Learning Disabilities Flashcards
What is the criteria for a learning disability?
1) Intellectual impairment (IQ < 70)
2) Social or adaptive dysfunction
- Deficits/Impairments in 2 or more of following adaptive skills: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure & work
3) Onset in the developmental period (before age 18)
What is a mild learning disability criteria?
IQ: 50-69, cognitive age: 9 to under 12yrs
Often don’tappearto be disabled & people tend to overestimate them
Will need:
More time to think
Concrete information
Repetition to learn
Will struggle:
To solve problems
To remember
What is the criteria for a moderate learning disability and what will these people struggle with?
IQ: 35-49, cognitive age: 6 to under 9yrs
- May notappeardisabled
- Will appear to have surface understanding
- Will be rigid in thinking
- May read but struggle to understand content
Will need:
Routine and structure
Will struggle:
To understand conversations
With the use of language
To generalise (skills and rules)
What is the criteria of a severe learning disability?
IQ: 20-34, cognitive age: 3 to under 6yrs
Need help with most everyday tasks
Very basic understanding of language
Use the environment to try understand situations
Can learn to do simple repetitive practical tasks
Willalways need support available
How is a profound learning disability defined?
IQ: <20, cognitive age: below 3yrs
- Have complex care needs
- Have additional health needs
- Often have multiple disabilities
- Little or no ability to care for own basic needs
Require constant help and supervision
Unlikely to understand any language
- Can communicate through noises and facial expression
Requires skilled carers who know them well
..?.. abnormalities increase the likelihood of having a LD
Sex chromosome
What are the aetiology of inherited LD?
Single gene:
- Fragile X,
- PKU,
- RettsSyndrome
Microdeletion/duplication:
- DiGeorgeSyndrome,
- Prader-Willi,
- Angelmansyndrome
Chromosomal abnormality:
= DownSyndrome
- Sex chromosome abnormalities
What are the possible causes of acquired LD?
Infective:
Rubella,
Zika virus
Traumatic:
hypoxic injury during birth,
head injury in childhood
Toxic:
Foetal alcohol syndrome/spectrum disorders
Maternal valproate use
What are some associated conditions with LD?
Idiopathic: for mostpatientsthe cause of LD isunknown
Cerebral Palsy
Autism Spectrum Disorder
Epilepsy
What us ‘diagnostic overshadowing’ in LD?
Presenting symptoms are put down to their learning disability, rather than seeking another, potentially treatable cause
What are some physical health problems in LD that are important to consider?
Epilepsy – increased incidence and complexity with severity of learning disability (10-50%)
Sensory impairments – hearing (40 %) and vision (20%), earwax
Obesity – predisposes to other health problems
Gastrointestinal – swallowing problems, reflux oesophagitis, Helicobacter pylorii, constipation
Cerebral palsy – especially with severe learning disability
Respiratory problems – chest infections, aspiration pneumonia
Orthopaedic problems – joint contractures, osteoporosis
Dermatological and Dental problems- 33% unhealthy gums, for Down’s Syndrome, 80%
What mental health disorders are to be considered in LD and how can they present differently?
Schizophrenia / Psychosis:Associated with change in personality and reduction in functional abilities
Mood Disorders:Less likely to complain of mood changes and noted by change in behaviour ie biological symptoms
Anxiety Disorders: increased association with autism and poor social support
Dementia: increased prevalence and earlier onset
ADHD: need to consider in context of developmental stage
Challenging behaviour is a socially constructed term rather than a diagnostic term: what is the general trend in prevalence?
General trend is towards greater prevalence of problem behaviour with increasing severity of LD(but people with profound LD exhibit less outwardly)
Why is LD a psychiatric speciality?
Higher incidence of psychiatric disorders in those with LD
More severe the LD - higher prevalence of psychiatric disorder
People with mild learning disability may present in broadly similar way to the general population
Presentation of mental illness different especially in moderate-profound LD
