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(Almost) Forced to Have an Abortion

From The Guardian.

The ruling has been overturned on appeal, although the appeals court judges have not given their reasons yet.

A lot of the details of the case are unclear, and because of privacy concerns (which are very legitimate), I don't know how much will be made public.

I'm aware that the original decision was not made at a whim by a judge. The NHS Trust caring for the woman, who is in her 20s and has a "moderately severe" learning disorder and a mood disorder, is moving to have the pregnancy terminated after an obstetrician and two psychiatrists have ruled it is the best option.

Nothing has been said to indicate that the fetus has any abnormalities or that continuing the pregnancy is a threat to the woman's health other than that, in the initial judge's estimation, it is a threat to the woman's mental health (although the mother wishes to have the child).

And there appears to be an investigation into the circumstances of the conception of the fetus. If the woman could be deemed to be legally incapable of consenting on her own to be a parent, it is likely that she could be deemed legally incapable of consenting to having sex, which means that the conception is likely to be considered to be the result of what legally is sexual assault.

I am also not sure why the judge thought that the woman's mother, who says she is willing to care for the child, might leave the country. I also do not know how much consideration the opinion of the social worker that works with the woman who believes the pregnancy should continue should be given compared with the opinion of the doctors - and I don't know how much time the doctors have spent with the woman compared with the social worker. Have the woman and her mother sought the opinion of any other doctors?

How do the judge and doctors know that the pain, for this woman, of dealing with the reality of childbirth, childcare, and the possibility of having the child be put up for adoption or put into foster care would be greater than the pain of being forced to have an abortion against her will? We can put ourselves into her shoes and think the forced abortion is less painful, but can any expert really know?

These quotes from the initial judge (from the link above) are particularly upsetting to me:
The judge said she was not sure the woman understood what having a baby meant. “I think she would like to have a baby in the same way she would like to have a nice doll,” Lieven said.

The woman may suffer more if the baby was born and then fostered or adopted than if the abortion was carried out, the judge said in the earlier ruling. She “would suffer greater trauma from having a baby removed. It would at that stage be a real baby,” she added.

Comments

  • I call myself pro-choice and generally leave such a decision up to a woman (with doctors' advice, but still up to the woman). This case makes me very worried because here the doctors are attempting to use the power of the state to take choice away from the woman and saying they know her best interests better than she does. It is precisely because I have been so critical of when a government has tried to force a woman to continue a pregnancy against her will that I am so worried about what this case means.

    Obviously, this case will be exploited by anti-abortion campaigners (and critics of the NHS and anything that resembles it - even and perhaps especially here in the US). I'm not trying to give support to their claims or their cause.

    This case is also important in the light of the rights of the disabled. I know it's not appropriate to compare it to Eugenics because Eugenics was about protecting some supposed purity of the gene pool rather than about the supposed best interests of the mother, but during the Eugenics era here in the US, many women had forced sterilizations because of "feeblemindedness." This disproportionately affected poorer women, racial minorities, and immigrants. Prostitutes and women who repeatedly bore children out of wedlock were also targeted because "feeblemindedness" was also interpreted to encompass a moral deficiency that was believed to be genetic. That last part is unrelated to this case but it shows how all kinds of biases inherent in society can creep into the enforcement of laws that exert control over women's bodies (and, in the case of Eugenics, men's bodies too).

    I don't think the judge is a racist (The pregnant woman's mother is from a Nigerian family. I do not know about the father.) or that the judge believes that the disabled should not reproduce. However, if courts have the power to force anyone to have an abortion for reasons of mental health, there is the potential for unconscious biases to influence the decision making of authorities, not just for individual authority figures but for the system as a whole.
  • CaissaCaissa Shipmate
    I am surprised that they use the phrase "learning disabilities" to refer to this situation, if it accurate.

    "On Friday, the court of protection in London decided an abortion was in the best interests of the woman, who is in her 20s, and is 22 weeks pregnant. She has the mental capacity of a six- to nine-year-old child." Later in the article they refer to a "learning disorder". I am not sure they are using these terms with any precision.

    In Canada, if an individual was considered to be incapable of making an informed decision, the courts would appoint an alternate decision maker.
  • The Court of Protection is precisely our alternate decision maker. They will appoint deputies to take day-to-day decisions for those incapable of making them, but major life-changing decisions are referred back to the Court.
  • This is one of those situations where I see no good solutions. I have no reason to believe the court to be biased in any particular direction and hence have no reason to try to substitute their extensively informed judgement for my poorly informed one.
  • This is one of those situations where I see no good solutions. I have no reason to believe the court to be biased in any particular direction and hence have no reason to try to substitute their extensively informed judgement for my poorly informed one.

