Missed opportunities: childhood learning disabilities as early indicators of risk among homeless adults with mental illness in Vancouver, British Columbia

Abstract

ObjectivesIt is well documented that early-learning problems and poor academic achievement adversely impact child development and a wide range of adult outcomes; however, these indicators have received scant attention among homeless adults. This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness.DesignThis study was conducted using the baseline sample from a randomised controlled trial (RCT).SettingParticipants were sampled from the community in Vancouver, British Columbia.ParticipantsThe total sample included 497 adult participants who met criteria for absolute homelessness or precarious housing and a current mental disorder based on a structured diagnostic interview. Learning disabilities in childhood were assessed by asking adult participants whether they thought they had an LD in childhood and if anyone had told them they had an LD. Only participants who responded positively to both questions (n=133) were included in the analyses.Outcome measuresPrimary outcomes include current mental disorders, substance use disorders, physical health, service utilisation and duration of homelessness.ResultsIn multivariable regression models, self-reported LD during childhood independently predicted self-reported educational attainment and lifetime duration of homelessness as well as a range of mental health, physical health and substance use problems, but did not predict reported health or justice service utilisation.ConclusionsChildhood learning problems are overrepresented among homeless adults with complex comorbidities and long histories of homelessness. Our findings are consistent with a growing body of literature indicating that adverse childhood events are potent risk factors for a number of adult health and psychiatric problems, including substance abuse.Trials registration numberThis trial has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374.

Demographic and psychological predictors of grade point average (GPA) in North-Norway: a particular analysis of cognitive/school-related and literacy problems

“…A small number of studies have employed screening questions, asking if the participants believe they have LD (e.g. Patterson, Moniruzzaman, Frankish, & Somers, 2012;Øverby, Lüdemann, & Høigaard, 2013). In the Patterson et al study (2012) two questions predicted several outcomes (e.g., educational attainment, mental and substance abuse problems), thus showing that brief measures may have acceptable validity, but we considered two questions as too narrow in our study.…”

Cognitive impairment and homelessness: A scoping review

“…Rates were compared with UK general population estimates of 2.5%–3% (Oakes & Davies, ) and Dutch estimates of 0.7% (Van Straaten et al, ). Although adults were not assessed for learning disability in Patterson's, Moniruzzaman, Frankish, and Somers () study, 36% of participants reported an learning disability in childhood, a diagnostic criterion for learning disability. A significantly high percentage of 39% learning disability was also found in Tripathi et al’s () homeless sample; however, measures of assessment were not well documented.…”

“…Low levels of educational attainment and inconsistent employment were also suggested as leading to poverty and subsequent homelessness (Hennessey et al, ). Many prevalence studies found that within homeless populations levels of educational attainment were lower for those with CI (Hurstak et al, ; Patterson et al, ; Rogoz & Burke, ; Stergiopoulos et al, ; Van Straaten et al, ). CI was also linked to contact with the Criminal Justice System.…”

Twice upon a time: Examining the effect socio‐economic status has on the experience of dyslexia in the United Kingdom

“…Thus, the majority of research that focuses on dyslexia in adulthood have explored issues of social deprivation but have not developed a specific social class analysis (see Dåderman, Meurling, & Levander, 2012;Macdonald & Deacon, 2015;Patterson, Moniruzzaman, Frankish, & Somers, 2012;Selenius, Dåderman, Meurling, & Levander, 2006;Yates, 2013). Previous research directly examining links between socio-economic status and dyslexia has predominantly focused on assessment and identification of children.…”