Learning Disabilities

Question 1

What is meant by a learning disability?

Answer 1

Conditions which originate during the developmental period, characterised by significantly below average intellectual functioning and adaptive behaviour

Question 2

What are the diagnostic criteria for a learning disability?

Answer 2

1. Intellectual impairment (IQ < 70)
2. Social or adaptive dysfunction
3. Onset in the developmental period (before age 18)

Question 3

What is meant by social or adaptive dysfunction?

Answer 3

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

Question 4

What are the characteristics of a mild learning disability?

Answer 4

IQ: 50-69,
Adaptive behaviour: 9 to under 12yrs
Often don’tappearto be disabled

->people tend to overestimate them

Question 5

What may people with a mild learning disability struggle with?

Answer 5

Will struggle:
To solve problems
To understand consequences and risks
To remember details

And will require more time to think and concrete information, and will need repetition to learn

Question 6

What are the characteristics of a moderate learning disability?

Answer 6

IQ: 35-49,
Adaptive behaviour: 6 to under 9yrs
Disability more likely to be apparent
May appear to have surface understanding
Will be rigid in thinking
May read but struggle to understand content

Question 7

What may a person with a moderate learning disability struggle with, or need more help/support with?

Answer 7

Will need routine and structure
Will struggle to understand conversations and sometimes using language

Question 8

What are some of the characteristics of a severe learning disability?

Answer 8

IQ: 20-34,
Adaptive behaviour: 3 to under 6yrs
Need help with most everyday tasks
Very basic understanding of language

Question 9

What are some of characteristics of a profound learning disability?

Answer 9

IQ: <20,
Adaptive behaviour: below 3yrs
Have complex care needs
Often have additional health needs
Often have multiple disabilities
Little or no ability to care for own basic needs
Unlikely to understand any language

Question 10

How do people with profound earning disabilities commuinicate?

Answer 10

Through facial expressions and noises

Question 11

Which chromosomal abnormalities can cause a learning disability?

Answer 11

Down Syndrome
Sex chromosome abnormalities

->Down Syndrome is the most common cause of all learning disabilities in the UK

Question 12

Which microdeletion/duplication abnormalities can cause a learning disability?

Answer 12

DiGeorge Syndrome
Prader-Willi
Angelman Syndrome

Question 12

Which single gene abnormalities can cause a learning disability?

Answer 12

Fragile X
PKU
Retts syndrome

->Fragile X is the most common single gene mutation causing learning disabilities in the UK

Question 12

What are some infective causes of learning disabilities?

Answer 12

Rubella
Zika virus

Question 13

What are some traumatic causes of learning disabilities?

Answer 13

Hypoxia during birth
Head injury in childhood

Question 14

What are some toxic causes of learning disabilities?

Answer 14

Foetal alcohol syndrome
Maternal valproate use

Question 15

Only 30% of learning disabilities have a known cause. The rest are idiopathic.

What are some condition which are associated with learning disabilties?

Answer 15

Cerebral palsy
Autism Spectrum Disorder
Epilepsy

->obviously not all people with these conditions have a learning disability, these are only associated conditions.

Question 16

Just a few points for awareness.

Answer 16

If a patient with a learning disability presents with a new compliant e.g. ‘Sarah has started to bang her head on the wall’, it’s easy for healthcare professionals to blame the learning disability. However, if Sarah is in her 30’s and has always had a learning disability, it’s unlikely this new behaviour is because of that, there may be a different underlying cause.

Also, a lot of the time, people with learning disabilities have a more basic understanding of language and questions, They may respond ‘no’ to ‘can I take you blood pressure?’ or ‘can I take your pulse?’ However, they may also respond the same way if asking ‘do you want to go on holiday?’ or ‘do you want to go out for dinner?’. This is because they have learned phrases that they rely on. They know that by saying no, nothing new will occur, t]nothing is expected of them. They might not understand so it’s better of them to have a predictable outcome whereby nothing changes.

Question 17

Are mental health conditions more or less common in people with learning disabilities?

Answer 17

More common but they are easily missed

->for interest, dementia is more common and has an earlier onset, especially in Down Syndrome. This is probably because chromosome 21 has a role in amyloid production and people with Down Syndrome have three of these chromosomes