Learning disabilities Flashcards
Define LD
A condition that effects the individual’s ability to learn + function independently
What is the DSM IV diagnostic criteria for LD? (3)
1) IQ of 70 or below
2) Deficits in 2 of the following areas - communication, self care, social skills, use of community resources, self direction, health + safety, functional academic skills
3) Onset before the age of 18
What is the department of health’s definition of LD?
Significant impairment of intelligence + significant impairment of social functioning that both were acquired before adulthood
Give an example of a learning difficulty?
Dyslexia
What is ASD?
A neurodevelopmental disorder
What are the areas of adaptive functioning? (4)
1) Self care
2) Language + communication
3) Self direction, health + safety
4) Independent living skills + community use
Why do LD have to occur before the age of 18?
Because the brain has finished maturing at 18
What are the Pre-natal causes of LD?
Genetic - Down’s syndrome, fragile X syndrome
Spina bifida
Cerebral palsy
Environmental - Drugs, alcohol, diseases passed on by mother
What are some of the Peri-natal causes of LD?
Biomedical factors - Toxoplasmosis, other infections of the womb
Environmental factors - Asphyxia, Hypoxia, Premature birth, difficulties during labour/birth
What are some of the Post-natal causes of LD?
Biomedical factors - Epilepsy, meningitis, measles, other infectious diseases
Environmental factors - Head injury, non accidental injury, lead/mercury poisoning, malnutrition, social deprivation
Define mild LD
IQ score of 50 - 70
Define moderate LD
IQ score of 35 - 49
Define severe/profound LD
IQ score of 0 - 34
What are some of the characteristics of a person with mild LD?
Delayed speech, but usual Reasonable comprehension Good non verbal communication Normal continence Self care - Possible to have independent living Normal mobility Capable of doing work + academia
What are some of the characteristics of a person with moderate LD?
Delayed speech with simple phrases
Comprehension of single phrase requests only
Limited non verbal communication
Limited with self care - needs supported housing
Delayed mobility
Limited academia, work simple with supervision
Some increase in other disorders eg epilepsy
What are some of the characteristics of a person with severe/profound LD?
Severe delay in speech, may not speak at all
Very limited understanding
Rudimentary non verbal communication
Mainly incontinent, help needed with ADL
Not capable of adult work + struggles with academia
Frequently MSK abnormalities
Very limited social development - many have ASD
Frequently have epilepsy, sensory deficits or CNS disorders
What is the most common cause of LD?
Down’s syndrome (Trisomy 21)
*25% of LD p’s will develop MH issues)
Why do patients with Down’s syndrome develop dementia more?
Coding protein for plaques is on chromosome 21, so extra chromosome causes increased incidence of dementia
How can communication be adapted for people with LD?
Use simple language + short sentences
Avoid jargon + negatives
Give concrete examples, don’t use abstract ideas
Be aware of literal meanings - caution with humour
May need to use sign language
Use pictures to express feelings
Check comprehension
How can LD appointments be suited to p’s?
Give first appointment of day - delayed waiting times
Double consultation time
Check level of understanding before starting
Explain exactly what is going to happen before starting
Take Hx from patient, collateral from carers
Pt may not have a good understanding of time so think of events eg Christmas
Continuity of care
