsychological foundations, and issues in clinical differentiation. The research also explores mindfulness-based interventions for adolescents with co-occurring ADHD and anxiety, as well as evaluating nursing care, staffing, and patient falls. Additionally, it discusses phonological skills and their role in learning to read, improving reading of science text for secondary students with learning disabilities, and efficacy of interventions to improve motor performance in children with developmental coordination disorder.

Running head: LEARNING DISABILITY PLAN OF CARE
LEARNING DISABILITY PLAN OF CARE
Name of the Student
Name of the University
Author note

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Introduction
In the modern nursing practice, valuing person and providing them with person centered
care has become one of the key aspect of healthcare service. This new strategy of healthcare is
not just focusing about the health of the person but also provides the patient care related to his or
her culture, preference, needs, values, clinical decisions and full of response and respect. In this
process nurses prepare plan of care involving the interventions and treatment that guides the
nursing professional. This written record help nurses to keep a track of the service they provide
to their patients. According to Watson (2012), learning disability affected people are as normal
and smart as others, however they are unable to read, write, spell or recall quickly as other
people can do. Further, higher level skills such as organization, time management, abstract
reasoning and attention are also affected due to this neurological processing related issue.
Therefore, plan of care is an important aspect of learning disability affected patients. A detailed
plan of care learning disability will include role of nurses and their consistency of care. It also
ensures a holistic approach for LD patients through a transparent approach of care. The primary
benefit of using this will be the nurse’s ability to keep a track of their goal and extent of
achievement. According to the statistics of the World Health Organization, there are more than
1.5 million people in the United Kingdom is affected with learning disability and more than
250,000 children are affected with tis syndrome in England (Ehri 2017). This assignment, the
proper patient management techniques, including assessment, planning, implementation and
evaluation will be discussed. Further implementation of these in plan of care and its benefits will
be discussed thoroughly.

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Plan of care for learning disability
The plan of care for patients with learning disability should focus on holism. The holistic
care approach will help to heal the patient’s mind, body, soul in an environment that will help to
build a relationship of trust and belief between the patient and the healthcare professional.
Further the plan of care should focus on goals, such as patient centered care, recordable
interventions, observe and measure the achievement of the goal, the goals should be directive,
and understandable so that healthcare professionals can follow that. Moreover, the nature of the
plan of care should be credible and realistic and time bound. Apart from these, there are several
principles of plan of care. The principles are as follows:
 The plan of care should be proactive, planned and properly coordinated.
 the patient should be provided with choices regarding his or her own health and
care related needs
 The patient should not be removed from the community and if possible the care
should be provided in the presence of his or her family through paid carers.
 Further, the patient should be asked about the place where they want to receive
care.
 They should be provided access to activities and services like other normal people
such as education, employment, games and training so that they can improve their
health condition on their own (Gillespie and Graham 2014).
 The healthcare facility should provide them with best facility and care process as
it is their Human Rights (Melby-Lervåg, Lyster and Hulme 2012).
 They should be provided with access to social healthcare support within their own
community

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 They should be provided with proper safety and security access like other patients
within the healthcare facility.
 Finally, if the assessment and treatment related needs are not being able to
fulfilled within community care center, then these interventions c=should be
completed in a high quality healthcare facility and they should not be kept there
for longer duration as it can affect their mental stability (Solis et al. 2012).
People with learning disability requires long term support and individualized approach so
that can proactively can apply strategies that have been finalised by the healthcare experts to
manage the behavioral changes. Hence a plan of care is an important aspect of care for learning
disability patients (Gillespie and Graham 2014). The patient requires a wide range of healthcare
services that are being delivered by different agencies. Therefore, the healthcare professionals
who work in community healthcare centers should comply with the national and international
standards to prepare a compact care of plan which will be inclusive of healthcare needs of the
patients affected with learning disability (Grigorenko 2012).
There is a variation in the needs of the patients. The level of support is determined by the
individual factors such as severity of the learning disability (from mild to moderate to higher)
and the nature of the person’s learning disability. This occurs due to the presence of genetic or
environmental causes, social opportunities. Therefore, the abovementioned factors help to
facilitate the improvement in learning disability as it develops social skills and functional ability
of the affected person (Watson 2012).
Therefore, while caring for the patient with learning disability, the nurses should have
purposeful aims such as:

