Learning disabilities

Question 1

What is the ICD-10 classification of a learning disability?

Answer 1

• IQ <70
• loss of adaptive social functioning
• onset before age 18

Question 2

what is the most common prenatal cause of learning disabilities?

Answer 2

• Downs syndrome
• Fragile X
• maternal drug and alcohol abuse
• foetal alcohol syndrome

Question 3

what “developmental age” would someone with an IQ <20 be at?

what is an IQ <35 associated with?

what is associated with IQ 35-49?

Answer 3

• about 12 months
• 50% have epilepsy
• more receptive tan expressive language

Question 4

what is the most common peri-natal causes?

post-natal?

Answer 4

• HIE, injury due to birth complications

- illnesses, injury or environmental conditions (meningitis etc)

Question 5

what conditions are associated with learning difficulties?

Answer 5

• cerebral palsy
• autism
• epilepsy (30%)
• Prader-Willi syndrome
• Tuberous sclerosis (up to 50%)

Question 6

what are the features of autism?

Answer 6

• inflexible thinking and behaviour (concrete thinking)
• rigid routines
• unusual sensory perception
• characterised by a lack of social instinct
• struggle with interaction, communication and imagination
• hypo/ hypersensitivity

Question 7

What is aspergers syndrome characterised by?

Answer 7

• sensory distortion
• perceptual distortion (of light, shade, colour, movement)
• executive function difficulties (personal organising and planning)
• central coherence difficulties (arranging details/ making connections)
• inflexibility of thought and action (leading to difficulties in making transitions)

Question 8

Why is psychiatry important in LD?

Answer 8

• more likely to develop mental health problems

- experience more biopsychosocial health problems

Question 9

what kind of symptoms are there of depression in someone with LDs?

Answer 9

• agitation
• appetite
• weight
• sleep
• self care/ regression
• psychomotor retardation
• tearfulness

Question 10

what do you have to worry about in LD when prescribing medications?

what might depressive features indicate?

Answer 10

• more side effects

- early onset dementia

Question 11

what might you worry about with dementia assessment?

Answer 11

• normal assessment tests are not possible in LD patients

Question 12

What other mental health issues are common apart from depression?

Answer 12

• anxiety: lack of confidence in everyday situations, may present in a change in behaviour
• psychosis: people with LD may present with a change in behaviour

Question 13

what biological causes are there for challenging behaviour?

Answer 13

• mental illness
• epilepsy
• pain
• hunger
• Lesch Nhyan syndrome (self injury)
• Prader Willi (overeating)

Question 14

what social/ environmental causes are there for challenging behaviour in LD?

psychological?

Answer 14

• limited space
• noise
• other demands
• boredom

Psychological:

• fear
• learned responses
• belief

Question 15

what are the signs of addiction?

Answer 15

• narrowing of repertoire
• drinking on your own
• compulsion to drink
• tolerance to drinking
• continuing despite negative consequences
• withdrawal

Question 16

what class of drug is cocaine? 
amphetamines?
Benzos?
ketamine?
LSD?
MDMA?

what is mephadrone like?

what is psilobycin mushrooms?

Answer 16

• a
• b
• c
• b
• A
• a
• amphetamines
• 5HT partial agonist, disorientation, lethargy, hallucinations