intellectual impairment Flashcards
learning disability
- “A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life.”
- MENCAP
intellectual impairment
Intellectual disability involves problems with general mental abilities that affect functioning in two areas:
- Intellectual functioning (such as learning, problem solving, judgement, IQ – mild, moderate or severe)
- Adaptive functioning (activities of daily life such as communication and independent living)
intellectual disability prevalance
Intellectual disability affects about one percent of the population, and of those about 85% have mild intellectual disability.
- Males are more likely than females to be diagnosed with intellectual disability.
terms that can be used
Person with an intellectual impairment
People with a learning difficulty e.g. dyslexia
People with a learning disability
Developmental delay
terms which should not be used
Mentally retarded
Mentally handicapped
Intellectually disabled
Special needs
and learning disabled people - borderline
key way to refer to someone with intellectual impairment
PERSON…………with an intellectual impairment/disability
global terms in health and social care
- Person with additional care needs
- Person with additional support needs
- Person who requires special care – very broad – intellectual impairment, cancer, age
eugenics
A philosophical and social movement which sought to improve the human race
Stems from Darwin’s publication “The origin of species” and Mendel’s Laws
Developed by Francis Galton and Charles Davenport
Eugenic = Well Born
- 2 Types
- Positive encouraging those with “desirable traits” to reproduce more
- Negative - discouraging those with “undesirable traits” to reproduce less
Eugenics is USA
- Forced sterilization
- 50 States with > 60,000 disabled people sterilised
Eugenics in Nazi germany
July 1933
- “Law for the Prevention of Progeny with Hereditary Diseases. “
- Included: congenital feeble-mindedness (learning disability), schizophrenia (mental illness), manic depression (now bipolar), hereditary epilepsy, Huntington’s chorea, hereditary blindness, hereditary deafness, serious physical deformities.
1939-1941
- Aktion T4 Program
- 700,000 deaths Including those who had congenital defects and learning disability
lennox castle hospital
Opened in 1936
Considered “ahead of its time”
- Purpose built villas
1913 Mental Deficiency Act
- Allowed “special hospitals” to be built to prevent dilution of the gene pool
Cases
- People with learning disability – admitted and locked away as they were ‘corrected’
- Abusive behaviour evidence
- Deaths – mass graves possible
was lennox castle hospital a new concept
not a new concept
- Lunacy Act 1857 (Scotland)
- Asylums
- For ‘mad’ admissions
- Special Schools
- Take people with learning disabilities out of their family units
lennox castle hospital closure
Closed in 2002
- People with Learning Disability or Mental Incapacity were “locked up” hidden from the community
- Punishments were often given
- No choice in decisions made
- Chores
- Segregation of male / female
- Use of Paraldehyde – sedatives, clinical trial type work
2 sides – some positive experience – well supported and care
But, importantly positive change now
social and policy changes
relatively recent
The concept of normalisation, reinforced by legislation (Department of Health, 1990), led to closures of long-stay institutions
- Transfer of residents to smaller homes in the community with a change in emphasis and responsibility for care and support from health to social services.
60% of adults with a learning disability now live with their families.
- Also living longer – new challenge
vulnerable people
some people with intellectual impairment are not able to be cared for sufficiently in a family environment
- Need a specialised caring environment
- Need to ensure they are not abused – Winterbourne view case
ICIDH 1980
impairment Vs Disability
In the context of health experience an impairment is any loss or abnormality of psychological, physiological or anatomical structure or function. Impairment is considered to occur at the level of organ or system function.
Disability is concerned with functional performance or activity, affecting the whole person.
Disability: In the context of health experience a disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being
WHO
disability Vs impairment
Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions.
Impairment is a problem in body function or structure
WHO
activity limitation
is a difficulty encountered by an individual in executing a task or action
WHO
participation restriction
- problem experienced by an individual in involvement in life situations.
Social model of disability
- Disability is caused by the way society is organised, rather than by a person’s impairment or difference.
medical model of disability
- The medical model of disability says people are disabled by their impairments or differences.
- Under the medical model, these impairments or differences should be ‘fixed’ or changed by medical and other treatments,
social model for causing disablity limitations
society willing to overcome disability so no longer viewed as
- Social organization (for example, work practices, buildings or products) that takes little or no account of people who have impairments and / or
- social organization that creates segregated and second-rate provision (for example, segregated welfare provision, transport, employment, education and leisure facilities).
barriers to positive social model changes for disabiled
- Segregated social provision
- Inflexible organisational procedures and practices
- Inaccessible information
- Inaccessible buildings
- Inaccessible transport
- Negative cultural representations
- Very true historically – positive changes but still steps
4 times for causes of learning disability
- preconception
- pre-natal
- perinatal
- postnatal
preconception causes of learning disability
heredity - perinatal genotype
environmental - maternal health
pre-natal causes of learning disability
heredity - chromosomal, genetic
environmental - infection, maternal health, nutrition, toxic agents
perinatal causes of learning disability
environmental - prematurity, injury
postnatal causes of learning disability
hereditary - untreated genetic disorders (PKU)
environmental - infection, trauma, toxic agents, nutrition, sensory social deprivation
6 syndromes associated with learning disability
- Autistic Spectrum Disorders
- Down’s Syndrome
- Cerebral Palsy
- Fragile X Syndrome
- Prader Willi
- PKU
Not everyone with these syndromes will have a learning disability – 2 separate things
Down’s syndrome
A neurodevelopmental disorder of genetic origin affecting chromosome 21.
Causes
- Most commonly DS is due to a full trisomy of chromosome 21 (95%)
- Small number of cases is due to mosaicism (2-4%)
- Inherited chromosomal rearrangement involving chromosome 21 (2–4 %)
head and neck clinical features of Down’s syndrome
- Broad flat face
- Slanting eyes
- Short nose
- Epicanthic eye fold
- Flat back of head
- Atlantoaxial instability of neck – imp in position pts – need to support neck
DS causes (3)
- Most commonly DS is due to a full trisomy of chromosome 21 (95%)
- Small number of cases is due to mosaicism (2-4%)
- Inherited chromosomal rearrangement involving chromosome 21 (2–4 %)
DS prevalence
Occurs in every 1 in 700 births
- DS has been estimated to affect 41 725 people in England and Wales in the year 2011 (Wu and Morris, 2013).
People with DS are living for longer, reflected in the age distribution peaking at 40 years of age.
Antenatal screening and subsequent termination have resulted in the total number of live DS births decreasing
greatest risk factor for DS
The single greatest risk factor for DS is advanced maternal age
- Women over the age of 35 are more likely to have a child with DS with the risk continuing to increase with advancing age.
Despite this, the majority of children with DS are born to younger mothers as the total number of births in this group is greater (Olsen et al., 1996).