Intellectual Disability I Flashcards
How common are intellectual disabilities?
People with learning difficulties account for 3% of the population
What are some issues people with learning difficulties face in hospital?
Lack of effective flagging systems and staff knowledge to flag this group in hospital
Poor understanding of specific requirements of people with learning difficulties and their specific needs
How do learning difficulties impact life expectancy?
Lower life expectancy by 18 years in females and 14 years in males
What are some comorbid conditions associated with learning difficulties?
Twice as likely to suffer from diabetes, heart failure CKD or stroke
26x more likely to have epilepsy, 8x more likely to have severe mental illness and 5x more likely to have dementia
What is the definition of a learning disability?
Condition of arrested or incomplete development of mind = especially characterised by impairment of skills which contribute to overall level of intelligence
When do learning disabilities tend to present?
During the development period
What areas do people with learning disabilities have deficits in?
Intellectual functioning = IQ <70
Adaptive functioning
What is the most commonly used tool for psychometric assessment of people with learning difficulties?
Wechsler Adult Intelligence Scale (WAIS)
What tools are used for psychometric assessment of children with learning disabilities?
Depends on age = Wechsler Intelligence Scale for Children (WISC) or Wechsler Preschool and Primary Scale of Intelligence (WPPSI)
What are some alternative tools for psychometric assessment of people with learning disabilities?
Stanford Binet and Raven’s Progressive Matrices
What is the grading of severity of learning disabilities?
Borderline = IQ 70+ Mild = IQ of 50-69 Moderate = IQ of 35-49 Severe = IQ of 20-34 Profound = IQ <20
What is the presentation of borderline learning disability?
IQ of 70-84 and mental age between 12-15
Not a category in DC-10, ICD-10 or DSM-IV
What are some features of mild learning disability?
Most common type
Rarely organic aetiology
IQ between 50-69 and mental age between 9-12
What is the presentation of mild learning disability?
Delayed speech = able to use everyday speech
Full independence
Capable of unskilled or semi-skilled work
Difficulties with reading and writing
What are some features of moderate learning disability?
IQ of 35-49 and mental age between 6-9
Discrepant profiles
Majority have organic aetiology
What is the presentation of moderate learning disability?
Slow with comprehension and language Delayed self care and motor skills Can do simple practical tasks and usually fully mobile Limited achievements Epilepsy and physical disability common
What is the presentation of severe learning disability?
IQ of 20-34 and mental age between 3-6
Generally more marked impairment than in moderate LD and achievements more restricted
Epilepsy
What is the presentation of profound learning disability?
IQ <20 and mental age <3
Severe limitation in ability to understand or comply with instructions or requests
Little/no self care but basic tasks may be acquired
Often severe mobility restrictions
How is intellectual disability assessed in children?
Picked up in developmental screening = presentation possible as children don’t reach milestones
Follow up after premature birth or SCBU
Investigated through Child Developmental clinics
What are some common comorbid conditions in children with intellectual disabilities?
Autism spectrum disorder and ADHD
What are some antenatal causes of intellectual disability?
Maternal infections, poor diet and substance abuse
What are some perinatal causes of intellectual disability?
Extreme prematurity, birth injury, cerebral anoxia, neonatal septicaemia, pneumonia, meningitis, respiratory distress, hypoglycaemia, hyperbilirubinaemia
What are some chromosomal abnormalities associated with
Cri du chat = 5P, microcephaly, severe/profound ID
Angelman = 15Q, maternally derived ID, ataxia, paroxysms of laughter
Prader-Willi = 15Q, paternally derived ID, overeating, self harming behaviour
Velo-cardiofacial syndrome = 22Q, 50% have ID
Williams syndrome
What are some chromosome trisomies associated with learning disability?
Patau syndrome = trisomy 13
Edward’s syndrome = trisomy 18
Down’s syndrome = trisomy 21
