Multiple Learning Difficulties Research Articles

Capabilities, human value and profound disability: capability theory and its application to theatre, music and the use of humour

According to capability theory, we can identify everything that is of fundamental importance in the lives of people with profound and multiple learning difficulties and disabilities if we take full account of their human capabilities. In this paper I both acknowledge the contribution of capability theory to our understanding of the condition of profoundly disabled people and express some scepticism about the extent of that contribution, suggesting that there is more to the value of a human being than an audit of their capabilities might reveal. I explore human capabilities as discussed by Martha Nussbaum, and in connection with theatre, music and the use of humour.

Multi-sensory Storytelling to Support Learning for People with Intellectual Disability: An Exploratory Didactic Study

Abstract In this paper we present a study about multi-sensory content within the context of learning activities aimed at people with intellectual disability. A story was prepared together with traditional stimulus (audio and visual) and multisensory (audio, video, tactile and smell). Knowing that people with intellectual disability, due to their cognitive limitation, have multiple learning difficulties, namely in areas such as: communication, reading/writing and attention [1] , it is really important to create innovative and pedagogically effective solutions that may motivate them and assist their learning process. Therefore, this study presents Preliminary results showing an overall improvement regarding the participant's memory when using the very multi-sensory contents.

Personalised Learning for Young People with Profound and Multiple Learning Difficulties Colley Andrew Personalised Learning for Young People with Profound and Multiple Learning Difficulties 168pp £19.99 Jessica Kingsley 9781849053679 1849053677

WORKING WITH people who have profound and multiple learning disabilities (PMLD) is challenging. As any worthwhile book on the subject should make clear, progress is usually slow and achieved only in miniscule steps.

Philosophy and profound disability: learning from experience

Reflection on profound and multiple learning difficulties and disabilities raises a series of questions in moral and political philosophy, a claim supported by philosophical argument but also given credence by human testimony, some examples of which are presented here. I introduce three young people with profound learning disabilities, before presenting testimony on their behalf, organised so as to coincide with a series of related philosophical questions about human dignity, respect, citizenship and dependency. I suggest that there are implications that apply to all people and not only to those with profound learning difficulties.

Preferential treatment or unwanted in mainstream schools? The perceptions of parents and teachers with regards to pupils with special educational needs and challenging behaviour

This study explored the perceptions of parents and teachers regarding the differential treatment or stigma experienced by pupils with challenging behaviour – more specifically, those with behavioural, emotional and social difficulties (BESD), as well as children with visible special educational needs (Down's syndrome and/or profound and multiple learning difficulties) who frequently displayed challenging behaviour as a characteristic of their SEN. Semi‐structured interviews were conducted with ten parents of children with challenging behaviour, together with 15 educational practitioners employed in mainstream and BESD schools. Findings revealed how several parents, and staff employed in BESD schools, viewed pupils with challenging behaviour as ‘unwanted’ in mainstream schools. The remaining parents, as well as mainstream practitioners, reported the opposite and indicated that these pupils received treatment deemed to be ‘preferential’ in the mainstream. This has direct implications for those concerned with supporting pupils with challenging behaviour in mainstream settings.

Worlds apart? How pupils with statements lead a life away from the class: Findings from the Making a Statement project