4LEARNING DISABILITY PLAN OF CARE
 Implement clinical processes that will help to improve the patient condition.
 Understand the socio-demographic and clinical nature as well as characteristics of
the patient so that appropriate clinical interventions can be implemented.
Different aspects of plan of care
There are several elements of plan of care that helps to maintain all these
abovementioned principles and patient needs while caring for learning disability patient. These
are patient and disorder assessment, planning of intervention and care, implementation of these
interventions and evaluation process. In the following section, the effect and contribution of
these elements in the care planning process will be described.
Assessment
Assessment is an important aspect for identification of any disease and depending on the
assessment results the severity of the disease is determined (Cavendish 2013). The assessment of
learning disability should be systematic, structured and observational so that the degree of
disability can be assessed. Therefore, the healthcare experts need proper and compact assessment
criteria so that the effectiveness of the disease syndrome can be observed at first try (Hauerwas,
Brown and Scott 2013). However, in common clinical setting the lack of assessment are
observed as the experts are unaware of the learning disability, its life-long effects and lack of
their understanding regarding acceptance, and willingness to accommodate the affected patient
within a normal healthcare facility. Further inappropriate healthcare experts regarding this
disorder and failure of present multidisciplinary team to consider the issue are primary reasons
that assessment could not occur properly (Hauerwas, Brown and Scott 2013). Therefore,

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integrating assessment and diagnosis methods should be implemented that will help in
determining
 The severity of the disorder in different social settings and effect of those on
patient’s health.
 Differential diagnosis will also be used so that distinction between different types
of learning disabilities can be identified and according to that interventions can be
applied on the patient.
 A comprehensive assessment should be used so that proper intervention plan can
be prepared as person-centered care.
 Further a special multidisciplinary team should be implemented in the care
process so that provision of the service can be met (American Speech-Language-
Hearing Association 2016).
The assessment data should be shared with patient, his or her family and the designated
healthcare expert so that they can communicate with each other to finalise a proper plan a care
for the patient according to his or her physical, emotional and cultural needs (Cavendish 2013).
Interventions and plan of care
While treating a patient with learning disability, a method namely ASPIRE is generally
followed by the healthcare facilities. ASPIRE stands for assessment, systematic assessment,
planning the intervention, implementation, rechecking the entire process and evaluation.
Assessment is an important aspect of the learning disability plan of care as it helps to gather
information regarding patient, its skills and the level of intervention which will be required to
improve patient condition. Conducting structured or semi-structured or unstructured interviews

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helps the nursing professionals to understand the abovementioned traits of patients. However, the
nursing professional should also have several skills such as knowledge of appropriate assessment
tools, proper observation skills, underpinning knowledge base so that assessments can be carried
out with proper conviction. According to Haydicky et al. (2012), it is an important aspect for
plan of care as understanding the reason for the unique behavior of the patient is important for
healthcare experts. Further, it helps to maintain and control the behaviors of patient. This helps to
understand the social behavior, aggressive nature of challenging behavior of the patient. Hence,
after primary assessment patients should be observed or interviewed so that these aspects of his
or her personality can be exposed. Further the pan of care will include, talking with patient so
that patient’s stories can be gathered (Solis et al. 2012). Further the systematic should be carried
out regarding the need pf the patient and the needs should be discussed with the family and the
patient so that important needs can be incorporated in the process. Furthermore, a goal should be
set against a specific time frame and after that action plan should be implemented that will have
each of the step, its goal and assigned time frame (Gillespie and Graham 2014). Finally, the risk
related to the care plan should be assessed and if any serious risk is present in it, it should be
replaced and managed with proper replacement of interventions. Therefore, through these
aspects the plan of care will become a document with need of the patient and his or her learning
disability, a proper plan of risk management, having duty of each member involved in plan of
care, their action and responsibilities. Further, it will be presented as the document of the entire
record of care if the patient seek healthcare assistance form some other healthcare facility, hence
it will help the patient in that situation as well. Moreover, the healthcare facility should take care
of the legislations related to plan of care for learning disability people such as The NHS and

