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unit 12 supporting individuals with additional needs distinction
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Learning Aim A: P1,M1 and D1Examine reasons why individuals may experience additional needs
P1 Explain diagnostic procedures to determine additional needs for one child and one adult
with different additional needs.
A.M1 Assess the requirements of one child and one adult with different additional needs.
A.D1 Evaluate the significance to the individuals, their families and society of a diagnosis of
additional needs.
The phrase "additional needs" refers to and denotes the requirement for "extra support or
services so that they can participate fully" in activities and daily life (Australian Department of
Health, 2010). A service user with an additional need often finds it more difficult to participate
,in social events or carry out everyday responsibilities like personal care because they have more
complex and specialised demands than service users without any additional needs. When it
comes to daily tasks like cooking or writing, service-users with additional needs often need
assistance because they find it more difficult to perform them because of their needs.
A learning disability was previously known as a mental handicap or intellectual disability,
however after more research and service-users showing their discomfort with the diagnosis of a
mental handicap, the name of the diagnosis was changed to a learning disability. A learning
disability is “the presence of a significantly reduced ability to understand new or complex
information, to learn new skills (impaired intelligence), with a reduced ability to cope
independently (impaired social functioning), which started before adulthood, with a lasting
effect on development” (NHS, 2018). A service-user who is considered to have a learning
disability will typically have a poorer cognitive function and therefore have less ability to
understand, learn, and complete various activities that service-users without a learning
disability would not struggle with. Furthermore, learning disabilities will either be classified as
mild, moderate, severe or profound depending on the impact it has on an individual's life as
well as the support required by health and social care professionals.
A mild learning disability is defined as when an individual may be able to communicate their
needs, but may struggle to process or explain new information. Therefore, they may require
more time to fully understand complex ideas or may need information to be repeated multiple
times for them to be able to fully understand it. A service-user with a mild learning disability
may “usually able to hold a conversation, and communicate most of their needs and wishes”
(NHSGGC, 2019), they are often independent and will have basic skills to function in society,
however, due to the more minimal impact on their life, mild learning disabilities are likely to go
undiagnosed in individuals. Typically Dyslexia can be classed as a mild learning disability as it
has limited impact on an individual and allows them to remain largely independent, however
there can be severe cases of Dyslexia as all individuals may experience the condition in different
ways.
Service-users with a moderate learning disability are likely to have additional needs compared
to those without as they may have a larger struggle with language as well as understanding new
concepts. Individuals may “need some support with caring for themselves, but many will be able
to carry out day to day tasks with support” (NHSGGC, 2019) and therefore will be able to
maintain some of their independence in their daily life. They may have slightly limited verbal
communication and therefore may need support from health and social care to find an effective
way to communicate their needs. For example, Autism may be a moderate learning disability
for certain individuals, however, as it is a spectrum, service-users will experience different
symptoms and severities of Autism despite having the same diagnosis.
,Individuals with a severe learning disability will have a variety of additional needs and
subsequently will require more support from health and social care services to maintain their
health and wellbeing. They will need a “high level of support” (NHSGGC, 2019) to maintain their
daily life, however, may be able to maintain independence with regards to their personal care.
Service-users with severe learning disabilities may often struggle with areas other than their
intellectual development as they may have additional medical or mobility needs which must be
considered by health and social care professionals when working together. Severe learning
disabilities may include Down’s Syndrome as it can have both physical and mental symptoms
which would lead to an individual experiencing additional needs and requiring a higher level of
support due to their likely limited, or impaired, abilities.
Individuals often experience conditions differently and may often have different additional
needs that arise from their condition. For example, conditions such as Autism are often seen as
being on a spectrum and can therefore have various impacts on each individual as some
individuals may have difficulty getting a bus, however others may have no problem, despite
having the same condition and the same severity of disability. Due to many individuals
experiencing disabilities in different ways, they will therefore require personalised care to
ensure that all of their needs are met and they are able to continue engaging in activities and
remain as independent as possible. Furthermore, one type of learning disability is not typically
generalised and therefore classed by its severity due to each individual experiencing the
disability in different ways and therefore having a varying level of severity due to their personal
experience.