IN FEBRUARY, the coalition government’s long-awaited Children and Families Bill began its passage to Royal Assent. Its first reading in Parliament set out how services relating to adoption, looked-after children and those with special education needs (SEN) will change under the proposed legislation. Following the Lamb Inquiry into parental confidence in the SEN statementing system, and several reviews into provision for types of SEN (e.g. The Salt Review on severe, profound and multiple learning difficulties, and John Bercow’s review of speech, language and communication needs), the coalition have drafted proposals that will bring about the biggest changes in SEN in 30 years. One of the most significant moves will be to replace statements awarded to pupils with the highest level of SEN with Education and Health Care Plans (EHCPs). EHCPs, like the current statements, set out a pupil’s educational needs and the provision that he or she should receive to meet them. However, little is known about the day-to-day teaching and support that pupils experience once a statement is put in place. So, with such seismic change on the cards, we might ask if the call for reform is premature. Last year, we conducted the Making a Statement (MaSt) project to find out more about the teaching, support and interactions experienced by pupils with statements attending mainstream primary schools. We shadowed 48 pupils in Year 5 who had statements for moderate learning difficulties or behavioural, emotional and social difficulties, making minute-by-minute observations. We followed each pupil for a full school week. Observations of 151 average attaining ‘control’ pupils were also collected to provide a reference point for comparison. We also produced detailed case studies on each of the statemented pupils, based largely on interviews with 195 teachers, teaching assistants (TAs), SENCos and parents/carers. Spending a week at a time carrying out observation and having discussions with practitioners and parents/carers, demonstrated that schools are making every effort to attend to the needs of pupils with statements amid a period of intense flux and uncertainty for schools and local authorities. However, quantitative and qualitative analyses of these data identified some overarching concerns that capture the MaSt study’s key results. These results, which we describe below, will be of interest to both policymakers and professionals working with pupils with SEN in schools and local authorities. Firstly, we found that a high degree of separation and TA support are strong and consistent characteristics of the educational experiences of pupils with statements. The pupils spent over a quarter of their time away from the mainstream class, the teacher and their peers. A clear point to emerge was the almost constant accompanying presence of a TA in relation to all the locations in which pupils worked. There is, in other words, an intimate connection between TAs and the locations, both in and away from the classroom,

Effects of ‘The Listening Program’ on Children with Profound and Multiple Learning Difficulties

Background: ‘The Listening Program’ (TLP), a commercially available music-based auditory stimulation technique, claims to positively affect behaviour and learning in people with autism and dyslexia through targeting auditory processing difficulties. The author investigated changes in mood (calm vs anxious), attention to task, and person engagement in young people with profound and multiple learning difficulties (including auditory processing deficit) who participated in TLP. These behaviours were also examined following exposure to regular classical music. Methods: In a multiple single case study twelve participants aged 9-19 years completed TLP plus a shorter placebo regular classical music cycle. Assessment procedures included video recording, observational checklists, the school's ‘Profound Education’ Curriculum, and a post-study questionnaire for carers. Results: Greater indications of positive change were seen in attention to task and person engagement after TLP than with regular music. These positive changes were more apparent in participants with sensory processing difficulties, particularly those with Rett Syndrome. Participants with predominantly motor impairment (cerebral palsy) did not show measurable change. Some improvement in mood was observed following both regular classical music and TLP for those with sensory processing difficulty. Conclusions: The challenge posed by carrying out studies with this client group is addressed and decision making for subsequent clinical practice is examined.

Which way next? What is the real choice for students leaving a special school?

Warnock advocated that all young people with learning difficulties should be entitled to an appropriate education beyond the compulsory age of 16. The purpose of the study was to investigate attitudes to post‐16 educational provision for students with special educational needs. What are the strengths and weaknesses of current provision and is it deemed adequate from the perspective of the student? The study reveals that despite many of Warnock's visions becoming a reality, many have not. For students with moderate learning difficulties the doors have, by and large, been opened to access mainstream further education provision at least to some extent. However, for those students with more severe difficulties, including autistic spectrum condition and profound and multiple learning difficulties, provision appears to be either inadequate or simply unavailable.

Collaboration and integration of services in Greek special schools: two different models of delivering school services

Multidisciplinary collaboration is considered to be very important for the education of pupils with special educational needs and particularly those pupils with the most severe disabilities. This research adopts a multiple case‐study design in order to understand collaboration and the integration of services and the effectiveness of these among pupils with profound and multiple learning difficulties (PMLD) in Greece. The teams, choosing case studies in five special schools, considered 10 pupils and their parents. Reviews and analyses of the legislation; the use of diaries; participant observations and semi‐structured interviews were used for the collection of data. Two different models of service integration which provide different opportunities to the inclusion of pupils with PMLD were revealed since schools have different methods of integrating health and social professionals. In the first model, the school works with outside services, whereas in the second, services are within the school. In addition, roles and responsibilities differ within the different models. Service integration and collaboration were found to be more effective in schools where teachers and health and social professionals work under the same management. The study suggests the expansion of the second model of multidisciplinary collaboration with the integration in schools of health therapists, educational psychologists and social workers.

