Intellectual disabilities Flashcards
What is an intellectual disability according to ICD-10?
A condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence
I.e. cognitive, language, motor and social abilities
What are the criteria for intellectual disability?
IQ <70
Social or adaptive dysfunction
Onset in development period
What is mild LD?
IQ 50-69 or functional age 9-12
What is moderate LD?
IQ 35-49 or function age 6-9
What is severe LD?
IQ 20-34 or functional
age 3-6
What is profound LD?
IQ <20 or functional age <3
How might LD be inherited?
Fragile X PKU Retts syndrome DiGeorge syndrome Prader-Willi Angelman syndrome Down Syndrome
What are some infective causes of LD?
Rubella
Zika virus
What are some traumatic causes of LD?
Hypoxic injury during birth
Head injury in childhood
Foetal alcohol syndrome
How does epilepsy affect LD?
Increased incidence and complexity with severity of learning disability (10-50%)
Are LD more prevalent with sensory impairments?
Yes
Hearing (40%)
Vision 20%
What are some GI disorders associated with LD?
Swallowing problems
Reflux oesophagitis
H Pylori
Constipation
Are there any resp problems associated with LD?
Chest infections
Aspiration pneumonia
Is cerebral palsy associated with LD?
Yes
Does LD affect psychiatric disorder incidence?
Higher incidence of psychiatric disorders in those with LD
Presentation of mental illness different especially in moderate-profound LD
How does LD affect presentation for psychiatric disorders?
Those with lower IQ/ communication difficulties often present with ‘challenging behaviour’
It’s all about baseline
Where there is less verbal communication, observable signs are relied on more in making the diagnosis
What kind of observable signs may be relied on for psych diagnoses in LD patients?
Weight loss Withdrawal Agitation Tearfulness in depression Behavioural disturbance in psychotic disorder
How might presentation of anxiety disorders be different in LD?
Ritualistic behaviour and obsessional themes significantly increased in LD
What are some social disorders which are more prevalent in LD?
ADHD
Autism
What is diagnostic overshadowing?
Presenting symptoms are put down to their learning disability, rather than seeking another, potentially treatable cause
What are some effects of Asperger’s?
Social interaction and communication difficulties but with speech and language unaffected
How does autism spectrum disorder present?
Delay in speech and language/social skills Repetitive/obsessive behaviour Poor eye contact Rigidity of thought Lack of imagination
How does ADHD present?
Hyperactivity
Impulsive tendencies
Poor attention span
How is ADHD treated?
Methylphenidate (ritalin)
CBT
What is the diagnostic triad for autism?
Communication impairment
Impairment of social relationship
Ritualistic behaviour