A diagnosis can be defined as “a judgment about what a particular illness or problem is, made
after examining it” (Cambridge Dictionary, 2019) and is typically based on the results of a
diagnostic assessment which aims to highlight and identify any problems or symptoms
experienced by an individual. Symptoms are any subjective evidence of disease which are used
to identify and diagnose conditions to ensure that service-users can receive adequate
treatment to promote their health and wellbeing. During a diagnostic assessment, an individual
concerns will be identified, their medical history and current living conditions may be assessed
and they will often received either a mental or physical examination to determine the nature of
a condition. Diagnostic procedures help to determine what type of illness/disability a service-
user may be experiencing and are created to summarise all areas of health to ensure a holistic
approach is provided and all possible causes are explored. After a service-user has experienced
a diagnostic assessment, a healthcare professional will come to a conclusion with regards to
their health and will be able to identify any of their additional support needs that must be met.
Many different disabilities will have a slightly differing diagnostic assessment procedure that is
specifically tested to highlight any problems with regards to a certain condition such as
Dyslexia.
,If an individual is believed to have Dyslexia, an assessment will be arranged with a qualified
specialist teacher who has an Assessment Practice Certificate that allows them to formally
identify and diagnose Dyslexia. During the assessment, an individual's “literacy and numeracy,
as well as memory and processing skills,” (Pearson, 2019) will be assessed to identify if there is
an additional need and if there is, in which area it has the most effect. As Dyslexia can have a
wide range of symptoms depending on the individual, often further tests with be ordered to
determine the level of additional support required by an individual and how services should
best provide that support. Furthermore, specialists may often become involved to help identify
strategies that can be put in place to best support individuals and therefore allow them to feel
confident and secure with their professional support.
However, a diagnostic procedure testing for Dyslexia may not identify Dyslexia as the cause of
symptoms but may identify that a problem has child with their vision or hearing which will
enable them to get the required support and adaptations such as a hearing aid or glasses,
which would reduce their symptoms. When an individual is diagnosed with Dyslexia, there are
no levels of severity that they are diagnosed with and instead all cases of Dyslexia are put into
the same category. There are no cures for Dyslexia but it can be managed. And in order to help
individuals manage their Dyslexia, health and social care professionals will support them to
read and write in a way that meets their needs. Causes of Dyslexia are unknown, however it is
hereditary which suggests that there is a genetic marker for the disorder that is passed on
between generations. As with most learning disabilities, there are a range of severities which
can also be dependent on how quickly it is diagnosed. To be able to diagnose health conditions,
professionals like an educational psychologist and or a certified assessor are required to have
different qualifications and credentials for each condition as each diagnosis will require
different skills which can be obtained by taking on further studies, such as a Postgraduate
Diploma in Learning Disabilities to diagnose Dyslexia.
Attention Deficit Hyperactivity Disorder (ADHD) is commonly identified by parents or teachers
due to the behaviours being easier to identify over long periods of time spent with an
individual. “A Child Behaviour Checklist (CBCL/6-18) is used to confirm diagnosis” (Pearson,
2016) by a Doctor or Psychologists with either a relevant Medicine or Psychology degree, when
an individual has displayed symptoms over a long period of time and the condition is suspected
by professionals or the individuals family. For a Psychologist, they would need a degree in
clinical psychology in order to make a diagnosis. When a child between the ages of 6 and 18 is
undergoing a diagnostic assessment, a marking scheme is used to rate and plot the child’s
behaviour over a certain period of time; this information contributes to the decision made by
specialists as to whether or not an individual has ADHD.
,Diabetes can be diagnosed by either a Specialist or a Doctor and must be diagnosed by
measuring the blood glucose levels of an individual. In order to diagnose Diabetes, an individual
must have a degree in Medicine and be registered with the GMC as a practicing Doctor.
