Learning Disabilities Flashcards

Question

what were the feeble

Answer 1

Feeble-minded persons - persons who whilst not being as defective as imbeciles still required care, supervision and control for their own protection or for the protection of others.

Answer 2

persons who from an early age display some permanent mental defect coupled with vicious or criminal propensities on which punishment has had little or no effect.

Answer 3

Dr John Langdon Down (1828-1896) founded Normansfield hospital, Richmond, in 1868, for people with mental handicap (LD) By end of 19th century – 120 asylums in England & Wales housing more than 100,000 Concept of community care in 1950s led to closure of institutions

Answer 4

* Cost * Emerging treatments * Scandals * Civil rights philosophy * Antipsychiatry movement * Normalisation concept

Answer 5

Main growth is prenatal & first few years of life Most vulnerable to damage during this growth period Adolescence: Myelination proceeds from back to front, with continued development Periods of intense restructuring of synaptic networks occur

Answer 6

- intra-uterine - prenatal complications - early infancey

Answer 7

Damage to the brain very early in life is more likely to have a global rather than specific impact * Undamaged areas can take over functions * However repair processes may result in misconnections A brain area may have different functions at different ages, so damage may be silent initially Sensory input has a driving role in development Development is affected by hormonal and other external influences

Answer 8

Prenatal causes- chromosomal dsorders, inborn errors of metabolism, developmental disorders of brain formation and environmental influences perinatal causes- anoxia, low birth weight and syphillis and herpes complex postnatal- biological, psychosocial, child abuse and neglect

Answer 9

Nutritional deficiencies – folic acid Toxin exposure – alcohol, drugs Genetic mutations (autosomal dominant / recessive Chromosomal (trisomy, deletion, sex chromosome abnormality)

Answer 10

Prematurity Congenital infection (TORCH, HIV) Hypoxic-ischaemic encephalopathy (intrapartum asphyxia)

Answer 11

Infection Traumatic brain injury Severe neglect and abuse

Answer 12

FRAGILE X SYNDROME

Answer 13

Down's syndrome

Answer 14

Trisomy – Down’s syndrome Deletion – Cri du chat, Angelman’s, Prada-Willi, Rubinstein-Taybi, Smith-Magenis Sex chromosome anomaly – Fragile X syndrome, Klinefelter’s, Turner, Lesch-Nyhan

Answer 15

CALM Carbohydrate – galactosaemia Amino acid – phenylketonuria Lipids – Tay-Sachs, Gaucher’s, Niemann-Pick Muccopolysaccharidosis – Hurler’s

Answer 16

Spina bifida (Neural tube defect) Tuberous sclerosis Anencephaly Neurofibromatosis Corpus callosum agenesis

Answer 17

● The child is not being able to turn to a sound by 6 months ● The child is not being able to start babbling by 9 months ● Failure to understand a simple command without a gesture by 18 months ● The child can’t use approximately 10 to 25 single words by 2 years ● Failure to speak two-word phrases by 26 months ● Failure to speak in three-word sentences by 3 years ● Unintelligible speech in a child more than 3 years ● Regression in language skills at any age

Answer 18

Delay in reaching developmental milestones: Fine and gross motor, language, social Mild deficits may not be picked up until school Genetic and chromosomal disorders tend to be associated with additional features which may be diagnostic Increased incidence of: Hearing impairment (40%) Epilepsy (22% v 1%) Dementia

Answer 19

Autism Specific Learning Disorders Cerebral Palsy (without extensive cognitive impairment) Global Developmental Delay

Answer 20

Presence of a diagnosis creates a bias or prejudice in the interpretation of symptoms Also issues of discrimination: worse or less treatment offered Tendency for clinicians to attribute symptoms or behaviours of a person with LD to their underlying cognitive deficits and under-diagnose the presence of co-morbid psychopathology

Answer 21

Biological factors * Pain, physical ill health, polypharmacy * Some genetic conditions associated with specific mental health problems Negative life events: More likely to have experiences abuse, poverty etc Fewer resources * Lack of social support * Reduced coping skills Other people’s attitudes: Stigma and discrimination

Answer 22

More common * ASD * ADHD * Anxiety * OCD * Repetitive self-injury * Disruptive behaviour Less common * Substance misuse * Conduct disorder

Answer 23

* Aggression (e.g. hitting, kicking, biting) * Destruction (e.g. ripping clothes, breaking windows, throwing objects) * Self-injury (e.g. head banging, self-biting, skin picking) * Tantrums (e.g. running away, eating inedible objects, Other (rocking / stereotyped movements) * Prevalence 10-15% * More common in males * Most prevalent 15-34 years * Have greater prevalence with increasing severity of learning disability * More than one type of problem behaviour may occur

