The article reviewed here is a Department of Health document titled ‘Estimating Future Numbers of Adults with Profound Multiple Learning Disabilities in England’ and which is freely available here. This document is based on research undertaken by the Centre for Disability Research and the article is authored by Eric Emerson. The aim of the associated project is defined as being to ‘estimate change in the future numbers of adults with profound multiple learning disabilities in England over the period 2009 to 2026’. The methodology is described clearly and begins with an estimation of children with special educational needs from a 2008 school census involving 6.8 million pupils. The prevalence rate estimates are stratified according to age group and gender and there are some assumptions about age at entry and leaving school in people with profound multiple learning disabilities. A trend towards a decreasing prevalence from age 7 to 15 is noted although the reasons are unclear. This is equivalent to an increase prevalence of 4.8% annually and further supporting evidence is provided. Using data from a Sheffield case registry and adjusting for population demographics, the annual increase in prevalence during this period was calculated at 4.7% which is close to the figure obtained from this analysis and thus provides supporting evidence and reasons for why this might be a cohort effect are given. A demographic analysis of the data was undertaken and a number of findings were consistent with previous research including gender and ethnicity results.
The next stage was to adjust for mortality, a very difficult area given the heterogeneity of conditions leading to profound multiple learning disability, the heterogeneity of comorbid illness, advances in management during the project period and a number of other confounding factors. The estimate was that there would be an ‘average annual percent increase of 1.8%’ during the period 2009 to 2026 although it is also noted that there will be a decline in the number of people reaching adulthood in the general population during this period (with an upturn in the latter period due to increasing birth rates). Thus for a catchment area of 250,000 people they estimated that ‘the number of young people with PMLD becoming adults in any given year will rise from 3 in 2009 to 5 in 2026’ although the difficulties in estimating mortality rates are noted.
This is a useful piece of research which can be further revised as data from other sources becomes available and has implications for planning service delivery.
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