    Let's imagine the worst-case-scenario. The woman gives birth, is severely unhappy after having the child, the woman's mother is unable to take care of the child, the child is put into the foster care system, further traumatizing the woman who is the child's mother, and the child has a very unstable upbringing, and perhaps the woman's mood disorder, worsened by the experience of having a child without fully understanding the implications, leads her to take her own life.

    Does a desire to prevent that scenario, which is a possibility but not a certainty, justify the certainty of taking away a woman's fundamental autonomy over her own body?
  • Gee DGee D Shipmate
    This is one of those situations where I see no good solutions. I have no reason to believe the court to be biased in any particular direction and hence have no reason to try to substitute their extensively informed judgement for my poorly informed one.

    Exactly.
  • Um. I don't see any damned reason to take away the power to choose to give birth, not only from the woman, but from her next-of-kin. Basically they seem to have decided both are incompetent to make decisions--not just the learning disabled woman (and again,what a weird way to describe her--it doesn't sound particularly drastic!) but also the apparently compos mentis mother of the woman. Why?

    As for trusting the court--maybe I would have thought so, before the Trump era. Now I have basically no trust in institutions anymore.
  • KarlLBKarlLB Shipmate
    edited June 2019
    "learning disabled" is a standard UK term for what would have been called "mentally handicapped" in the past - it can mean very profound disability. It doesn't just mean "bottom Maths set".
  • Somewhere in the article it places the woman at age 6-9 in mental ability. Age 6 means functionally illiterate and functionally innumerate - you need a reading age of 9 to achieve minimum literacy and be able to read well enough to improve your literacy by continued reading, similarly maths. But that will also mean a lack of understanding of how the world works, sex and contraception, an inability to self care safely. It hasn't said in what form those learning difficulties express themselves.

    The problem is you really do not know what is going on here. Having seen and dealt with some horrific things, I wonder if there are concerns about the mother's care of the pregnant daughter? So concerns about the grandmother's care? We dealt with a case where we had serious concerns about a daughter with severe learning difficulties, and there was a concern she was being prostituted by the mother. It went to social care and was extremely messy and unpleasant. Try proving something like that with a young woman with learning difficulties. It was bad enough getting the mother's severe physical abuse of a young boy with learning difficulties we worked with proved; it's not enough to have suspicions when you are dealing with a convincing mother who presents well.
  • I would think almost certainly the baby would be apprehended from the hospital shortly after birth and placed into care. The costs to the system are enormous if the child is funded until adult. The costs of abortion are small in comparison.
  • I would think almost certainly the baby would be apprehended from the hospital shortly after birth and placed into care. The costs to the system are enormous if the child is funded until adult. The costs of abortion are small in comparison.

    A new born baby would likely be adopted within weeks at minimal cost to the "system", but that's not a relevant consideration in the legal case.
  • DoublethinkDoublethink Shipmate
    edited June 2019
    For reference:

    In the UK “learning disability” = “intellectual disability” = “mental retardation” (the latter term is still used in ICD10 though not everyday clinical communication.)

    Normal IQ is normed around 100, below 70 would put you in the learning disability range (2 standard deviations below the mean, or bottom 2.5 percent of the population)

    Technically, a mild LD IQ is in the range 50-70. Moderate LD 34-49. However, LD is diagnosed by developmental history, + cognitive impairment + impairment in adaptive functioning (daily living skills).

    God only knows the accuracy, or not, of the newspapers’ reporting. But I invite you to consider the emotional and psychological impact of going through labour if you do not know it is going to happen, and you do know what is happening for most of the time. That is presumably what they are worried about. It is also true that having your baby taken from you because you can not care for it, is extremely distressing. (Child could be fostered at birth if they were solely worried about her parenting, child protection meetings would start before the birth and involve planning around the birth and if the child could be taken home etc. These would also involve planning parenting assessments etc.)

    Depending on what condition the woman has, and it’s severity, it is entirely possible she may not have the ability to understand a child’s needs.

    All that said, there are many people with mild learning disability who raise children successfully, with greater and lesser extents of formal and informal support.

