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Student Life

Communicating with people with learning disabilities

BMJ 2005; 330 doi: (Published 01 June 2005) Cite this as: BMJ 2005;330:0506254
  1. Keri-Michèle Lodge, second year medical student1
  1. 1Leicester Warwick Medical Schools

In this part of our series on communication, Keri-Michèle Lodge looks at the problems facing people with learning difficulties

“I hate doctors,” says Jim with his electronic Lightwriter communication aid. Jim is 23 years old and has severe learning disabilities, dysarthria, and an overwhelming dislike of doctors.

There are about 210 000 people with severe learning disabilities like Jim in the United Kingdom.1 Another 1.2 million have mild or moderate learning disabilities.1 Learning disabilities decrease a person's abilities to understand, remember, or express information or to learn new skills, affecting their intellectual and social development throughout life.2 People with learning disabilities may have difficulties with spoken and written language, coordination, attention, or self control.3 Often, learning disabilities coexist with other conditions, including physical impairments, sensory impairments, or behavioural disorders.

Worse health

People with learning disabilities are a vulnerable and socially excluded group. David Congdon, head of external relations for Mencap, a UK charity working with people with learning disabilities, says that people with a learning disability have worse health than people generally. “They are three times more likely to die from respiratory disease,” he says. Other health problems that are more common are dental disease, coronary heart disease, gastrointestinal cancers, sensory impairments, dementia, schizophrenia, epilepsy, thyroid problems, osteoporosis, and sedentary lifestyles. Smoking and alcohol consumption are less common.4


I wish my doctor would talk to me

Despite having greater health care needs than the general population, a recent Mencap survey showed that people with learning disabilities experience problems accessing health care.5 Communication problems were a key issue. Some people with learning disabilities find it difficult to communicate pain or distress in an understandable way and may express this by changes in behaviour or personality. They are also less likely to report an illness and symptoms. …

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