Sounds of intent, phase 2: gauging the music development of children with complex needs

This article reports the latest phase of research in the Sounds of intent project, which is seeking, as a long‐term goal, to map musical development in children and young people with severe, or profound and multiple learning difficulties (SLD or PMLD). Previous exploratory work had resulted in a framework of six putative music‐developmental stages set across three domains of musical engagement: reactivity, proactivity and interactivity. This was intended as a first step in enabling teachers and therapists to gauge their pupils’ levels of musical development. The research described in this paper indicates that a moderately fine‐grained observation schedule (involving three sub‐levels per Sounds of intent developmental stage) may be sufficient to show longitudinal change in the observed musical engagement of pupils with PMLD, three groups of whom participated in a specially designed programme of musical activities over a six‐month period. However, mapping the individual’s levels of attainment onto their chronological ages indicates that, generally speaking, musical progress is likely to be made in tiny increments – notionally equivalent to around one Sounds of intent level during a child’s entire time in compulsory education (4–16 in the UK). This suggests that an even finer‐grained observation scheme may be of value to practitioners seeking to chart change in the longer term. It is proposed that this should be the subject of further research, and should comprise two components: level and frequency of engagement.

The curriculum for children with severe and profound learning difficulties at Stephen Hawking School

The increasing number of children with profound and multiple learning difficulties means that many schools for children with severe learning difficulties are having to review the curriculum that they offer. In addition, these schools are continuing to question whether a subject-based approach, in line with the National Curriculum, is the most appropriate way of meeting the educational needs of children working at the earliest stages of development. The staff at Stephen Hawking School, in east London, have been reviewing their curriculum over the past two years to try and meet the needs of their changing population, the needs of the National Curriculum and the suggestions and proposals in both the Rose and Cambridge reviews.

Unintentional intrusive participation in multimedia interactive environments

This paper presents data from two independent case studies, a 15 year old female with Cerebral Palsy and related profound and multiple learning difficulties and a 7 year old male with extreme behaviour associated with Autistic Spectrum Disorder. An audiovisual immersive interactive environment was developed to encourage creative interaction and expression from the participants. There were support workers present in both case studies and it is the interventions of these support staff which are the main focus of this paper. Results indicated that profuse but unintentional interventions from the staff may have distorted interaction with, dissuaded or diverted participants from meaningful engagements with the reactive feedback provided by the system.

Making music with images: interactive audiovisual performance systems for the deaf

This paper describes the technical and aesthetic approach ­utilised for the development of an interactive audiovisual performance system designed specifically for use by children with multiple learning difficulties, including deafness and autism. Sound is transformed in real-time through the implementation of a Fast Fourier Transform and translated into a moving image. This image is adapted so that relevant information can be understood and manipulated visually in real-time. Finally, the image is turned back into sound with only minimal delay. The translation process is based on research in computer music, neuroscience, perception and abstract film studies. The system is achieving a significant user base amongst the deaf and disabled community through projects involving the British Broadcasting Corporation and the London Philharmonic Orchestra. Alongside continuing collaboration with the Sonic Arts Network, the system has now been made freely available to the public, and is being developed as a speech therapy tool.

Evaluating the impact of incorporating dance into the curriculum of children encountering profound and multiple learning difficulties

In 2005, LUDUS Dance, a professional contemporary dance and dance in education company based in the English city of Lancaster, were funded by the Arts Council England to deliver a dance programme to a school for children encountering1 Profound and Multiple Learning Difficulties2. After a brief description of the project this article will adopt a standard report style to present an evaluation of the impact of incorporating dance into the curriculum of children at the school. The evaluation employs a novel quantitative technique; this is discussed, and some suggestions are made for future research in the area of evaluating the impact of dance when working with children encountering PMLD.

One step back

From 2005 to 2006 LUDUS Dance, a professional contemporary dance and dance-in-education company based in the English city of Lancaster were funded by the Arts Council England to deliver a dance programme to a school for children encountering profound and multiple learning difficulties (PMLD). Following the reported impact of incorporating dance into the educational experience of the participating children, this article considers why dance and somatic practice may be of particular significance for the individual encountering PMLD, situating the question of the place of dance and movement in education, and its impact on those encountering PMLD, in a deeper theoretical context.