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community care act 1990, the children care act 1989 and various care related acts (Seifert and
Epsin 2012).
Implementation of interventions
The implementation of interventions related to patient’s learning disability should be
based on the patient’s ability to adopt to the interventions that are being applied by the healthcare
facilities. The high quality and evidence based interventions that are proven to improve patient
condition might not affect a patient hence, application of intervention should be done on patient
acceptance level (Haydicky et al. 2012). While implementing the plan of care, several factors
should be kept in mind related to patient and its cultural competent care. These are the patients
dignity, its consent, communicate, explain, document and considering its cultural and social
norms. The implementation should be done on section basis so that within a short activity period
the patient is able to perform a set of activities that targets his or her mental, physical and
emotional wellbeing conclusively. Further, while applying healthcare interventions, training and
skill related interventions, social communication skills should also be implemented in the
process. This social intervention with clinical methods will target overall aspect of the learning
disability and will help in overall improvement of the learning disability. Further the healthcare
experts caring for the learning disability patient should break the activities or interventions in
smaller sections and administer probes in the process so that patient can grasp the knowledge and
skill easily without any delay (Seifert and Epsin 2012). The expert should provide daily quality
feedbacks to the patient and use diagrams and pictures to reinforce the knowledge within the
patient so that independent, well designed and intensive care plan can be implemented for the
learning disability affected patient.

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Evaluation
While assessing the effectiveness of the applied intervention, the patient’s ability to
absorb the interventions should be assessed. Depending on the severity of the learning disability,
the patient’s general skills such as reading, writing, hearing, interpretation and recall related
activities are hampered (Stuebing et al. 2012). Therefore while assessment or evaluation process
of the applied intervention these factors should be kept in mind. while discussing a general
evaluation process, the evaluation should be done inform of the patient or his or her family as
they have the right to know about their health, further, the healthcare expert should provide
evidence for evaluating some activity as best or worst as the patient has given his or her entire
strength while performing the task as the evidences will help them to understand the reason for
success of failure (Hauerwas, Brown and Scott 2013). The evaluation should be based on
interviews, observations and reviews the healthcare experts perform after the patients perform
their activities. therefore, the experts should not be biased and provide an appropriate and
effective result as depending on the evaluation result further interventions will be applied on the
patient. The base of evaluation should be patient’s improvement and depending on that
reassessment or re-prescribing any intervention should be done.
The relationship between these elements and care planning
These abovementioned elements of plan of care are interlinked to each other and
successful completion of one aspect help the healthcare expert to perform another with
perfection and conviction. Therefore, learning disability nurses should implement all of these
elements while caring for a learning disability patient so that a proper plan of care can be
prepared, implemented and evaluated for patient improvement (Kalisch, Tschannen and Lee
2012). The first element assessment helps to determine the patient level of severity and

9LEARNING DISABILITY PLAN OF CARE
according to the severity the nursing professional decides the plan of care or nursing
interventions that will be applied on the patient. Further, after the decision making process, the
implementation process starts where the nursing professionals applies different level of activities
and interventions within the process. Therefore through that applied intervention and plan of
care, the nurses try to achieve the goal for the patient. Moreover, after the time period, the
evaluation process starts and depending on the patient degree of disorder severity and patients’
improvement, the effectiveness of the interventions are judged. Therefore, using these elements
in the care process, it becomes easier for the learning disability to implement the plan of care
while complying with the national and international legislations of caring for a patient with
learning disability (Smits‐Engelsman et al. 2013).
Conclusion
While concluding the assignment the necessity of healthcare professionals trained with
the care aspects for learning disability process should be mentioned. There are more than 1.5
million people affected with learning disability only in England, therefore it determines the
severity of this disease and its related healthcare interventions. In this assignment, different
healthcare prospects of learning disability has been mentioned. The important aspects of plan of
care such as assessment, planning interventions, application of them and proper evaluation
process has been described so that their role in patient safety and plan of care development can
be properly understood. Further, these aspects helps to understand the legal and honest way to
create a healthcare intervention for people affected with learning disability.

