Theories Underpinning Work with Children with Learning Disabilities - Essay Example

An Evaluation of the Sociological and Psychological Theories Underpinning Social Work Practice with Children with Learning Disabilities IntroductionUnderstanding psychological and sociological theories, as well as social policy, is essential to the nature, suitability, and effectiveness of contemporary social work practice with children with learning disabilities. The term ‘learning disability’ refers to a particular group of people who have difficulties in learning. These difficulties are usually in mathematics, writing, and reading. Nevertheless, within social work research, learning disability has traditionally been a debated category because until now there is no general consensus about the particular attributes of the category and the individuals who should be classified in it (Howe, 2009). Traditional knowledge of learning disability generally denotes chromosome deficits, poor intelligence, and other medically identified defects. Therefore, in order to resolve this issue, it is important to understand the sociological and psychological theories underpinning social work practice with children with learning disabilities (Parrish, 2009). This essay also includes a critical evaluation of the relevant current social policy context and direction. Overview of Learning Disabilities The most accurate definition of learning disabilities is as follows: “a variety of disorders that affect the acquisition, retention, understanding, organisation and/or use of verbal and non-verbal information” (Georgas, 2003, p. 16). Although learning disabilities are believed to be acquired or hereditary, development of the disability affects a person’s social performance, relationships, family life, and emotional wellbeing. There is also an increasing awareness of the effect of socio-cultural aspects on children’s learning difficulties and styles, consequently changing the perception, assessment, and treatment of learning disabilities. Learning disabilities may work together with emotional, social, and environmental forces to impair the process of personality growth. Children with learning disabilities are prone to experience weak motivation, anxiety, and depression, and to have poor self-confidence (Burke, 2008). They usually display poor interpersonal abilities leading to social exclusion. According to Howe (2009), this vulnerable population is predisposed to antisocial behaviour, both as offenders and victims. Children in special education are especially prone to aggression, both as aggressors and victims. Numerous difficulties encountered by children with learning disabilities persist into later life. The family of a child with learning disabilities may either be helpful or harmful, which may rely on the parent-child relationship, accessibility of outside resources and assistance, cultural factors, and socioeconomic standing. Other helpful variables are relationship with teachers, suitable educational assistance, and knowledge of learning disabilities, self-understanding, and self-confidence (Gates, Atherton, & Edwards, 2007). Social work programmes try to improve protective factors and lessen risk factors. Social workers are encouraged to gain accurate knowledge of the relationships among peers, family, children, environment, and institutions to understand the importance of societal and institutional perceptions and attitudes, and the family towards children, and to take into account all environmental factors as possible goals of intervention. Working with and supporting the family may enable the capacity of the family to deal with the further pressures and burdens brought about by learning disabilities, like providing continuous social and financial support for the children with learning disabilities, collaborating with the school, and coping with the stigma. A major intervention involves helping children with learning disabilities enhance their capability to interact and communicate with peers effectively (Thomas & Woods, 2003). Unfortunately, the role and standpoint of social work in the arena of learning disabilities has been inadequately represented due to the disproportionate focus on the academic features of the disorder, alongside an inadequacy of emphasis on the psychological and social requirements and functioning of the children. Sociological and Psychological Theories This essay evaluates and discusses the influence of four theories on social work practice with children with learning disabilities: (1) social constructionism, (2) behavioural, (3) cognitive-behavioural, and (4) psychotherapy. This essay argues that a sociological and psychological understanding of the experiences and difficulties confronted by children with learning disabilities and their families and the forms of coping mechanisms exercised by them is of specific importance in enlightening social workers who try to support and help this vulnerable population. In social policy literature, individuals with learning disabilities have been labelled with different names such as ‘mentally handicapped’, ‘idiots’, ‘learning disabled’, etc (Grant et al., 2010, 