Learning Disabilities

Question 1

According to the ICD-10 how do we classify someone with a learning disability?

Answer 1

Someone with IQ <70
Someone with a loss of adaptive social functioning
Someone who has had these features come on before the age of 18 (during development)
***a learning disability cannot be ACQUIRED later in life

Question 2

How do we classify learning disabilities?

Answer 2

According to IQ ranges:
MILD - IQ 50-69 - in these people motor and sensory deficits are slight and independence is good
MODERATE - IQ 35-49 - People understand things well but find it difficult to explain themselves
SEVERE - IQ 20-34 - There is increased motor and sensory deficits. 50% of people will have epilepsy
PROFOUND <19 - Development age halts at around 12months, increased vulnerability will need constant care

Question 3

What are some causes of learning disability that occur before birth?

Answer 3

Genetic conditions (most commonly T21)

Question 4

What are some peri-natal causes of learning disability?

Answer 4

Most common is birth asphyxia that can happen for a large range of reasons:

• Placental insufficiency (Mat Smoking or alcohol)
• Birth trauma (cord prolapse, placental abruption)
• Difficulties due to premature birth

Infections in the peri-natal period can also cause learning disabilities later in life

Question 5

What are some post-natal causes of learning disability?

Answer 5

Most commonly head injury or some form of trauma

Question 6

What are some medical complications of having Down Syndrome?

Answer 6

AVSD, Epilepsy, leukaemia, hypothyroid, diabetes, dementia and cataracts
Hearing and sight problems

Question 7

What is the most common inherited form of intellectual disability?

Answer 7

Fragile X syndrome - FMR1 gene mutation (too many CGG repeats)

Question 8

What is the leading preventable causes of learning disabilities?

Answer 8

Fetal alcohol syndrome

Question 9

What are some characteristic facial features of children with foetal alcohol syndrome?

Answer 9

Absent philtrum 
Widely spaced eyes 
Thin upper lip
Flat nasal bridge 
Round face

Question 10

What other conditions are linked to learning difficulties?

Answer 10

Cerebral palsy
Prader-Willi syndrome 
Tuberous Sclerosis (non cancerous tumours in brain)
ASD
Epilepsy

Question 11

What are the three domains of symptoms within Autistic Spectrum Disorder?

Answer 11

• Communications difficulties
• Restricted and repetitive behaviours
• Impaired social skills

Question 12

How do we make diagnoses of mental health conditions in people with learning disabilities ?

Answer 12

Can be really difficult but important because they are more likely to get them (more biological and psychological RFx such as isolation, unemployment)

For people with LDs in whom communication can be challenging BIOLOGICAL SYMPTOMS might be really important
- Sleep changes, appetite changes, changes to self-care, agitation, tearfulness, psychomotor retardation)

Question 13

Which mental health conditions are more likely to be seen in people with learning difficulties?

Answer 13

Anxiety
Depression
Dementia

Question 14

What organic cause is it important to rule out if you think someone with LD might have depression?

Answer 14

HYPOTHYROIDISM - people with Down’s are more likely to have underachieve thyroid

Also consider dementia - don’t misinterpret dementia for depression people with LD also more likely to get dementia