Learning Disabilities Flashcards
define IQ of profound LD
<20
define mild LD IQ
50-69
define IQ of moderate LD q
35 - 50
define LD of severe IQ
20-35
how is LD diagnosed
clinical assessment
- IQ
- ask about reading / writing
list indicators of LD
difficulty reading writing
difficulty achieving skills
LD register
attended special school
communication issues
prevalence of mild LD
2-3/100
cause of mild LD
no specific cause
prevalance of mod/severe/profound LD
3/1000
what are downs people at risk of in their 40-50s
early alzheimers
boys
large ears
long face
smiley
fragile X syndrome
physical illness issues of LD
higher risk of obesity due to poor diet
increased epilepsy risk
hearing / visual loss
psychiatric co-morbidities of LD
schizophrenia 3% vs 1% general
4x more likely to have depression/anxiety
autism - 75% have LD
biological vulnerability factors for mental illness
brain damage / epilepsy
vision / hearing impairments
genetics- autism, behavioural
drugs / alchol abuse
medication - epilepsy meds can cause behaviour / IQ issues
family vulnerability factors for mental illness
diagnostic issues causing bereavement like Sx
isolated - limited networks
overbearing parents
difficulties letting go
psychological vulnerability factors for mental illness
rejection / deprivation
low self esteem
communication issues
abuse
social vulnerability factors for mental illness
prejudice
poor support due to social skills
inappropriate services / environment
financial disadvantage
challenging behaviour in LD
culturally abnormal behaviour
persistent behaviour
limits use of community services
how to communicate with LD patient
no jargon
speak slower
use signs to indicate what you mean
open questions as they can be suggestible
allow plenty of time
Mx of mental health problems in LD
monitor efficacy of meds +/- side effects
MDT
work with social networks eg family
capacity to consent with MCA
Mx of mental health problems in LD q
use same meds as normal
start low, go slow
- ?higher sensitivity to drugs / side effects
psychological interventions for LD
behavioural - ABC
CBT
family education / therapy
psychodynamic psychotherapy
creative / complementary therapies - art / drama / aromatherapy
what is the ABC approach in psych therapy
antecedents - behaviour - consequences
social interventions in LD
community inclusion - valued social role, dignity, meaningful activities
avoid under/overstimulation
safe guard against abuse
what is ASD
neurodevelopmental disorder with social communication issues
describe the ASD spectrum
severe –> autism –> high functioning / aspergers
3 core domains of ASD Sx
- reciprocal social interactions
- verbal / non verbal communication
- restricted / repetitive behaviours or interests
what variability is shown in ASD
cognitive ability
severity of Sx
language skills
describe ASD development pattern
delay in development
regression of milestones achieved
describe milestones missed in ASD
no social smile
atypical attachment pattern - don’t attach to carer
don’t interact with peers / family
presentation features of ASD
routines - can not deviate from this
repetitive behaviour
fixations on certain things
sensory seeking behaviour
presentation features of ASD in adults
unable to interpret gestures / idioms
fixed routines
what is aspergers
similar to ASD/part of ASD spectrum but they have no issues with expressive language
prevalence of ASD
1% UK / 0.6% globally
why have prevalence of ASD increased
more awareness of ASD to get more diagnoses
improved survival rates of genetic conditions associated with ASD
what is heritability % of ASD
80-90%
why is heritability so high in ASD
due to wide range of phenotypes, and some multigenetic causes
pathology causes of ASD
abnormalities in major cortical / subcortical brain structures
increased cerebellar volume - ?too many synapse connections
elevated serotonin in blood
gold standard tool for diagnosis of ASD
autism diagnostic observatory schedule (ADOS)
- examiner sits with patient and tried to elicit ASD behaviour
min age for ADOS to be used to diagnose ASD
2 years old
genetic conditions associated with ASD
fragile X
Di george
mitochondrial disorder
downs
prader-willi
angleman
epilepsy ?
Mx for ASD
bio
- manage medical conditions, psychopharmacology
social
- reasonable adjustments, edicational interventions
psych
- therapy
what meds & when can be used in ASD
only if comorbid conditions
- SSRIs - fluoxetine for obsessions
- irritability = aripiprazole / risperidone
- dopamine antagonists for stereotypical motor behaviour