    The use of so-called “mental age” in these situations is really unhelpful. A six year old, and a person with the cognitive capabilities of a six year olds and an additional two decades of learning and experience are vastly different in how they are able to interact with the world.
  • DoublethinkDoublethink Shipmate
    edited June 2019
    Um. I don't see any damned reason to take away the power to choose to give birth, not only from the woman, but from her next-of-kin. Basically they seem to have decided both are incompetent to make decisions--not just the learning disabled woman (and again,what a weird way to describe her--it doesn't sound particularly drastic!) but also the apparently compos mentis mother of the woman. Why?

    As for trusting the court--maybe I would have thought so, before the Trump era. Now I have basically no trust in institutions anymore.


    You can’t take a significant decision on behalf of an adult in the uk without a legal basis to do so. Mother could have had herself made court appointed deputy (power delegated from the court of protection) but clearly has not done so. Otherwise a best interest decision has to be made taking into account the wishes and feelings of the individual and their family and the opinions of all involved in their care.

    I would ask how this woman got pregnant - capacity to consent to a sexual relationship might well be an issue - if she was in her mother’s care at the time, there maybe some lack of confidence in her ability to act in her daughter’s best interest.

    (I note also that the woman is said to have a mood disorder, and it is not clear if she is currently acutely unwell or not - this can also raise risk of post partum psychosis and the report doesn’t tell us enough about her previous psychiatric history to know if this is a substantial risk. It also doesn’t tell us, for example, if this has happened before.)
  • I would think almost certainly the baby would be apprehended from the hospital shortly after birth and placed into care. The costs to the system are enormous if the child is funded until adult. The costs of abortion are small in comparison.

    A new born baby would likely be adopted within weeks at minimal cost to the "system", but that's not a relevant consideration in the legal case.

    It's nice to know they wouldn't factor the costs in.

    Adoptions here take at least two years to finalize. Assisted adoption can have funding to the adopting parents until adult.
  • Gee DGee D Shipmate
    A court order for adoption here may take time, sometimes years. I gather from reading some of the rare cases involving adoption that get reported that the usual practice is a quick order placing the infant in departmental care and that care is exercised by placing the infant with a couple. Sometimes that placement is intended from the start to be interim, other times as a preliminary to adoption.
  • CrœsosCrœsos Shipmate
    Let's imagine the worst-case-scenario. The woman gives birth, . . .

    I'm not sure the phrase "worst-case-scenario" belongs in a paragraph assuming a medically uncomplicated childbirth. I'm pointing this out not to be pedantic (though I love being pedantic) but to highlight the faulty assumption that childbirth is both easy and risk-free that seem to underlie such analyses.
  • lilbuddhalilbuddha Shipmate
    This is one of those situations where I see no good solutions. I have no reason to believe the court to be biased in any particular direction and hence have no reason to try to substitute their extensively informed judgement for my poorly informed one.

    Let's imagine the worst-case-scenario. The woman gives birth, is severely unhappy after having the child, the woman's mother is unable to take care of the child, the child is put into the foster care system, further traumatizing the woman who is the child's mother, and the child has a very unstable upbringing, and perhaps the woman's mood disorder, worsened by the experience of having a child without fully understanding the implications, leads her to take her own life.

    Does a desire to prevent that scenario, which is a possibility but not a certainty, justify the certainty of taking away a woman's fundamental autonomy over her own body?
    The autonomy here is highly questionable, as DT already pointed out.
    In my, limited, experience, those ascribed a "mental age" are often less able than the typical child of that age. It is a shortcut to help create relatable reference, but it is far from comprehensive.
  • The description given of the woman's mental capacity at the original High Court hearing was that it was "moderately severe". It was also not challenged that she had mental health issues in addition to those of mental capacity. What these mental health issues are, or how they manifest themselves, was not detailed; however, it was reported (and went unchallenged) that if the grandmother is given care of the baby then the woman herself will have to be found accommodation elsewhere - in other words, she cannot be in the same house as the child, which would imply that they feel a baby would not be safe in the same environment.

    The issue of the doll came up when the woman was being questioned about what she thought might be in her abdomen, whether she liked babies, would she like a baby, etc. She was asked if she would prefer a baby or a new doll and she said she'd like a doll.

    It would seem that the grandmother is not British and that she has spoken of going back to her country of origin (unspecified); if that happens and the grandmother has been given custody of the child, then this woman with learning difficulties and mental health issues would by then be in the care of social services here but would have no family.

