Cognition, Language, Learning Flashcards
What is required to be considered to have an intellectual disability?
Limitations in intellectual functioning as well as adaptive/behavior skills originating before age 18
(within context of community/cultural/linguistic factors)
What are the five components of going about identifying a potential cause for intellectual disability?
- History: Behavioral patterns
- Family History: Stillborns, miscarriages, consanguinity
- PE: Dysmorphism/unusual features
- Genetic Testing
- Imaging: Microcephaly, ect
What is the imaging study of choice with concern for intellectual disability?
MRI
True or False: EEG is part of the workup for intellectual disability
False: In absence of seizures, EEG isn’t indicated
What are the 3 most common known causes of intellectual disability?
- Fetal alcohol syndrome
- Fragile X syndrome
- Down syndrome
What is the most common preventable cause of intellectual disability?
Fetal alcohol syndrome
What problems can kids with fetal alcohol syndrome who have IQs in normal range have?
- Neurobehavioral deficits
2. Increased risk for psychiatric disorders
What two mental health problems are kids with Down syndrome at increased risk for?
- ADHD
2. Oppositional-defiant disorder
What should you think if there is a family three filled with uncles with learning problems?
X-linked disorder like Fragile X
When is metabolic screening done in the workup of intellectual disability?
Only if there is PE findings or history to support testing
What is the most common cause of intellectual disability?
Genetics
Besides genetics, what are 2 other causes to consider for intellectual disability?
- Perinatal infection
2. Teratogen exposure
What IQ constitutes mild intellectual disability?
55-70
What IQ constitutes moderate intellectual disability?
40-55
What IQ constitutes severe intellectual disability?
25-40
What IQ constitutes profound intellectual disability?
Below 25
True or False: Severe intellectual disability is usually picked up at a younger age
True
What % of cases of intellectual disability fall in the mild range?
Up to 85%
When is mild intellectual disability usually picked up?
Time of entry into school (later than more severe intellectual disability)
What type of development can visual impairment delay?
Motor
What type of development in young children is often a better gauge of cognitive function?
Language (versus gross motor)
Up to what age can an infant with profound hearing loss demonstrate normal language development?
6-9 months: Babbling won’t progress to definite “mama” and “dada”
What is needed for a child younger than 6 who is having difficulty pronouncing certain consonants?
Reassurance
How is ASD diagnosed?
Clinically
Name 4 characteristics of ASD
- Serious impairment of social skills
- Delayed language development (except Asperger)
- Repetitive behaviors/restricted interests
- Presentation prior to 36 months
What is an important component of autism which distinguishes it from of forms of language delay?
- Lack of eye contact
2. Lack of social engagement
What is an important part of history in diagnosing ASD?
Child’s interactions with other family memeber
What are 2 things which can help distinguish ASD from intellectual disability?
- Delayed/atypical language
2. Odd interests/activities
What rules out ASD (for the most part)?
Good social interaction
True or False: With Asperger syndrome, there is no language delay
True
In what syndrome is development normal until age 1, then begins to regress?
Rett
What syndrome should you think of with acquired microcephaly?
Rett
What is a requirement for any child undergoing evaluation for a speech delay?
Hearing test
What is important to screen for in family history with workup for a learning disability?
Others with speech, language, learning, or behavioral problems (ADHD)
(may be a clue to specific disorders like Fragile X)
True or False: A child can have a learning disability with normal or even superior intelligence
True
Learning disability is defined as a gap between the expected and observed performance in any of which 6 areas?
- Listening
- Speaking
- Reading
- Writing
- Reasoning
- Math skills
Up until what age can a findings of a child who reverses letters (like b/d) be a normal finding?
Age 7
What is key for learning disabilities?
Early intervention
*Delay in diagnosis can cause repeated academic failures and decreased school motivation
Name 4 red flags for a learning disorder
- Delay in speech and language development
- Can’t recognize letters/numbers by the end of kindergarten
- Speech delay in preschooler
- Can’t read simple words by end of 1st grade
True or False: There can be significant negative social impact when kids are held back a grade
True
*But moving someone on who is failing doesn’t address academic problems either
Name 2 drugs which can alter school performance
- Anticonvulsants
2. Antihistamines
What mental health problem can cause poor school performance?
Depression
*But, poor school performance can also cause depression
Children with learning disabilities are at increased risk for what two things?
- Behavioral disorders
2. Mood disorders
True or False: Learning disabilities can be outgrown
False
What can be important for self esteem of a child with a learning disability?
Extracurricular activities
What is encouraged for kids with learning disabilities?
Use of special tools: Private tutoring, resource room, ect.
True or False: Most common eye disorders don’t impact ability to read
True
When are things like tinted eyeglasses or eye gymnastics helpful to improve reading ability?
Never
What should you consider with a child who is struggling in something like history or social studies?
Reading difficulty or problems with short term memory
What do achievement tests distinguish between?
IQ (potential) and achievement (actual) intellectual peformance
Name some factors which can influence intelligence testing
- Genetics
- Cultural/language bias
- Emotional/psychosocial factors
- Ability to focus/pay attention
Which is more important on IQ tests (like the WISC-IV)… overall score or sub-test profile scores?
Subtest- this allows for more detailed information on child’s difficulties
What does the WISC-IV stand for?
Wechsler Intelligence Scale for Children
What should you think with a child who has below normal scores on an achievement test despite a normal IQ?
Specific learning disability
True or False: The predictive value of IQ testing increases with age
True
What are the first 5 things to consider when you have a child with school failure?
- Medical history (signs of things like asthma, IBD, or neurological disorders like Tourette’s)
- Educational history
- Physical exam
- Family history
- Emotional issues (Recent divorce or move)
Once you have gotten a good history and exam, what is the next thing to do for a child with school failure?
Testing
