Learning Disabilities Flashcards
What is the ICD 10 definition of intellectual disability?
A condition of arrested/incomplete development of the mind
characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence - cognitive language, motor and social abilities
What is the ICD 10 definition of intellectual disability?
A condition of arrested/incomplete development of the mind
characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence - cognitive language, motor and social abilities
What is the intellectual disability criteria?
- IQ < 79
- Social or adaptive dysfunction (deficits in 2 or more skills)
- Onset in the developmental period (before 18yrs)
What IQ test is used?
Wechsler Adult intelligence scale
How is the social or adaptive dysfunction measured?
Vineland adaptive behaviour scale - by questioning someone who knows the patient very well.
What are the social or adaptive skills questioned?
Communication Self care Home living Social skills Community use Self-direction Health and safe Functional academics Leisure and work
(need to have impairments in 2 or more).
What is it called if someone acquires disability AFTER they are 18?
Acquired head injury.
What is the relationship between intellectual disability and mortality?
The more severe the intellectual disability - the higher the mortality rate.
What is the relationship between intellectual disability and mortality?
The more severe the intellectual disability - the higher the mortality rate.
What do you need to remember about the IQ test?
If someone has an IQ <70 but does not meet the rest of the criteria, they do NOT have intellectual disability.
How many people have an IQ of <70?
Should be 2.5%
Is actually 1-2% - because of mortality differences.
What is the mean IQ and standard deviation?
Mean = 100
Standard deviation = +/- 15
What is the criteria for a mild intellectual disability? IQ and functional age?
IQ = 50-69
OR
Functional age = 9-12yrs
What is the criteria for moderate intellectual disability?
IQ= 35-49
OR
Functional age- 6-9yrs
What is the criteria for severe intellectual disability?
IQ= 20-34
OR
Functional age= 3-6yrs
What is the criteria for profound intellectual disability?
IQ= <20
OR
Functional age <3yrs
How is the diagnosis between severe and profound intellectual disability judged?
Using clinical judgement. Because an IQ < 40 is very unreliable.
How would someone with a mild intellectual disability present?
Live alone to some extent
Problems identifying risk and managing difficult situations
Vulnerable to people who might want to exploit them
How might someone with a moderate intellectual disability present?
Obvious adaptive functioning difficulties
Some difficulties wit language communication BUT very good at expression communication
Require help with food, going to activities and making sure they are ready.
How might someone with a severe intellectual disability present?
Require a big amount of day to day help.
Struggle to do anything themselves
**Difficulties in communication is a key feature.
What are the main inherited causes of intellectual disability?
Fragile X syndrome
DiGeorge syndrome
Prader-Willi
Downs syndrome
Which genetic/inherited cause of intellectual disabilities is most common?
Downs syndrome
What psychiatric disorder does DiGeorge syndrome commonly cause?
Schizophrenia
What are the acquired causes of intellectual disability?
MOST - Idiopathic Rubella Zika virus Hypoxic brain injury during birth (cerebral palsy) Brain injury during childhood Foetal alcohol syndrome
What percentage of intellectual disability is idiopathic?
70%
Which medication if used by mothers during pregnancy are associated with a lower IQ and disability?
Sodium valproate.
What is one of the most common causes of death in people WITHOUT intellectual disability?
Cardiovascular problems
What is one of the most common causes of death in people WITH intellectual disabilities?
Respiratory - NOT smoking, often aspiration pneumonia.
Which medical conditions are associated with intellectual disability?
Epilepsy
Sensory impairment
Obesity
GI (reflux, constipation, H. pylori, swallowing problems)
Respiratory (chest infections, aspiration pneumonia)
Cerebral palsy (especially in severe intellectual disability)
Orthopaedic problems (joint contractures, osteoporosis)
Dermatology and dental problems
What is the percentage of people with intellectual disabilities that have hearing impairments?
40%
What is the percentage of people with intellectual disability that have vision impairments?
20%
What is the association between intellectual disability and psychiatric problems?
The more severe the intellectual disability - the higher the chance of a psychiatric disorder developing.
How do people with intellectual difficulties present with a psychiatric problem?
Mild ID - normal psychiatric presentation
Moderate/Severe - Very different to normal psychiatric presentation
eg - less complex delusions
What percentage of the population WITHOUT an intellectual difficulty has schizophrenia/psychosis?
1%
What percentage of the population WITH an intellectual difficulty has schizophrenia/psychosis?
3%
How are people with intellectual difficulties likely to present if they have a mood disorder?
Change in behaviour rather than report in a change in mood.
What is the correlation between intellectual difficulties and autism?
50% of people with autism also have an intellectual disorder.
What is diagnostic overshadowing?
For example - when you diagnose someone with poor behaviour being due to their intellectual disability but they are actually acting out because theres something wrong with them (like lack of support, change in carers).