Commonly, a dipstick test is done which tests the individuals urine for glucose before any other
tests are completed, however, if the dipstick test detects glucose then multiple blood tests will
be run to determine the blood glucose levels of an individual and therefore identify if the
physiological abnormalities are caused by Diabetes. Furthermore, once Diabetes has been
diagnosed, appropriate treatment can be recommended to ensure that an individual is able to
manage their own insulin levels and therefore maintain their own health and wellbeing.
Professionals would have used an initial dipstick test to identify where his initial symptoms of
Diabetes came from, allowing him to receive management and care to meet any needs arising
from the disorder.
Furthermore, Dyspraxia can cause an individual to have poor coordination and is usually first
identified by parents or teacher as they will spend time with the child whilst they are
completing activities that they are likely to struggle with. A diagnosis is commonly made by a
multidisciplinary team who will assess them using the Motor ABC assessment method which
tests their gross and fine motor skills and is compared with developmental milestones to see if
there are any delays present due to the poor coordination. An individual will also have their
mental ability assessed, as well as their family medical history taken to exclude any other
possible causes of the symptoms.
“In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and
Statistical Manual of Mental Disorders (DSM-5)” (Autism Speaks, 2019) which is commonly used
alongside the 10th edition of the International Classification of Diseases (ICD-10) to diagnose
disorders. The DSM identifies certain criteria that an individual must meet in order to receive a
diagnosis of a mental disorder such as Autism. Both the ICD and DSM have lengthy criteria that
an individual must meet in order to be diagnosed with a certain condition which is often why
man individuals may go undiagnosed for many years, as they may meet the majority of but not
all diagnostic criteria. Diagnostic manuals such as the DSM are frequently updated as new
symptoms and conditions are identified as well as professionals also sometimes wishing to
simplify the criteria due to their previous complexity. For example, the diagnosis of Asperger
Syndrome was removed from the DSM due to many professionals not believing that there was
a distinct difference between Autism Spectrum Disorder and Aspergers.
In the Children and Families Act 2014, standards of practice are given with regards to
diagnosing a disability to ensure that all professionals follow the same procedures when
diagnosing. A variety of health and social care organisations supply “information about specific
disabilities, including case studies, diagnostic tools to assess specific needs, the qualifications
,needed by the assessor, and the standards by which they have to abide” (Pearson, 2016) to
ensure that all diagnosis’ are made to correctly and that all care or treatment provided is to a
high standard. For example, the standards of practice defined under the Children and Families
Act 2014 may explore the credentials required by a health and social care professional in order
to make a diagnosis of a disability such as a learning disability.
In order for professionals to be able to diagnose and assess service-users they must have
certain qualifications and meet the standards given in the Children and Families Act 2014. To be
able to diagnose health conditions, professionals are required to have different qualifications
and credentials for each condition as each diagnosis will require different skills which can be
obtained by taking on further studies, such as a Postgraduate Diploma in Learning Disabilities to
diagnose Dyslexia. “The Professional Association of Teachers of Students with Specific Learning
Difficulties (Patoss) provides a list of qualifications that teaching professionals need before they
can diagnose and assess students” (Pearson, 2016) which ensures that all professionals have
the correct qualifications and can therefore correctly diagnose service-users.
Typically, a diagnosis must be made by a specialist in a certain area for example a Learning
Disability must be diagnosed by a professional who has undertaken extra training and
specialised in learning disabilities which helps to ensure that service-users are not
misdiagnosed. Furthermore, Doctors or professionals who have attended medical school and
then specialised, such as a Psychiatrist, are typically the only professionals in healthcare who
can diagnose illness as they have the correct level of expertise to make an informed diagnose
and prevent the risk of misdiagnosis and subsequent wrong treatment.
In July 2014, the Department of Education published the Special Educational Needs and
Disability (SEND) Code of Practice which replaced the original 2001 code. One of the major
changes that occurred within the new code of practice is that provision of care for those with
SEND needs was extended up until the age of 25, allowing for older individuals who did not
access support early enough to still be supported by services to manage their additional needs
and continue to develop.