    The whole case is very disturbing, not least the whole question of how did this person who seems to have no mental capacity become pregnant. The would-be grandmother made great play about her religious belief when challenging the original ruling, so it would seem that her (the grandmother's) religious beliefs are being placed above those of her daughter's well-being - because surely if this child-woman is suddenly removed from the family home because of the baby it is going to cause her immense upset and distress?

    Of course, back in the day when dinosaurs roamed the earth the state, under legislation to do with mental capacity, would have found a way for this young woman to be sterilised so this sort of situation didn't arise. Tut tut, how barbaric we all said - but as this case shows sometimes there is no absolute right and wrong but simply choosing the lesser of two evils. IMHO the Court of Appeal, in choosing to block the termination, have decided instead to cause another evil by ensuring that a child of rape is brought into the world, with all the emotional baggage that will cause, and a woman of limited intellect and capacity is abandoned by her family. Of course it is a victory for the right-to-life lobby, but the cost is too great.
  • lilbuddhalilbuddha Shipmate
    Of course, back in the day when dinosaurs roamed the earth the state, under legislation to do with mental capacity, would have found a way for this young woman to be sterilised so this sort of situation didn't arise. Tut tut, how barbaric we all said -
    Because it was. Unless you are a fan of Francis Galton or admire this Churchill quote
    The multiplication of the feeble-minded is a very terrible danger to the race
    Eugenics is never a wonderful thing, though this woman, and others like her getting pregnant is not wonderful either.
    but as this case shows sometimes there is no absolute right and wrong but simply choosing the lesser of two evils.
    That life is often the lesser of two evils is correct. Sterilisation is fraught with exactly where the line is drawn and that is not a simple thing.
    IMHO the Court of Appeal, in choosing to block the termination, have decided instead to cause another evil by ensuring that a child of rape is brought into the world, with all the emotional baggage that will cause,
    This is assuming the woman has the capacity to process what happened and that she was forced. That is is rape, I am not contesting. That she experienced trauma is not explicit.
    and a woman of limited intellect and capacity is abandoned by her family. Of course it is a victory for the right-to-life lobby, but the cost is too great.
    There are ways this could not be fucked up for the child and the woman, but they seem to be receding rather quickly.

  • The emotional baggage I was referring to was that for the (as yet unborn) child. The poor scrap will come into a situation where it will wonder why its own mother couldn't look after it, quite possibly why she lives in another country, will grow up to wonder how this child-adult could have formed a relationship, and then have to face that the act that brought about their being was non-consensual. I call that baggage with a capital B. And although the woman may not have experienced trauma, that is likely to be because she didn't realise what was going on.
    lilbuddha wrote: »
    There are ways this could not be fucked up for the child and the woman, but they seem to be receding rather quickly.
    Really? I can't think of or see any.

    Question: Have any of you any direct experience of what is involved with someone with the capacity of a small child going into labour? I have. Sufficient to say the words acute, distress, incomprehension don't even come close: try absolute, total, terror and you get a bit nearer.
  • lilbuddhalilbuddha Shipmate
    The emotional baggage I was referring to was that for the (as yet unborn) child. The poor scrap will come into a situation where it will wonder why its own mother couldn't look after it, quite possibly why she lives in another country, will grow up to wonder how this child-adult could have formed a relationship, and then have to face that the act that brought about their being was non-consensual. I call that baggage with a capital B.
    If the grandmother raises the child as her own, the child need never know otherwise.This has been done. In a nuclear family society such as the UK, being without one parent has been a stigma. In some Nigerian cultures, the extended family has a much bigger role to play and the stigma of being "illegitimate" does not exist.
    Question: Have any of you any direct experience of what is involved with someone with the capacity of a small child going into labour? I have. Sufficient to say the words acute, distress, incomprehension don't even come close: try absolute, total, terror and you get a bit nearer.
    I am not denying the pain of labour or her inability to process it. We also do not know what the lasting effect, if any, that will have.
    I am not arguing for her to carry the child to term. Just pointing out parts of the equation. There is no perfect outcome.

  • EnochEnoch Shipmate
    ... Of course, back in the day when dinosaurs roamed the earth the state, under legislation to do with mental capacity, would have found a way for this young woman to be sterilised so this sort of situation didn't arise. Tut tut, how barbaric we all said - but as this case shows sometimes there is no absolute right and wrong but simply choosing the lesser of two evils. ...
    Involuntary eugenic sterilisation has been lawful in quite a lot of countries in the past, and not just fascist ones. However, I think you'll find that, although there were plenty of opinion formers etc back in the first half of the last century who advocated it, it was never actually permitted in any of the UK's three jurisdictions.

