Learning Disabilities Flashcards
What are the 3 main criteria used to define learning disability? [3]
Impaired intellectual function (IQ< 70)
Impaired adaptive function
Arising in developmental period (< 18 years)
TBL
What are mild, moderate, severe and profound learning disablities (with regards to IQ classification) [4]
Mild 50-69
Moderate 35-49
Severe 20-34
Profound < 20
What are the general causes of mild vs severe learning difficulties? [2]
Mild Learning Disability
* often no specific cause
* lower end of normal distribution curve
* 2-3/100
Severe Learning Disability
* usually specific cause e.g. brain damage, genetic abnormalities, hypothyroidism
* ~3/1000 (Moderate, Severe and Profound)
To have a learning disability, need to have impaired adaptive function.
State and describe the 3 domains of adaptive functioning that could be impaired? [3]
Most will have 2+
What is important to think about the definition of learning disability?
Impairments must arise in the developmental period
- therefore e.g traumatic brain injury sustained in adulthood is not a learning disability neither is schizophrenia or dementia
People with learning disabilities have higher rates of physical health problems. What are these? [5]
What worsens these issues? [1]
- Sensory impairments
- Epilepsy (roughly ¼)
- Physical disabilities and mobility impairment
- Respiratory disease (higher risk of infections)
- Gastrointestinal problems (e.g. reflux, constipation)
- Acquired health problems (e.g. overweight, obesity)
These physical issues are worsened by health inequities and barriers to access to healthcare
Give 4 examples of health inequities that people with learning disabilities may live with [4]
Over one-third deaths of people with ID are “avoidable” i.e. preventable by the provision of good quality healthcare (cf. 13% general population deaths)
People with ID may be exposed to more adverse environmental conditions e.g. poverty, poor housing, low income, lack of opportunity, bullying, loneliness
Preventative health measures might not serve people with ID well e.g. public health messages unsuitable, rates of cancer screening are lower
People with intellectual disability face barriers to diagnosis and treatment – physical barriers, systems factors, attitudinal barriers
Don’t learn
Describe clinical features of Down’s Syndrome [+]
Characteristic physical appearance
Intellectual disability (mild-severe)
Hearing / vision impairment
Congenital heart disease
Increased risk of leukaemia and testicular cancer
Hypothyroidism
GI disorders incl. constipation, Coeliac disease, GORD, hernias, congenital abnormalities
Infertility
Depression
Early-onset Alzheimer’s dementia
Describe the phenotypic characteristics of Fragile X syndrome [5]
- Broad forehead
- Long, narrow face
- Hypotonia
- Hyper-extensible joints
- Macro-orchidism
State three physical associations of Fragile X syndrome [3]
- Epilepsy
- Mitral valve prolapse
- Otitis media
Why is fragile X syndrome significant with regards to LD? [1]
Most commonly inherited cause of LD
What are the mental / behavioural disorders of Fragile X? [5]
- Mental / behavioural disorder
- Intellectual disability (mild-severe)
- Autistic spectrum disorder (up to 50%)
- Social anxiety, shyness, gaze avoidance
- ADHD
- Panic disorder
- Stereotypic movements
State 5 pre-natal causes of learning disability [5]
Pre-natal
* Genetic syndrome
* Infections eg Rubella
* Iodine deficiency
* Pre-eclampsia
* Maternal alcohol consumption (foetal alcohol syndrome)
State 1 intra-partum and 3 post-natal causes of learning disability [4]
During Birth
* Birth trauma, asphyxia eg cerebral palsy
Post natal
* Environmental factors
* Infections eg meningitis
* Traumatic brain injury
What are the two core aspects of ASD [2]
Persistent deficits in communication & social interaction across contexts
- e.g. having difficulties in forming relationships or non-verbal language
Restricted, repetitive patterns of behaviour, interests or other activities
NB: Symptoms must be present in early childhood (but may not become apparent until social demands exceed limited capacities.
What do you need to consider about mental illness in ID? [1]
There is an increased Prevalence of Mental Illness in learning disability (1% vs 3%)
What are the medical [3], genetic [3], diet [1] and neuroanatomical causes of mental illness [1] in ID?
Medical Factors
* Hypothyroidism associated Depression in Down Syndrome.
* Sensory impairment
Associations with specific syndromes and genetic loci
* Prader-Willi, Down Syndrome have an association with Depression
* Autism is associated with Anxiety
* Smith Magenis Syndrome associated with self injurious behaviors
Diet and lifestyle
* increased rates of inactivity and poor nutrition
Neuroanatomical changes
* Frontal lobe disorder may increase frequency of behaviours which challenge
What are the pyschological causes of mental illness in ID? [4]
- Reduced Adaptive functioning skills
- **Reduced problem solving ability **
- Poor help seeking behaviours
- Cognitive Deficits eg temporal memory and reduced understanding of time can impact on how life events are experienced
What is important to note about the presentation of mental illess in severe LD? [1]
The more severe the LD, the more likely that you will have to rely on observations of behaviour and “biological symptoms” (e.g. changes in sleep, appetite and routine)
- They are more likely to have “atypical symptoms” e.g. self-injurious behaviour or physical aggression in depression
- Psychotic symptoms are usually “simple” in nature e.g. hearing sounds rather than words; may be “talked out” of a delusion
What are Signs and symptoms suggestive of mental disorder in a person with LD? [4]
Non specific behavioural disturbances
- Aggression, self injury, withdrawal
Repetitive movements out of keeping of person’s usual presentation
Biological symptoms prominent
- Not sleeping, poor appetite, weight loss
Tearfulness
Change in functioning is highly significant
- No longer going to work, day centre, neglecting self care/hygiene
Simple and fleeting psychotic symptoms
- Hearing single voices, isolated false beliefs
What are ‘behaviours that challenge?’ [1]
What are causes? [3]
Biological – physical health problems (infections, constipation, pain), behavioural phenotype
Social/environmental – changes in routine, life events, boredom and lack of meaningful activities
Psychological/metal illness
TBL
Someone has difficulty putting words down paper - it may be down to a learning difficulty.
How would you implement a strategy
What is the difference between learning disability and learning difficulty? [2]
Give examples [2]
Learning difficulty:
- localised impairment that causes difficulty in learning
- e.g. dyslexia, dyspraxia
Learning disability
- global impairment that affects daily function and adaptive functioning
- typically have IQ lower than 70
- e.g. Down syndrome