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References
American Speech-Language-Hearing Association, 2016. Scope of practice in speech-language
pathology. Retrieved from: https://test.asha.org/policy/SP2016-00343/
Cavendish, W., 2013. Identification of learning disabilities: Implications of proposed DSM-5
criteria for school-based assessment. Journal of learning disabilities, 46(1), pp.52-57.
Ehri, L.C., 2017. Reconceptualizing the development of sight word reading and its relationship
to recoding. In Reading acquisition (pp. 107-143). Routledge.
Geary, D.C., 2013. Early foundations for mathematics learning and their relations to learning
disabilities. Current directions in psychological science, 22(1), pp.23-27.
Gillespie, A. and Graham, S., 2014. A meta-analysis of writing interventions for students with
learning disabilities. Exceptional Children, 80(4), pp.454-473.
Grigorenko, E.L., 2012. Language-based learning disabilities. In Encyclopedia of the Sciences of
Learning (pp. 1724-1727). Springer US.
Hauerwas, L.B., Brown, R. and Scott, A.N., 2013. Specific learning disability and response to
intervention: State-level guidance. Exceptional Children, 80(1), pp.101-120.
Hauerwas, L.B., Brown, R. and Scott, A.N., 2013. Specific learning disability and response to
intervention: State-level guidance. Exceptional Children, 80(1), pp.101-120.

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Haydicky, J., Wiener, J., Badali, P., Milligan, K. and Ducharme, J.M., 2012. Evaluation of a
mindfulness-based intervention for adolescents with learning disabilities and co-occurring
ADHD and anxiety. Mindfulness, 3(2), pp.151-164.
Hooper, S.R. and Willis, W.G., 2013. Learning disability subtyping: Neuropsychological
foundations, conceptual models, and issues in clinical differentiation. Springer Science &
Business Media.
Kalisch, B.J., Tschannen, D. and Lee, K.H., 2012. Missed nursing care, staffing, and patient
falls. Journal of nursing care quality, 27(1), pp.6-12.
Melby-Lervåg, M., Lyster, S.A.H. and Hulme, C., 2012. Phonological skills and their role in
learning to read: a meta-analytic review. Psychological bulletin, 138(2), p.322.
Seifert, K. and Espin, C., 2012. Improving reading of science text for secondary students with
learning disabilities: Effects of text reading, vocabulary learning, and combined approaches to
instruction. Learning Disability Quarterly, 35(4), pp.236-247.
Smits‐Engelsman, B.O.U.W.I.E.N., Blank, R., VAN DER KAAY, A.C., MOSTERD‐VAN DER
MEIJS, R.I.A.N.N.E., VLUGT‐VAN DEN BRAND, E.L.L.E.N., Polatajko, H.J. and Wilson,
P.H., 2013. Efficacy of interventions to improve motor performance in children with
developmental coordination disorder: a combined systematic review and meta‐
analysis. Developmental Medicine & Child Neurology, 55(3), pp.229-237.

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Solis, M., Ciullo, S., Vaughn, S., Pyle, N., Hassaram, B. and Leroux, A., 2012. Reading
comprehension interventions for middle school students with learning disabilities: A synthesis of
30 years of research. Journal of learning disabilities, 45(4), pp.327-340.
Stuebing, K.K., Fletcher, J.M., Branum-Martin, L. and Francis, D.J., 2012. Evaluation of the
technical adequacy of three methods for identifying specific learning disabilities based on
cognitive discrepancies. School Psychology Review, 41(1), p.3.
Watson, N., 2012. Theorising the lives of disabled children: How can disability theory
help?. Children & Society, 26(3), pp.192-202.