3). Apparently, these labels are socially constructed by those who are in power. Berger and Luckmann (1967 as cited in Grant et al., 2010) provided the most eloquent description of ‘social constructionism’ (Grant et al., 2010, p. 19): Every individual is born into an objective social structure within which he (sic) encounters the significant others who are in charge of his socialisation. These significant others are imposed on him. Their definitions of his situation are posited for him as objective reality. He is thus born into not only an objective social structure but also an objective social world. The significant others who mediate this world to him modify it in the course of mediating it. They select aspects of it in accordance with their own location in the social structure, and also by virtue of their individual, biographically rooted idiosyncracies. Basically speaking, individuals or groups with the authority to label an individual and dictate his/her roles and needs operate based on their own classifications or perspectives. Every so often that authority is bestowed upon them by the society. For instance, individuals who are categorised by medical experts as falling within the range of learning disability are mandated to be dealt with in specific ways (Race, 2012). Hence medical professionals wield considerable influence over the availability and accessibility of education, extensively affecting the lives of numerous individuals with learning disabilities. An important suggestion of social constructivism is that an individual’s knowledge of his/her own identity and of others is entirely personal or subjective. It is not advisable for social workers to take a broad or general view of the ‘self’ and a ‘correct’ social order. On the contrary, psychodynamic models accept the presence of a general psychosocial process, and medical social workers apply that understanding to evaluate the strength and weaknesses of the social capacity of their clients (Cartledge, 2005). For social constructivists, the concept of a universal human nature is discarded. Because of this point of view, narrative professionals do not depend on developmental phases as relevant to the emergence of a disorder or treatment (Lambie & Milsom, 2010). Nevertheless, not depending on any form of common framework could be quite problematic for social workers who are trained to view all individuals as having particular characteristics in common. The influence of social constructivism on social work practice is quite new. Social constructivism offers a valuable framework for structuring social work practice with children with learning disabilities. Some of the widespread social work practice rules for children with learning disabilities inspired by social constructivism are as follows: examining, challenging, and modifying beliefs about reality; identifying problems and objectives, determining and reinforcing their current capabilities and strengths; and application of open-ended or unstructured questions in interviewing or conversing with clients (Grant et al., 2010). As a result, social workers must gain sufficient skills in employing questions to keep on with the conversation until clients show some changes, instead of trying to dictate what clients must do to cope with their conditions or to improve their lives. Unfortunately, some social workers are still working within the beliefs, ideals, and norms of the society where in they are located. Children with learning difficulties are seldom viewed as important and useful individuals in many societies and they often experience social rejection; a lot of them also experience poor health outcomes than members of the ‘mainstream’ society (Hodkinson, 2007). In the UK, termination of pregnancy can usually be performed only up to the second trimester. Yet, it is allowed to perform abortion even up to the third trimester due to foetal defect (Clark & Griffiths, 2008). Allowing this kind of abortion where the foetus is diagnosed as having deficiencies related to learning difficulties suggests that the lives of individuals with learning difficulties are viewed as insignificant. Hence, social workers helping children with learning disabilities in a society where beliefs about the lack of value of individuals with learning disabilities run rampant should try to break down these barriers towards the effective delivery of social services for this vulnerable population. In addition, these social workers have a duty to help parents who were forced to undergo abortion due to diagnosed foetal abnormality. Fortunately, through their efforts to assimilate children with learning difficulties into the mainstream society, social workers also contribute to the advancement of the rights of children with learning difficulties and thereby affect the ideals, norms and beliefs of the society (Howe, 2009), even though their expert position and the learning disability agencies of which they are often associated with may also function, paradoxically, to perpetuate stereotypes of individuals with learning difficulties. Empirical findings show that behavioural treatments requiring a precise functional assessment