    The only examples I can find have been fairly recent ones. They've been rare, and in all cases it has been strictly in the interest of the potential parent, not the eugenic aspect.

    I don't think any of them have involved aborting a child of someone who was already pregnant at the time.
  • Social care will think long and hard before agreeing for this grandmother to bring up her grandchild when her vulnerable daughter has become pregnant under her care?
  • lilbuddhalilbuddha Shipmate
    Enoch wrote: »
    ... Of course, back in the day when dinosaurs roamed the earth the state, under legislation to do with mental capacity, would have found a way for this young woman to be sterilised so this sort of situation didn't arise. Tut tut, how barbaric we all said - but as this case shows sometimes there is no absolute right and wrong but simply choosing the lesser of two evils. ...
    Involuntary eugenic sterilisation has been lawful in quite a lot of countries in the past, and not just fascist ones. However, I think you'll find that, although there were plenty of opinion formers etc back in the first half of the last century who advocated it, it was never actually permitted in any of the UK's three jurisdictions.
    From The New Statesman in an article on the eugenics movement:
    Although such legislation was never actually passed in Britain, this did not prevent many sterilisations being carried out under various forms of coercion.

  • lilbuddhalilbuddha Shipmate
    Social care will think long and hard before agreeing for this grandmother to bring up her grandchild when her vulnerable daughter has become pregnant under her care?
    There is this, even though that could have happened by accident rather than neglect. We don't know the fitness of the grandmother.

  • But I invite you to consider the emotional and psychological impact of going through labour if you do not know it is going to happen, and you do know what is happening for most of the time. That is presumably what they are worried about.

    If she is already 22 weeks pregnant, then a termination will also involve labour - there is no avoiding it at this stage. It's a ghastly situation whatever happens.

  • But the difference in size between a 22 week gestation foetus and a 40 week gestation baby is significant. At 22 weeks most women are barely showing as pregnant, at 40 weeks it's usually obvious.
  • la vie en rougela vie en rouge Circus Host, 8th Day Host
    No reason labour could not be a planned caesarian, which would surely be less distressing.
  • I don't know if its comparable, but I've given birth to three full term pregnancies, of babies weighing 7lb 4oz, 8lb 3oz, and 1lb 13oz (stillborn) and the third was the longest and most painful labour. I was told that it's normal for it to be harder to deliver a dead baby.

    First time I went into hospital at 10pm and delivered at 4am, second time went in after midnight and delivered at 4.30am, third time went into hospital and took the tablets to induce labour at 6pm, and was in full blown labour from midnight till noon.

    As there is no problem with painkillers affecting the baby in the case of a stillbirth, it's possible to have a pain free delivery. But in 1999 I was advised that recent research had found a link between the painkillers, hallucinating during labour and post-partum psychosis. So I was advised against them. This issue may have been resolved by now, of course; I would hope that this isn't still the case twenty years on.
  • You've obviously not had a caesarian. They aren't a bundle of fun either. A caesarian results in the same scars as a hysterectomy.
  • la vie en rougela vie en rouge Circus Host, 8th Day Host
    Er no, I have had a caesarian. And a rather traumatic one at that – apart from the catastrophic circumstances (25 weeks) the anaesthesia wasn’t strong enough and I had to be shot up with two syringes of intravenous morphine towards the end. I'm perfectly aware they're no fun. However, I do think it would still be less psychologically distressing, especially if carried out under a general anaesthetic.

    This is a situation where every course of action involves distress. The question is what is the least worst.
  • CaissaCaissa Shipmate
    I have been offline for several days and this is parenthetical to the discussion. It's another pond difference it appears in how "learning disabilities" is defined. Below is the definition of the Learning Disabilities Association of Canada.


    Official Definition of Learning Disabilities
    Adopted by the Learning Disabilities Association of Canada January 30, 2002 Re-endorsed on March 2, 2015

    Learning Disabilities refer to a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or nonverbal information. These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning. As such, learning disabilities are distinct from global intellectual deficiency.