Answer 24

* Institutionalisation * Low stimulation * Abuse * Neglect * Bereavement

Answer 25

Lesch-Nyhan De Lange Smith-Magenis Prader-Willi Fragile X

Answer 26

it is complex Evidence that increasing offending is seen in mild LD & borderline intelligence Rare in moderate to severe LD

Answer 27

Autistic spectrum disorder - Lifelong condition 1 percent - Restricted, repetitive patterns of behaviour, interests or other activities - Persistent deficits in communication & social interaction across contexts Symptoms must be present in early childhood Symptoms limit and impair everyday functioning.

Answer 28

Language understanding limitations and range of vocabulary – may be good at masking their understanding Attention & concentration difficulties Memory problems Being complicit - "yes" to everything Shyness & low self esteem, feeling ‘different’, not used to having a chance to express their view

Answer 29

* Use simple and familiar key words * Keep sentences short and give one idea at a time * Use concrete rather than abstract ideas * Write things down, perhaps in colour, use worksheets * Give accessible information – pictures, leaflets * Perhaps do shorter (concentration) or longer (to aid understanding) sessions * Check to ensure you have explained clearly and they have understood * Involve and listen to family / carers / GP

Answer 30

Makaton is a communication tool together with speech and symbols, to enable people with disabilities or learning disabilities to communicate. It is not a British Sign Language or any form of Sign Language in its own right

Answer 31

Makaton can help children and adults who have difficulty with: Communicating what they want, think or how they feel Making themselves understood Paying attention Listening to and understanding speech Remembering sequencing

Answer 32

Protruding tongue Flat nasal bridge Upward slanted eyes Single palmar crease AVSD Dementia

Answer 33

* Autosomal Dominant * Deletion of Paternal 15q * M = F * Infancy – hyptonia, floppy baby, poor feeding (sucking reflex poor), developmental delay * Childhood – increased appetite, obesity * Compulsive behaviours – skin picking, tantrums * Hypogonadism – delayed / incomplete puberty * Strabismus ?

Answer 34

* Maternal chromosome 15 * Global developmental delay evident by 6 months * sitting at 12 months; walking at 3-4 years * ‘Happy puppet syndrome’ – wide mouth, wide-spaced teeth * hand flapping – uplifted flexed arms when walking * fascination with water * Speech impairment, non-verbal * Ataxia * Wide spaced legs, flat feet, toe walking / prancing gait

Answer 35

* >200 CGG repeats in FMR1 gene on X chromosome * commonest inherited cause of LD * 1 / 4000 males * M:F 2:1 * commonest single gene cause of autism * stereotypical movements, hyperactivity * facial features – protruding ears, elongated face, high arched palate * large testes * 10% seizures

Answer 36

a characteristic pattern of facial anomalies (smooth philtrum, thin vermilion border of the upper lip) evidence of growth retardation (pre-and/or postnatal) evidence of central nervous system abnormalities (e.g. Microcephaly, LD, irritability)

Answer 37

Social exclusion Bullying Poor access to education & training < 1 in 5 adults with LD are in employment > 50% continue to live with their birth family

Answer 38

Emotional or behavioural problems have a greater impact than LD Families that cope have managed 4 main tasks: * Adjustment to a child with developmental differences * Acceptance that the burden of increased care persists * Understanding emotional and behavioural disturbance and seeking appropriate help * Dealing with the cumulative effects of other 3 factors on family wellbeing and relationships

Answer 39

Deficits: language, long-term memory and motor function Strengths: visuo-spatial

Answer 40

Deficits: attention, visuo-spatial, short term memory and planning Strengths: auditory processing, music and concrete language

Answer 41

* Identification of self and non-self * Motor regulation and coordination, sensory modulation * Selective attention and attention-switching - this develops as children mature * Communication skills and theory of the mind - as children grow older, they gradually are able to understand that other people are agents who similar ideas of the world but can be different (Sally-Anne Test) * Emotion recognition, regulation and empathy - to understand emotions in yourself and other people - whether the child can recognise that they are/ another person is distressed * Self-concept and self-esteem - when do you start having a sense of self? * Reciprocal social interaction and relationship building * Reality testing, perspective-taking and other executive function skills - if you don't have theory of mind, it is hard to develop these skills - cannot understand other people's reality and perspective.