Learning Difficulty

Question 1

Learning disability

Answer 1

Significant reduction in intellectual ability (usually an IQ <70), significant impairment in social functioning, and onset in childhood.

Question 2

Learning difficulty

Answer 2

Patients have a specific difficulty in learning but no general impairment in intelligence or ability to be independent.

Question 3

Down’s syndrome genetics

Answer 3

Trisomy 21

Question 4

Risk factors of Down’s syndrome

Answer 4

maternal age of over 40yrs at conception.
Previous DS child.
DS mother

Question 5

Clinical features of DS

Answer 5

Short stature
Over-weight
Muscular hypotonia
Congenital heart defect
Oesophageal atresia
Single palmar crease
Webbed/Syndactylyl fingers
Sleep apnoea
Bradycephaly
Underdeveloped nose bridge
Brushfield's spots
Epicanthic folds
Low set ears
Protruding tongue
Low brain weight
Recurrent otitis media
Strabismus
Alan-axial instability in c-spine

Question 6

Complications of DS

Answer 6

Delayed puberty
Poor ovulation or spermatognenesis 
Depression
Dementia
Hirchsprung's 
Scoliosis

Question 7

Autism Spectrum Disorder definition

Answer 7

Present from early childhood.
Persistent disorder meaning the patient is limited in activities of daily living, communication and interacting with others and repetitive and restricted patterns of activities or interests.

Question 8

Asperger’s syndrome definition

Answer 8

Lies within autism spectrum. No delay in cognition or language unlike in classic autism. Still have impairment in social interaction and stereotyped interests and behaviours.

Question 9

ADHD definition

Answer 9

Persistent pattern of inattention with or without hyperactivity and impulsivity which interferes with development and functioning of patient. Present for at least 6 months in 2 different environments. Presents before the age of 12 years. Will reduce the quality of social, academic and occupation al functioning.

Question 10

Care and services for learning difficulty patients

Answer 10

MDT = community nursing, SALT, psychiatry, carer support, primary care/GP etc etc.
Annual health check - Cardiff health check template.
Dietary advice.
Information and advice for carers and families.
Parent-training programmes.
Early intensive behavioural intervention and CBT

Question 11

Management of ADHD

Answer 11

Refer to CAMHS
Non-drug = Family therapy and behavioural therapies.
Drugs = Methylphenidate/Ritalin, Amphetamines

Question 12

Name some symptoms which are manifestations of hyperactivity in ADHD

Answer 12

Fidgeting/squirming
Tapping
Running around
Restlessness
Talkative

Question 13

Name some symptoms which are manifestations of impulsivity in ADHD

Answer 13

Crossing road without looking
Interrupting
Blurting out answer before question complete
Can’t wait for turn/share when playing
Quick decisions without considering consequences

Question 14

Name some symptoms which are manifestations of inattention in ADHD

Answer 14

Lack of persistence with a task
Difficulty sustaining focus
Disorganised and loosing items
Not following-through instructions