A Communication Course for Adults with Profound Intellectual Disability and Physical Disabilities

From September to December 1989 Ipswich TAFE (an adult education facility near Brisbane, Queensland) hosted a Communication Course for five adults who each have a profound intellectual disability and physical disability (in the UK this is the equivalent of profound and multiple learning difficulties). None of the five students possess skills of intentional communication. The course is believed to be the first one of its kind in Australia and was of an experimental nature. The course content is described. The main aim of this presentation is to share information and to invite collaboration from others in similar areas of work.

`Sounds of Intent': mapping musical behaviour and development in children and young people with complex needs

This article reports on the first year of an Esmée Fairbairn Foundation-funded research project into the design and evaluation of an original `framework' for mapping the behaviour and development in, and through, music for children with complex needs, specifically those with profound and multiple learning difficulties (PMLD). An initial four-month design and pilot phase critiqued and evaluated a framework that was grounded in video-based iterative analyses of individual case studies that had been collected during the previous two years. The piloting phase was followed by a sustained period of classroom-based music lesson observation in five special schools over a period of seven months. A total of 630 observations were made using the framework for 68 participants whose ages ranged from 4 years 7 months to 19 years 1 month. Subsequent analyses support the general design features of the observational framework and provide new evidence of PMLD musical behaviour and development.

Literacy with parents for children with profound and multiple learning difficulties

This paper aims to explore the issue of literacy for children with profound and multiple learning difficulties (PMLD). A group of parents met for six sessions with the authors and discussed how literacy could be applied to their children in the homes. A multi-sensory approach was discussed and experimented with using various texts mentioned in the article. This paper deals with three main ideas, namely challenging parental constructions about their children and about literacy and story-telling; the possible therapeutic role of such a process and its ensuing influence on parents’ roles as advocates for their children; and the idea of experimenting with stories and practices using the senses. In conclusion, the relevance of the above for practising educational psychologists is highlighted.

Obtaining the views of children with profound and multiple learning difficulties

Obtaining the views of children including those with Special Educational Needs (SEN) and involving them in decisions surrounding their life and learning has become an increasingly relevant issue. Enabling ‘every child’ to make a positive contribution is high on the list of government priorities. However, work in the complicated area of establishing the views of children with more severe and complex needs such as those with Profound and Multiple Learning Difficulties (PMLD) appears to be in its initial and investigative stages and there is an apparent dearth of literature in this area.This review presents the available literature in an attempt to explore the extent to which it is possible to ascertain the views of children with PMLD. A comprehensive literature search revealed two main themes within the literature incorporating the ethical and conceptual issues associated with ascertaining/not ascertaining the views of children with PMLD and the methods and tools that are effective in accessing the views of children with PMLD.There is an apparent need for more research to establish effective ways to enable the views of children with PMLD to be heard. EPs are well placed to become involved in enabling children to have a voice in decisions surrounding their education at many levels and a number of implications for EP practice are included in the review.

Who goes to SLD schools in England? A follow-up study

This paper describes the results of a national survey of schools for pupils with severe learning difficulties (SLD) in England which aimed to obtain a profile of the characteristics of children and young people attending these schools. It is a follow-up to a previous study conducted by Male (1996). A postal questionnaire was sent to head teachers of all SLD schools in England which sought to elicit their perceptions as to the proportion of pupils in their schools with profound and multiple learning difficulties (PMLD), autistic spectrum disorders (ASD), life limiting conditions and challenging behaviours. Head teachers were also asked to supply information about pupil numbers, proportions of boys to girls, staff numbers and characteristics. One-hundred-and-sixty-seven head teachers replied, giving a 52 per cent response rate, representing in excess of 10,000 pupils. The results indicated perceived increases in the number of pupils with PMLD, ASD, life-limiting conditions and those showing challenging behaviours. Teacher: pupil ratios appear to have remained stable over time but TA numbers relative to pupil numbers have increased. The proportion of teachers in SLD schools possessing relevant additional qualifications appears to be decreasing. A particular challenge identified by head teachers was the increasing need to cater for a widening ability range of pupils.