Learning Disabilities

Question 1

Criteria for a learning disability

Answer 1

Intellectual impairment (IQ < 70)

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

Onset in the developmental period (before age 18)

Question 2

definition of learning disability ICD-11

Answer 2

Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately two or more standard deviations below the mean with standardized tests

Question 3

what are the characteristics of mild learning disability

Answer 3

IQ: 50-69,
Adaptive behaviour: 9 to under 12 yrs
Often don’t appear to be disabled
People tend to overestimate them

Question 4

what would a mild learning disability need

Answer 4

More time to think
Concrete information
Repetition to learn

Question 5

what will a mild learning disability struggle to do

Answer 5

To solve problems
To understand consequences and risks
To remember details

Question 6

what are the characteristics of a moderate learning disability

Answer 6

IQ: 35-49,
Adaptive behaviour: 6 to under 9 yrs
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 will an individual with a moderate learning disability need

Answer 7

Routine and structure

Question 8

what will an individual with a moderate learning disability struggle with

Answer 8

To understand conversations
With the use of language
To generalise (skills, rules, previous learning)

Question 9

what are the characteristics of a severe learning disability

Answer 9

IQ: 20-34,
Adaptive behaviour: 3 to under 6 yrs
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
Will always need support available

Question 10

what are the characteristics of a profound learning disability

Answer 10

IQ: <20,
Adaptive behaviour: below 3 yrs

Have complex care needs
Often 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

Question 11

how are learning disability categorised

Answer 11

mild
moderate
severe
profound

Question 12

aetiology of inherited learning disability

Answer 12

single gene
microdeletion / duplication
chromosomal abnormality

Question 13

single gene inheritence examples

Answer 13

Fragile X,
PKU,
Retts Syndrome

Question 14

microdeletion/duplication inheritance example

Answer 14

DiGeorge Syndrome,
Prader-Willi,
Angelman syndrome

Question 15

chromosomal abnormality inheritance example

Answer 15

Down Syndrome
Sex chromosome abnormalities

Question 16

aetiology of aquired learning disability

Answer 16

infective
traumatic
toxic

Question 17

infective aquired examples

Answer 17

Rubella,
Zika virus

Question 18

traumatic aquired examples

Answer 18

hypoxic injury during birth,
head injury in childhood

Question 19

toxic acquired examples

Answer 19

Foetal alcohol syndrome/spectrum disorders
Maternal valproate use

Question 20

what are some associated conditions with a learning disability

Answer 20

Idiopathic: for most patients the cause of LD is unknown

Cerebral Palsy
Autism Spectrum Disorder
Epilepsy

Question 21

what are some health inequalities faced by individuals with learning disabilities

Answer 21

Question 22

what are leading causes of mortality in those with learning disabilities

Answer 22

Congenital Malformation and Chromosomal Abnormalities
Cancer
Influenza and pneumonia
Cerebral Palsy
Cardiovascular disease

Question 23

what is diagnostic overshadowing

Answer 23

Presenting symptoms are put down to their learning disability, rather than seeking another, potentially treatable cause

Social cause - change in carers, lack of support, lack of social activities

Psychological issues - bereavement, abuse

Physical problems - pain or discomfort, e.g. from ear infection, toothache, constipation, reflux oesophagitis, deterioration in vision or hearing.

Psychiatric cause - depression, anxiety, psychosis, dementia

Question 24

what physical health issues should we be aware of in those with learning disability

Answer 24

Respiratory problems – chest infections, aspiration pneumonia

Cerebral palsy – especially with severe learning disability

Orthopaedic problems – joint contractures, osteoporosis

Dermatological and Dental problems- 33% unhealthy gums, for Down’s Syndrome, 80%

Question 25

what mental health issues should we be aware of in those with learning disability

Answer 25

Question 26

what challenging behaviour may be faced from those with LD

Answer 26

Wide range of behaviours – socially constructed rather than diagnostic term.

General trend is towards greater prevalence of problem behaviour with increasing severity of LD (but people with profound LD exhibit less outwardly)

Question 27

how should health proffessionals approach a LD patient

Answer 27

• Patience
• value of communication
• non verbal clause recognition
• alternative communication strategies
• explain appropriately
• meet several times to build rapport