of behaviour is the best way of evaluating and treating children with learning disabilities. There is a great deal of literature on the value of behaviour intervention as a method of correcting or lessening problematic behaviour in children who have learning disabilities. The methods used to correct or change individual behaviour are primarily derived from the theory of operant conditioning (Thomas & Woods, 2003). Behaviour modification in social work practice is rooted in the assumption that behaviour is acquired by the person obtaining some type of reinforcement after manifesting the specific behaviour. The process of reinforcement adds more force to the behaviour (Burke, 2008). The fundamental idea of behavioural models is that, if behaviour is acquired by a person obtaining reinforcement for a particular behaviour, then it is possible to unlearn or lessen the occurrence of that same behaviour by replacing or eliminating the reinforcing factor. However, there has been disapproval within social work practice with children with learning disabilities regarding the application of uncompassionate methods in the handling of individuals with problematic behaviours. As a reaction to the manner punishment methods have been applied, a variety of behavioural treatments have surfaced. An example of this form of interventions is ‘positive programming’, a set of techniques derived from efforts in the United States which eliminates the application of punishment (Gates et al., 2007, p. 380). The techniques of positive programming are rooted in the following guidelines: a rigorous evaluation of the problematic behaviour of a child with learning disabilities should occur, which involves evaluating environmental or external variables. Teaching must be a core element of interventions and this must place emphasis on acquiring new abilities to modify the problematic behaviour, for instance, motivating the child to be self-reliant, communication abilities, and facilitating achievement and self-esteem (Gates et al., 2007, pp. 380-381). Nevertheless, a certain level of care should be taken in applying behavioural methods in social work practice with children with learning disabilities. Gates and colleagues (2007) have argued that in spite of developments in behavioural therapies, a large number of children in the UK with problematic behaviours do not have access to quality behavioural services. Moreover, behavioural interventions are rooted in an impersonal perception of human behaviour and they are not likely to acknowledge the fact that individuals have the capacity to determine their own behaviours. Cognitive-behavioural theory could hence offer a way of mitigating the occurrence of problematic behaviours in children with learning disabilities. Cognitive behavioural therapy (CBT) models have been used in social work practice with children with learning disabilities. Some of the CBT methods used by social workers are social skills exercises and self-management (Parrish, 2009, p. 131). Several researchers have discovered that the results of CBT were remarkable. CBT are used by social workers in helping children with learning disabilities unlearn or understand problematic thought processes and behavioural patterns (Burke, 2008). This form of intervention is focused on self-management and as a consequence favourable results and new means of self-management can be created which can pave the way to new opportunities for children with learning disabilities. Nevertheless, CBT has some inherent weaknesses. Clark and Griffiths (2008) has observed that intense emotions like anger can hinder CBT because these hamper information processing needed by the child. It could be that children with learning disabilities and problematic behaviours are prone to emotional confusion and frustration that may weaken the effectiveness of CBT. However, several researchers support the effectiveness of CBT for children with learning disabilities. More studies, especially in the field of social work, on the effectiveness of CBT for children with learning disabilities should be conducted (Ruegg, 2006). According to Howe (2009), for children with mild learning disabilities, and for those who have other mental health disorders, a cognitive-behavioural intervention could be helpful. Likewise, even though scanty there are some proofs that psychotherapeutic interventions can be effectively used by social workers to help children with learning disabilities. It is important to note that social work practice with children with learning disabilities beforehand depended entirely on the psychiatric perspective and the inability of this perspective to satisfy the requirements if this vulnerable population fully resulted in social services for children with learning disabilities being designated as an independent area of expertise from that of psychiatry (Simpson & Miller, 2004, p. 14). However, when children with learning disabilities do acquire other mental disorders, they should be given adequate mental health treatment. Most probably this intervention would include psychoanalytical models (Simpson & Miller, 2004, p. 14). In addition, counselling may