Learning Disabilities

Question 1

Define LD

Answer 1

LD includes the presence of:
o A significantly reduced ability to understand new or complex information or to learn new skills
o A reduced ability to cope independently
o An impairment that started before adulthood, with a lasting effect on development

Question 2

Categories of LD

Answer 2

o Mild: 50-69
o Moderate: 35-49
o Severe: 20-34
o Profound: < 20

Question 3

Prevalence of LD

Answer 3

1-3%

Question 4

Age group with highest incidence of LD

Answer 4

10-14 years

Question 5

M:F ratio of LD

Answer 5

1.5:1

Question 6

Prevalence of different types of LD

Answer 6

Mild - 85%
Moderate - 10%
Severe - 4%
Profound - 102%

Question 7

How many people with LD have another MH problem?

Answer 7

75%

Question 8

How much earlier do people with LD die compared to the general population?

Answer 8

13-20 years

Question 9

What is secondary prevention of LD?

Answer 9

Early recognition, diagnosis, good medical care and rehab to avoid and reduce damage which could lead to LD - planning or genetic counselling after birth of child with genetic disorder, screening and early treatment of congenital hypothyroidism and PKU

Question 10

How many offenders have LD?

Answer 10

30%

Question 11

Prevalence of MH problems in those with LD

Answer 11

30-50%

Question 12

Prevalence of SCZ in LD

Answer 12

3%

Question 13

Prevalence of Bipolar in LD

Answer 13

1.5%

Question 14

Prevalence of depression in LD

Answer 14

4%

Question 15

Prevalence of agoraphobia in LD

Answer 15

1.5%

Question 16

Prevalence of OCD in LD

Answer 16

2.5%

Question 17

Prevalence of Autism in LD

Answer 17

7%

Question 18

Prevalence of severe problem behaviour in LD

Answer 18

10-15%

Question 19

What is PAS-ADD?

Answer 19

Psychiatric Assessment Schedule for Adults with Developmental Disabilities - allows for diagnosis under ICD-10 in people with LD through semi-structured interview

Question 20

Increase in risk of SCZ in people with LD

Answer 20

3x increase

Question 21

Prevalence of Dementia in those with Downs

Answer 21

o 1 in 50 of those aged 30-39
o 1 in 10 of those aged 40-49
o 1 in 3 of those aged 50-59
o > 50% of those over 60

Question 22

Increase risk of Alzheimers in those with Downs

Answer 22

3x increase

Question 23

Predisposing factors for behavioural problems in LD

Answer 23

o Sensory disabilities
o Poor communication
o Epilepsy
o Physical illness-ear infections, dental problems and constipation
o Medication
o Limited range of coping strategies
o Abuse
o Environmental factors

Question 24

How many people with LD show challenging behaviour

Answer 24

7%

14% in hospital

Question 25

What factors are associated with self-injurious behaviour in those with LD?

Answer 25

``` Moderate-severe LD Aged 10-30 Adverse environmental conditions Depression Certain LD like Fragile X ```

Question 26

Psychological treatments

Answer 26

CBT for anxiety, depression and anger Behavioural techniques to change maladaptive patterns of behaviour like phobias and inappropriate sexual behaviour ABC charts

Question 27

Major risk factor for Downs

Answer 27

Maternal age >40

Question 28

Incidence of Downs

Answer 28

1 in 1000 live births

Question 29

Incidence of Downs depending on mothers age

Answer 29

1:2,500 in women less than 30 years old 1:80 over 40 years old 1:32 when the mother is 45 years or older.

Question 30

Clinical features of Downs in the newborn

Answer 30

general hypotonia oblique palpebral fissures, small flattened skull high cheekbones protruding tongue

Question 31

Congenital defects in Downs

Answer 31

Congenital heart defects (-50%) such as VSD, mitral valve disease, patent ductus arteriosus GI abnormalities such as oesophageal atresia, Hirschsprung disease, umbilical and inguinal hernia Eye defects such as strabismus and myopia Hearing defects such as otitis media and sensorineural deafness Endocrine abnormalities include hypothyroidism and diabetes.

Question 32

Average IQ in Downs

Answer 32

50

Question 33

When does IQ decrease in Downs

Answer 33

Ages 1-30

Question 34

Prevalence of Dementia in Downs

Answer 34

``` 0-4% under 30 years of age 2-33% for 30-39 years of age 8-55% for 40-49 years of age 20-55% for 50-59 years of age 29-75% for 60-69 years of age. ```

Question 35

How many adults with Downs have epilepsy

Answer 35

10%

Question 36

Main cause of death in Downs

Answer 36

<1 is congenital heart disease | Up to 30 - bronchopneumonia