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What is a secondary disability?

Primary disabilities are characteristics or behaviours that reflect differences in brain structure and function, such as mental retardation, attention deficits and sensory integration dysfunction. Secondary disabilities are disabilities that the individual is not born with. These disabilities and behaviours develop over time because of a poor fit between the person and the environment.

NOFAS-UK/Mencap, 2010

A secondary condition is an additional condition that presupposes the existence of a primary condition. It is distinguished from other health conditions by the lapse in time from the acquisition of the primary condition to the occurrence of the secondary condition. Examples include pressure ulcers, urinary tract infections, and depression. Secondary conditions can reduce functioning, lower the quality of life, increase health care costs, and lead to premature mortality. Many such conditions are preventable and can be anticipated from primary health condition.

World Health Organisation, 2011

Treatment and prevention

Although it is rarely possible to treat the primary cause of a child's learning difficulty, it is often possible to prevent or at least minimize the impact of secondary disabilities, such as epilepsy, sensory impairment, behavioural or communication difficulties, and always possible to ensure that parents and carers are informed about appropriate support.

Whiting, 2001

Preventing secondary conditions related to existing disabilities is an important priority... Timely referral can facilitate access and decrease...the development of secondary conditions.

World Health Organisation, 2011

Cerebral palsy and secondary disabilities

[For young people with cerebral palsy,] inactivity leads to muscle weakness, stiffness, contractures, osteopenia/porosis, potential changes in motor pathways (preventable!)...

We need to anticipate and avoid secondary impairments, rather than treat them after they occur... [It requires a] paradigm shift emerging from the rehabilitation approach of acceptance of and compensation for injuries to strategies that promote neural recovery and restoration of function...

Damiano, 2008

Mental health needs and ASD

The identification of mental health difficulties in young people with PMLD or ASD is often confused by the challenge of interpreting behaviours which become associated with a 'condition' rather than a manifestation of a mental health problem... Identification of potential mental health problems was highlighted as a major challenge when working with these young people... whilst interventions and strategies were identified by teachers and other professionals, these were often reactionary and not always informed by an understanding of complex needs.

Fergusson et al, 2008

Secondary disabilities and FASD

It is reported that many CYP with FASD will have early entry into the criminal justice system – Kelly (2009) reported that, above age 11 years, 60% of CYP with FASD were in trouble with the law, and 50% had experienced confinement... Streissguth and colleagues (1996) found that 3% of 6-11-year-olds, 12% of 12–20-year-olds, and 23% of adults from a cohort of 415 subjects diagnosed with FAS or Foetal Alcohol Effects had attempted suicide (The adult figure is five times the US national average).

Blackburn et al, 2012

What types of secondary disabilities are there?
A young boy with his female teacher
                  smiles at the camera

Careful definition of secondary disabilities brings a real chance to make a positive difference, as correct management can alleviate symptoms...secondary disabilities can be significant and include the epilepsies, gastro-oesophageal reflux, constipation, postural deformities, spasticity, dystonia, movement disorders, pain, bladder problems, infections, osteopenia leading to fractures, drooling, behavioural and sleep disorders, sensory impairments, growth and endocrine disorders.

Horridge, 2010

Secondary disabilities in your school

Review key literature on the impact of secondary disabilities relating to the population of children in your school. Review the systems in place in your school to address secondary disabilities and to raise staff awareness.

Find out more (1)

Blackburn, C., Carpenter, B. and Egerton, J. (2012) Educating Children and Young People with FASD. London: Routledge.



Emerson, E. (2007) Challenging behaviour and psychiatric disorder in intellectual disability: common causal factors, Current Opinion in Psychiatry, 20 (5), 450-455.


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