help social workers assist parents of children with learning disabilities. A person-centred model of counselling may significantly help parents and other members of the family (Malone et al., 2000). Nevertheless, counselling suffers the same weaknesses as psychoanalytical and cognitive therapy because of the individual’s level of cognitive performance. It has been discovered that children with learning disabilities can successfully take part in therapeutic counselling but how effective counselling is for this vulnerable population requires further studies (Simpson & Miller, 2004). According to Clark and Griffiths (2008), a problem with these social work interventions is that therapeutic counselling, psychotherapy, and CBT are not quite accessible to children with learning disabilities in the UK. Children with learning disabilities are frequently exchanged between learning disability services and mental health agencies in unsuccessful efforts to acquire sufficient and appropriate treatments. A main explanation for this is the difficulty or intricacy of both the service and treatment requirements, and the lack of organised procedures for diagnosing and evaluating individual needs (Gates et al., 2007). Based on the evaluation of the four theories and their influence on social work practice with children with learning disabilities, several general guidelines can be recommended for social policy. The first guideline for social workers who help children with learning disabilities is to conduct a thorough evaluation before implementing any interventions. There must be a conclusive objective and assessments must be conducted on a regular basis. Second, chosen interventions should be motivating and empowering. The child with learning disabilities and his/her family must be actively drawn in and at the heart of the general intervention plan. Third, interventions must be person-centred and it must be always remembered that it is an individual, particularly a child, with a difficult condition. Associated with this is the idea that interventions must be comprehensive in the sense that they take into account the spiritual, biological, psychological, and social characteristics and conditions of the individual. And lastly, an integrated care model comprising a multidisciplinary perspective should be employed (Howe, 2009). These four guidelines provide important perspectives on how to help children with learning disabilities. Conclusions Children with learning disabilities are one of the most difficult service user groups to handle. There are so many aspects to take into account, ranging from social to psychological. The four theories discussed in this essay, namely, social constructionism, behavioural, cognitive-behavioural and psychotherapy, offer important explanations on how social workers could successfully help children with learning disabilities and their families. These four theories could also inform social policy in the UK in order to adequately provide for the mental health, social, and educational needs of children with learning difficulties. References Burke, P., 2008. Disability and Impairment: Working with Children and Families. London: Jessica Kingsley Publishers. Cartledge, G., 2005. Learning Disabilities and Social Skills: Reflections. Learning Disability Quarterly, 28(2), pp. 179+ Clark, L., & Griffiths, P., 2008. Learning Disability and other Intellectual Impairments: Meeting Needs Throughout Health Services. West Sussex, England: John Wiley & Sons. Gates, B., Atherton, H., & Edwards, H.M., 2007. Learning Disabilities: Toward Inclusion. Philadelphia, PA: Elsevier Health Sciences. Grant, G., Ramcharan, P., Flynn, M., & Richardson, M., 2010. Learning Disability: A life cycle approach. England: McGraw-Hill International. Georgas, J., 2003. Culture and Children’s Intelligence: Cross-Cultural Analysis of the Wisc-III. UK: Academic Press. Hodkinson, A., 2007. Inclusive Education and the Cultural Representation of Disability and Disabled People: Recipe for Disaster or Catalyst of Change? An Examination of Non-Disabled Primary School Children’s Attitudes to Children with Disabilities. Research in Education, 77, pp. 56+ Howe, D., 2009. A Brief Introduction to Social Work Theory. UK: Palgrave Macmillan. Lambie, G. & Milsom, A., 2010. A Narrative Approach to Supporting Students Diagnosed with Learning Disabilities. Journal of Counseling and Development, 88(2), pp. 196+ Malone, D.M., McKinsey, P.D., Thyer, B., & Straka, E., 2000. Social Work Early Intervention for Young Children with Developmental Disabilities. Health and Social Work, 25(3), p. 169. Parrish, M., 2009. Social Work Perspectives on Human Behaviour. England: McGraw-Hill International. Race, D., 2012. Learning Disability: A Social Approach. London: Routledge. Ruegg, E., 2006. Social Skills in Children with Learning Disabilities. Annals of the American Psychotherapy, 9(3), pp. 14+ Simpson, D. & Miller, L., 2004. Unexpected Gains: Psychotherapy with People with Learning Disabilities. London: Karnac Books. Thomas, D. & Woods, H., 2003. Working with People with Learning Disabilities: Theory and Practice. UK: Jessica Kingsley Publishers. Read More