    Learning disabilities result from impairments in one or more processes related to perceiving, thinking, remembering or learning. These include, but are not limited to: language processing; phonological processing; visual spatial processing; processing speed; memory and attention; and executive functions (e.g. planning and decision-making).

    Learning disabilities range in severity and may interfere with the acquisition and use of one or more of the following:

    oral language (e.g. listening, speaking, understanding);
    reading (e.g. decoding, phonetic knowledge, word recognition, comprehension);
    written language (e.g. spelling and written expression); and
    mathematics (e.g. computation, problem solving).

    Learning disabilities may also involve difficulties with organizational skills, social perception, social interaction and perspective taking.

    Learning disabilities are lifelong. The way in which they are expressed may vary over an individual’s lifetime, depending on the interaction between the demands of the environment and the individual’s strengths and needs. Learning disabilities are suggested by unexpected academic under-achievement or achievement which is maintained only by unusually high levels of effort and support.

    Learning disabilities are due to genetic and/or neurobiological factors or injury that alters brain functioning in a manner which affects one or more processes related to learning. These disorders are not due primarily to hearing and/or vision problems, socio-economic factors, cultural or linguistic differences, lack of motivation or ineffective teaching, although these factors may further complicate the challenges faced by individuals with learning disabilities.

    Learning disabilities may co-exist with various conditions including attentional, behavioural and emotional disorders, sensory impairments or other medical conditions.

    For success, individuals with learning disabilities require early identification and timely specialized assessments and interventions involving home, school, community and workplace settings.
    The interventions need to be appropriate for each individual’s learning disability subtype and, at a minimum, include the provision of:

    specific skill instruction;
    accommodations;
    compensatory strategies; and
    self-advocacy skills.

  • My caesarian was under epidural, but it took the anaesthetist half an hour to get it in place, my back looked like a pincushion and I had extra pain meds written up for the next few days. And a bruised urethra that meant I had had to have a catheter inserted for a few days, incomplete removal of the placenta and iron tablets to cope with the loss of over a litre of blood, so severe constipation and enema treatment, plus the regular inspections to find and check the remainder of the placenta. I had placenta praevia, birth at 38 weeks to allow for lung development.
  • KarlLBKarlLB Shipmate
    Caissa wrote: »
    I have been offline for several days and this is parenthetical to the discussion. It's another pond difference it appears in how "learning disabilities" is defined. Below is the definition of the Learning Disabilities Association of Canada.


    Official Definition of Learning Disabilities
    Adopted by the Learning Disabilities Association of Canada January 30, 2002 Re-endorsed on March 2, 2015

    Learning Disabilities refer to a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or nonverbal information. These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning. As such, learning disabilities are distinct from global intellectual deficiency.

    Learning disabilities result from impairments in one or more processes related to perceiving, thinking, remembering or learning. These include, but are not limited to: language processing; phonological processing; visual spatial processing; processing speed; memory and attention; and executive functions (e.g. planning and decision-making).

    Learning disabilities range in severity and may interfere with the acquisition and use of one or more of the following:

    oral language (e.g. listening, speaking, understanding);
    reading (e.g. decoding, phonetic knowledge, word recognition, comprehension);
    written language (e.g. spelling and written expression); and
    mathematics (e.g. computation, problem solving).

    Learning disabilities may also involve difficulties with organizational skills, social perception, social interaction and perspective taking.

    Learning disabilities are lifelong. The way in which they are expressed may vary over an individual’s lifetime, depending on the interaction between the demands of the environment and the individual’s strengths and needs. Learning disabilities are suggested by unexpected academic under-achievement or achievement which is maintained only by unusually high levels of effort and support.

    Learning disabilities are due to genetic and/or neurobiological factors or injury that alters brain functioning in a manner which affects one or more processes related to learning. These disorders are not due primarily to hearing and/or vision problems, socio-economic factors, cultural or linguistic differences, lack of motivation or ineffective teaching, although these factors may further complicate the challenges faced by individuals with learning disabilities.

    Learning disabilities may co-exist with various conditions including attentional, behavioural and emotional disorders, sensory impairments or other medical conditions.

    For success, individuals with learning disabilities require early identification and timely specialized assessments and interventions involving home, school, community and workplace settings.
    The interventions need to be appropriate for each individual’s learning disability subtype and, at a minimum, include the provision of:

    specific skill instruction;
    accommodations;
    compensatory strategies; and
    self-advocacy skills.

    This is the UK usage https://www.nhs.uk/conditions/learning-disabilities/
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