We've preselected "All levels" for you, but you can change your study level at any time by choosing one of the options on
this menu. Changing your study level will return you to the beginning of the module.
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
In this clip you will see how families work hard to prevent secondary disabilities: Postural Care: Craig's story.
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?
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.
Problems viewing video whilst online may be the result of controls on the network you are using to access the SALT materials.
Should problems viewing video persist, it is recommended that users download the video using the link provided.
Problems viewing video whilst offline?
If you are using Firefox or Internet Explorer, you may find that some video resources will not play in your browser when you’re
working offline. We’ve supplied a link with each video to open it in your default media player if this happens.
The mp4 videos on this site are not compatible with older versions of Windows Media Player. If you want to watch the videos
offline, please download an alternative such as QuickTime or RealPlayer, and set this as your default media player. You will also need to do this if you want to download videos from the materials’
‘Further reading’ area.
Alternatively, you may choose to work through the materials in Chrome or Safari.
Please go to your browser settings and turn on JavaScript to make full use of this site.
