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A Report on Children with Learning Disabilities who Engage in Self-harm

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A Report on Children with Learning Disabilities Who Engage in Self-Injury By Gayle De Souza GM6005 Aims and Learning Outcomes The aim of this report is to critically analyse self-injury behaviours in children with learning disabilities and the impact of improved communication on challenging disruptive behaviours. After reading this report it is hoped that you should: * Be able to define self-injury and possible causes * An awareness of alternative methods of non-verbal ways of communicating * Be able to acknowledge the importance of cultural diversity when participating in assessments Contents Page Introduction and identification of needs pages 4 - 5 Communication/Self-Injury pages 6 - 9 Cultural Needs pages 10 - 11 Further Discussion/Conclusion pages 12 - 13 References pages 14 - 15 Appendix: *Case Study and rationale for choosing case page 16 *Fig.1. Main reasons indicated for self-harming page 17 *AAC Tools brief description. page 18 Introduction This report will attempt to identify and analyse the child's needs indicated in the case study (see appendix Case Study). These needs will be further discussed with supporting literature around the issues of self -injury and the ability of children with learning disabilities to communicate their needs although experiencing severe language impairments. In order to assess needs, a robust and holistic assessment needs to be undertaken. ...read more.


Barol (1996) concludes that in over three quarters of the situations where she has been consulted to assess a disruptive individual's behaviour including self -injury, a persons behaviour changes for the better when their needs are met and this may mean adapting their environment to meet their needs to facilitate this. Shelly self-injures on a daily basis and a cycle of medication, restraint and removal becomes the daily cycle in which all key professionals play an active role. Jones et al (2004) considers that oppression and abuse are the context in which people with learning disabilities self-harm, this has been given credence as a possible explanation in the general population on self-harm and yet there is very little literature regarding this subject for people with learning disabilities. Self-injury can be defined as the "repeated, self-inflicted, non-accidental injury, producing bleeding or other temporary or permanent tissue damage (Schneider et al 1996). There is a distinction made by some authors between self-harm (used in mental health settings) and self -injury (used in learning disabilities services), self injury tends to include cutting, burning and carving behaviours (Favazza 1996). Whereas head-banging, biting, scratching, hair pulling and pinching are seen as self-injury. The distinctions between the two labels is contested by several authors and it is suggested that it is far 'less recognised' that learning disabled individuals may self-injure for similar reasons to those attributed to non-learning disabled individuals (see appendix Fig 1.) ...read more.


As her family have found it difficult coming to terms with her disability this would appear to substantiate some of the views of Sunil Deepak (2000) that some traditional South Asian families may feel shame if they have a disabled child. These feelings need to be explored within the context of family life and the effect on Shelly's feelings of self worth and value. This should form an active dialogue in her family centred-care. It is important to acknowledge that of the non-learning disabled children that called child line, family issues were highlighted as a significant factor for self-harming with Bullying being the highest factor (see appendix Fig 1). In conclusion the literature around self-injury and learning disabled children is under represented and it emphasises the need for more research in this area. The importance of cultural identity needs to be entwined in the holistic assessment and care planning to ensure the child's needs are understood and met. It is of paramount importance that policy, training and guidance on restraint in behaviour management are in place, as a safeguard for children with learning disabilities. It might be argued the literature on self-harm on non-learning disabled children offers an important foundation in which to develop tools of investigation into the different needs of disabled children, as they are children 'first and foremost'. ...read more.

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