Intellectual Disabilities: Basic Sciences, Clinical Features & Management Flashcards
females with a LD have 18 year lower life expectancy than general population - true or false?
true
males with LD have 14 year lower life expectancy than general population - true or false?
true
PWLD are more likely to have what mental conditions?
epilepsy
severe mental illness
dementia
PWLD are more likely to have what physical conditions?
hypothyroidism diabetes heart failure CKD stroke
what is the definition of LD?
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 is the criteria to be diagnosed with LD?
IQ < 70
developmental aetiology (<18 years)
deficits in adaptive functioning
what scale is most commonly used to assess adults with LD?
wechsler adult intelligence scale (WAIS)
or
wechsler preschool & primary scale of intelligence (WPPSI)
what scale is most commonly used to assess children with LD?
wechsler intelligence scale for children (WISC)
what is the IQ for:
a) mild LD?
b) moderate LD?
c) severe LD?
d) profound LD?
e) borderline LD?
a) 50-69
b) 35-49
c) 20-34
d) <20
e) 70+
what are symptoms of mild LD?
mental age 9 to under 12 years
most Common
delayed speech - able to use everyday speech
full independence – self care, practical & domestic skills difficulties in reading and writing
capable of unskilled or semi-skilled work
problems of social or emotional immaturity
rarely organic aetiology
what are symptoms of moderate LD?
mental age 6 to under 9 years. slow with comprehension and language
limited achievements
delayed self care and motor skills
simple practical tasks - often with supervision
usually fully mobile - physically active
discrepant profiles
majority organic aetiology
epilepsy & physical disability common
what are symptoms of severe LD?
mental age 3 to under 6 years.
generally more marked impairment than in moderate LD and achievements more restricted
epilepsy
what are symptoms of profound LD?
mental age less than 3 years. severe limitation in ability to understand or comply with requests or instructions little or no self-care. often severe mobility restriction. basic or simple tasks may be acquired.
what chromosomal abnormalities can cause LD?
cri du chat 5P angelman 15Q prader-willi 15Q velo-cardiofacial syndrome 22Q williams syndrome 7Q downs syndrome trisomy 21 patau syndrome tisomy 13 edwards syndrome trisomy 18
what sex chromosome abnormalities can cause LD?
trisomy 45X (LD rare)
trisomy X 47XXX
klinefelter 47XXY
fragile X (faulty FMR1 gene)
what can be genetic causes of LD?
defects of protein (phenylketonuria), carbohydrate (mucopolysaccharides) and lipid metabolism (neurolipidoses)
also tuberous sclerosis, congenital hypothyroidism and lesch nyhan syndrome (x linked)
what maternal infections can cause LD?
rubella
CMV
toxoplasmosis
what other prenatal factors can cause LD?
exposure to medication or drugs
alcohol (FASD)
poor diet
substance abuse
what perinatal factors can cause LD?
neonatal septicaemia pneumonia meningitis / encephalitis birth injury newborn complications
what postnatal factors can cause LD?
CNS infections, vascular incidents, brain injury, NAI, toxins
congenital hypothyroidism
cerebral palsies, epilepsy, ASD
what does the o’brien principles state?
people with LD will continue to grow and develop given an appropriate environment
what makes psychiatric diseases more difficult to treat in those with LD?
treatment resistance
susceptibility to side effects
epilepsy
what is significant about schizophrenia in LD?
3x more common, earlier onset
main symptom may be behaviour change
what are symptoms of schizophrenia in severe LD?
unexplained aggression bizarre behaviour social withdrawal mood liability increased mannerisms or stereotypies