Learning Disabilities Flashcards
According to the ICD-10 how do we classify someone with a learning disability?
LD CRITERIA
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
How do we classify learning disabilities?
CLASSIFYING LD
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
What are some causes of learning disability that occur before birth? (9)
GENETIC CONDITIONS that cause LD
- most commonly T21
- Turners
- Klinefelters XXY
- Tuberosclerosis (50%)
- Prader Willi and Anglemans syndromes (15q deletion)
- 15q duplication syndrome
- 22q11.5 deletion syndrome
- Hydrocephalous
- Phenylketonuria
What are some peri-natal causes of learning disability?
PERI NATAL CAUSES OF LD
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
What are some post-natal causes of learning disability?
POST NATAL CAUSES OF LD
Most commonly head injury or some form of trauma
-e.g. HIE
What are some medical complications of having Down Syndrome? (8)
COMPLICATIONS OD DOWNS SYNDROME
- AVSD
- Epilepsy
- Leukaemia
- Hypothyroid
- Diabetes
- Dementia
- Cataracts
- Hearing and sight problems
What is the most common inherited form of intellectual disability and how is it caused?
Fragile X syndrome - FMR1 gene mutation (too many CGG repeats) is the most common form of intellectual disability
What is the leading preventable causes of learning disabilities?
Fetal alcohol syndrome
What are some characteristic facial features of children with foetal alcohol syndrome? (5)
FETAL ALCOHOL SYNDROME
- Absent philtrum
- Widely spaced eyes
- Thin upper lip
- Flat nasal bridge
- Round face
Whats the most common genetic cause of learning disability?
Downs syndrome T21 is most common genetic cause of LD
What are the three domains of symptoms within Autistic Spectrum Disorder? (3)
AUTISM
- Communications difficulties
- Impaired Imagination (leading to restricted and repetitive behaviours)
- Impaired social skills
- *30% will have intellectual disability
- *40% will be non-verbal
Why is it more difficult to diagnose of mental health conditions in people with learning disabilities ?
-Patients with LD are more likely to get MHC (more biological and psychological RFx such as isolation, unemployment)
For people with LDs in whom communication can be challenging, BIOLOGICAL SYMPTOMS might be more important
- Sleep changes, appetite changes, changes to self-care, agitation, tearfulness, psychomotor retardation)
Which mental health conditions are more likely to be seen in people with learning difficulties? (3)
COMMON MHC FOR PATIENTS WITH LD
Anxiety (check TFT)
Depression (check TFT)
Dementia
behaviour changes are usually an early indicator
What organic cause is it important to rule out if you think someone with LD might have depression? (2)
DIFFERENTIALS FOR DEPRESSION IN LD
HYPOTHYROIDISM - people with Down’s are more likely to have underachieve thyroid
Also consider dementia - people with LD also more likely to get dementia (especially downs syndrome) and symptoms can look similar
Name some other causes of LD
The following can all result in LD:
- Cerebral palsy
- infantile spasms
- epilepsy (30% will have LD)
- Tuberosclerosis (50%)
