Adult learning disability clinics

The prevalence of hearing loss in adults with learning disabilities is considerably higher than in the general population. According to a study from the Netherlands, 21% of people with learning disabilities will have a hearing impairment compared with 1.9% of the general population. However, there is likely to be a large proportion of undetected hearing loss in the adult learning disability population. A holistic service providing a person-centred approach is required to meet individual needs; working closely with family, carers, key workers/support workers in addition to other agencies when required.

Service delivery: The service is for assessment of adults with developmental or neurological disorders and complex needs who are not able to perform reliably on standard behavioural assessments. It is delivered at the level of secondary or tertiary care and patients can be referred by the community team and GP. To ensure high-quality person-centred care, the service is best delivered as a one-stop clinic where a clinical assessment is jointly performed by a senior audiologist and an audiovestibular physician. Prior reports and questionnaires from family, carers and key or support workers are useful to ensure best use of the appointment. Non-traditional methods of testing and video recording may be used. Patients with moderate to severe or profound learning difficulties often require specialist testing equipment (eg electrophysiological tests).

Workforce: Medical professionals with training in aetiological investigations and auditory disorders in the adult population, eg audiovestibular physicians and ENT specialists. The specialist and supra-specialist services consist of a multiprofessional team including an audiovestibular physician, audiologists, hearing therapists or audiologist with hearing rehabilitation skills and speech and language therapists. Forty-five minutes is usually required for a new patient and 20–30 minutes for a follow-up appointment.

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