Many charities and specialist organisations may also supply information regarding the
qualifications needed to diagnose certain learning disabilities and health disorders.
Organisations that provide support for professionals diagnosing learning disabilities will also
provide advice and support for those with additional needs to ensure that they feel included
and are able to live as normally as possible, whilst also making informed decisions about their
own care.
Since Ben has Down’s Syndrome as his primary diagnosis through screening test, cvs and
amniocentesis, he would likely be supported by the Down’s Syndrome Association to help him
,manage the effects of his illnesses. Additionally, the professionals working in the Residential
Home may also consult with the charity in order to ensure that they can work to the same high
standards consistently and are able to offer support to Ben. The Down’s Syndrome Association
has various pages on their website which helps to direct individuals to the information that they
need, for example professionals will access different information to carers who will access
different information from Ben.
Aspire is a UK charity supporting those with spinal cord injuries such as Rebecca, they primarily
support those who have experienced paralysis as a result of their injury. Aspire have various
professionals that work with them in order to support those with spinal injury in any way
possible, they run various events in order to raise the money needed to provide services that
they do and keep the charity running. They run various Housing Campaigns which aim to
support those with spinal injuries to find a suitable place to live and since Rebecca’s family
home is not suitable, they would be able help her to find somewhere suitable to live.
Certain parameters will be used to describe diagnosed conditions which will look at areas such
as cause, severity, stability and prognosis. A cause will be identified which will be what has
triggered/resulted in the condition occurring and may be a variety of factors such as genetic
predisposition or pollution exposure. For example, a stroke is caused by a blood clot forming in
the brain and stopping blood supply, however the clot may have been triggered by high blood
pressure, obesity, diabetes, and other factors. Identifying the cause of a health problem can
help to ensure that adequate treatment can be given, as well as preventing the issue from
occurring again or worsening.
Strokes are blood clots that occur in the brain and can cause permanent damage if not treated
within the specific window in which the effects can be reversed. Strokes can range in severities
however if the effects of the stroke are not reversed with medication in the one hour window,
then the effects will have various impacts on an individual’s’ life and could be severe. Over
time, the condition is likely to improve in the long-term with the correct support such as
physical therapy and drug treatments which will help to keep the condition controlled and
prevent the effects of the stroke from being life limiting.
Dementia is the term given to “persistent disorder of mental processes, including memory loss,
personality changes and difficulties with thinking, problem solving and language” (Pearson,
2016). Dementia is usually caused by problems with the blood supply to the brain interrupting
the signals which results in the hippocampus and cerebral cortex shrinking, subsequently
causing poor memory. Having Dementia in the family increases the risk of an individual
suffering from Dementia however does not mean that the condition will definitely be inherited,
certain risk factors also exist for Dementia such as older age however will not always result in
the condition forming. Symptoms of Dementia may impact individuals in different ways, for
,example an individual may begin: losing items around the house, struggling in a conversation to
find the right word, forgetting recent events or forgetting birthdays and anniversaries. As
Dementia progresses, an individual can become aggressive as they will be confused and lose
control over their emotions which may cause them to be perceived as a burden by their family
as they will be challenging to keep safe so may be sent into Residential or Nursing Care to
ensure they are safe. Alzheimer's is the most common form of Dementia and individuals with
Alzheimer’s will experience similar symptoms to those with Dementia such as memory lapses,
poor orientation and decline in language abilities. In the later stages of Alzheimers, an
individual may begin to experience hallucinations or behaviours that are deemed out of
characters such as agitation and disturbed sleep patterns.
