Learning difficulties

Question 1

What is a learning difficulty?

Answer 1

Difficulty in acquiring knowledge and skills to the normal level expected of those of the same age, especially because of mental disability or cognitive disorder

Question 2

What is the difference between a learning disability and a learning difficulty?

Answer 2

Disability - low IQ, affecting global brain functioning, mental retardation
Difficulty - something that makes it harder to learn but can be corrected by a small thing eg changing paper colour, bigger text

Question 3

Name 2 possible learning difficulties

Answer 3

ADHD

ASD

Question 4

Name 2 learning disabilities

Answer 4

Down syndrome

Fragile X syndrome

Question 5

What are the risk factors for ADHD?

Answer 5

Family history of ADHD or other mental health conditions
Exposure to environmental toxins
Maternal drug useage
Smoking during pregnancy
Premature birth

Question 6

What are the risk factors for ASD?

Answer 6

Male sex
Family history
Other disorder - fragile X syndrome, tuberous sclerosis, Rett syndrome
Premature birth
Older parents

Question 7

What are the risk factors for Down syndrome?

Answer 7

Advancing maternal age
Parents being carriers of genetic translocation for Down syndrome
Having had one child with Down syndrome

Question 8

What are the risk factors for fragile X syndrome?

Answer 8

Genetically inherited
Male - mother carrier of gene
Female - father/mother carrier of gene

Question 9

How common is ADHD?

Answer 9

8.4% of children and 2.5% adults

More common amongst boys

Question 10

How common is ASD?

Answer 10

1 in every 54 (1.9%) of 8 year old
4.3 times more common in boys
Equal representation among different racial and ethnic groups

Question 11

How common is Down syndrome?

Answer 11

Most common chromosomal condition diagnosed

1 in 700

Question 12

How common is fragile X syndrome?

Answer 12

x2 more common in men
Women often have milder symptoms than men
Affects around 1 in 4000 men and 1 in 8000 women
Women can be carriers, men cannot

Question 13

Name 3 genetic disorders that could be a differential diagnosis

Answer 13

Deletion at 22q11p
Kleinfelter's
Prader-Willi
Angelman's
Rett syndrome
Neurocutaneous disorders ef neurofibromatosis, Sturge-Weber syndrome, tuberous sclerosis

Question 14

Name 3 acquired disorders that could be a differential diagnosis

Answer 14

History of prematurity
Congenital hydrocephalus
Traumatic brain injury
Prior cerebral infection eg encephalitis
Lead/mercury poisoning

Question 15

Name 3 other disorders that could be a differential diagnosis

Answer 15

Intellectual disability/developmental delay
Language or developmental disorder
Visual or hearing impairment
Seizure disorder
Substance abuse

Question 16

Name 3 emotional disorders that could be a differential diagnosis

Answer 16

Anxiety
Depression
PTSD
Psychosis

Question 17

How does ADHD present?

Answer 17

Inattention

Hyperactivity and impulsivity

Question 18

How does ASD present?

Answer 18

Problems with social interaction and communication skills

Limited, repetitive patterns of behaviour, interests or activities

Question 19

What are the physical symptoms of Down syndrome?

Answer 19

Flattened face
Small head
Short neck
Protruding tongue
Upward slanting eye lids
Unusually shaped or small ears
Poor muscle tone
Broad, short hands with a single crease in the palm
Relatively short fingers and small hands and feet
Excessive flexibility
Tiny white spots on iris
Short height

Question 20

What are the developmental symptoms of Down syndrome?

Answer 20

Mild-moderate cognitive impairment
Delayed language
Affects short and long term memory

Question 21

What are the physical symptoms of fragile X syndrome?

Answer 21

Low muscle tone
Large ears
Flat face
High forehead
Often difficult to recognise in children

Question 22

What are the developmental symptoms of fragile X syndrome?

Answer 22

Intellectual disability

Question 23

What are the behavioural symptoms of fragile X syndrome?

Answer 23

Significant social anxiety
Short attention span
Distractibility
Impulsiveness
Restlessness
Over-activity
Sensory problems (ADHD like symptoms)
Autism

Question 24

What are the possible carrier traits of fragile X syndrome?

Answer 24

Social interaction
Communication difficulties
Learning difficulties
ADHD
Anxiety
Depression
Early menopause
Parkinson's like conditions

Question 25

How is ADHD diagnosed?

Answer 25

6 or more symptoms of inattentiveness or 6 or more symptoms of hyperactivity and impulsiveness
Symptoms continuously for at least 6 months
Started to show symptoms before 12
Over the age of 6

Question 26

How is ASD diagnosed?

Answer 26

Look at how the child interacts

Ask parents a few questions

Question 27

How is Down syndrome diagnosed?

Answer 27

Often diagnosed in the womb
Or
Diagnosed a birth which chromosomal analysis

Question 28

How is fragile X syndrome diagnosed?

Answer 28

DNA blood tests looking for changes in the FMR1 gene

Question 29

How is ADHD managed?

Answer 29

Medications to help with concentration and impulsions
Psychoeducation
CBT
Parent training and education programmes
Social skills training

Question 30

What drugs might you give for ADHD?

Answer 30

Methylphenidate
Dexamfetamine
Lisdexamfetamine
Atomoxetine
Guanfacine

Question 31

How is ASD managed?

Answer 31

Behavioural management therapy
CBT
Early intervention
Educational and school-based therapies
Joint attention therapy
Medication treatment
Nutritional therapy
Occupational therapy
Parent-medicated therapy
Physical therapy
Social skills training
Speech-language therapy

Question 32

How is Down syndrome managed?

Answer 32

SLT
Physiotherapist
Optician or hearing specialist
Occupational and educational support

Question 33

How is fragile X syndrome managed?

Answer 33

Treatments to minise symptoms - eg benzodiazepines when anxious
Appropriate education and medication
Therapy services

Question 34

What does an IQ below 70 mean?

Answer 34

Significantly below average

May be lacking capacity for certain decisions