Coronary heart disease is caused by fatty deposits building up in the arteries surrounding the
heart and preventing blood flow from leaving the heart and circulating the body. Various
lifestyle factors can influence an individual’s risk of coronary heart disease such as their weight,
diet and exercise habits, these factors can interact with any genetic factors that may make an
individual more susceptible to the condition. Experiencing coronary heart disease may cause
chest pains (angina) and may increase the individual’s risk of having a heart attack if the
blockage becomes too big and blood flow is completely restricted. Since the disease can range
in severities, it can be managed differently by individuals with either medication, a lifestyle
change, or a combination of the two which will help to keep the condition stable over time. In
more serious cases, surgery can be considered as an option in order to completely reverse the
effects of the disease and provide instant relief for the individual, especially if they have been
identified to be at high physical risk.
When a baby is born, certain tests will be done on them shortly after their birth to investigate
their health and identify any problems that they currently have, or many have as the grow up.
For example, a heel prick test is done on every baby after birth to determine any abnormalities
within their blood such as Phenylketonuria which is important to detect and treat as soon as
possible to prevent the individual from becoming unwell throughout their whole life.
Furthermore, during pregnancy there are optional tests offered to mothers (typically who are at
a greater risk of ill health) such as a screening for Down’s Syndrome.
Cognitive and learning needs affect and individuals cognitive processes such as their thinking,
memory and problem solving which can therefore result in them having additional needs as
they will have a limited ability completing certain activities. “Specific learning difficulties (SpLD)
affect one or more specific aspects of learning” (GOV.UK, 2019) and encompassess difficulties
such as dyslexia, dyspraxia and attention deficit hyperactivity disorder. “The term ‘Learning
Difficulties’ is generally applied to people with global (as opposed to specific) difficulties (Halton
Children’s Trust, 2019), as they do not affect an individual's intellectual abilities whereas a
, learning disability does. For example, Dyslexia does not reduce an individual's intellectual
abilities, it simply reduces their cognitive abilities which can often prevent them from learning,
however does not always have negative impacts on their intellectual abilities which is why it is a
difficulty, rather than a disability.
Dyslexia is a learning difficulty that is usually hereditary and affects an individuals cognitive
abilities such as the way information is stored and processed. If an individual is believed to have
Dyslexia, an assessment will be arranged with a qualified specialist teacher who has an
Assessment Practice Certificate that allows them to formally identify and diagnose Dyslexia.
During the assessment, an individual's “literacy and numeracy, as well as memory and
processing skills,” (Pearson, 2019) will be assessed to identify if there is an additional need and
if there is, in which area it has the most effect. As Dyslexia can have a wide range of symptoms
depending on the individual, often further tests with be ordered to determine the level of
additional support required by an individual and how services should best provide that support.
Furthermore, specialists may often become involved to help identify coping strategies that can
be put in place to best support individuals and therefore allow them to feel confident and
secure with their professional support.
Dyspraxia is a ‘form of developmental coordination disorder’ (DCD), which impacts an
individual's coordination and motor skills, often preventing them from meeting developmental
milestones or falling behind. It is usually first identified by either parents or teachers as they will
be present whilst the individual is experiencing delays and not meeting the expected
milestones, allowing them to identify concern and suggest a diagnostic assessment.
A diagnosis is commonly made by a multidisciplinary team who will assess them using the
Motor ABC assessment method which tests their gross and fine motor skills and is compared
with developmental milestones to see if there are any delays present due to the poor
coordination. An individual will also have their mental ability assessed, as well as their family
medical history taken to exclude any other possible causes of the symptoms. After an individual
has been diagnosed, their parents will likely get into contact with their schools Special
Educational Needs (SEN) Department who will help to provide support to the individual to
ensure that they are able to maintain functioning in society and reduce the impacts of their
learning difficulty through providing strategies and aids to help them learn coordination and
become familiar with their surroundings.
Attention Deficit Hyperactivity Disorder affects an individual's cognitive abilities as they are
often temperamental and have high levels of energy, resulting in them often being unable to
concentrate on information. ADHD has strict diagnostic criteria and an individual must have at
least six symptoms which must have developed before the age of twelve, and lasted for over six
months, to ensure that the symptoms are not related to another condition such as a
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