Learning disabilities Flashcards
What is the ICD-10 definition of an intellectual disability / learning disability / mental retardation?
‘A condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence i.e. cognitive, language, motor and social abilities’
Name the commonly used IQ scale in adults
Wechsler Adult Intelligence Scale
To be diagnosed with an intellectual impairment, what does your IQ need to be?
IQ < 70
Diagnostic criteria of Intellectual Disability
You have to show/have:
- An IQ < 70
- Social or adaptive dysfunction (Vineland Adaptive Behaviour Scale) - Deficits / Impairments in 2 or more of following adaptive skills: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure & work
- Onset in the developmental period (before age 18)
Can you have an IQ < 70 and still not be defined as having a learning disability?
Yes, if you have an IQ<70 but no problems functioning within your environment then you would not be defined as having a learning disability
Which 2 factors are used to classify the severity of a learning disability?
- Intellectual functioning
- Adaptive functioning
What are the IQ levels and functional ages associated with:
- Mild LD
- Moderate LD
- Severe LD
- Profound LD
- Mild - IQ: 50 - 69 or functional age 9-12yrs
- Moderate - IQ: 35 - 49 or functional age 6-9yrs
- Severe - IQ: 20 - 34 or functional age 3-6yrs
- Profound IQ: <20 or functional age <3yrs
Intellectual disability can either be inherited or acquired. What are some of the inheritable traits associated with a LD?
- Single gene: Fragile X, PKU, Retts Syndrome
- Microdeletion/duplication: DiGeorge Syndrome, Prader-Willi, Angelman syndrome
- Chromosomal abnormality: Down Syndrome
How might someone acquire a learning disability?
- Infective: e.g Rubella, Zika virus
- Traumatic: hypoxic injury during birth, head injury in childhood
- Toxic: Foetal alcohol syndrome
- Idiopathic: for most patients the cause of LD is unknown
Name some inequalities people with learning disabilites face
- Social exclusion
- Socioeconomic deprivation
- Inaccessible services
- Discrimination
- Challenges to communication
- Lack of appropriate knowledge and skills of professionals
- Minimal evidence base from research
What are some common and/or important physical conditions associated with learning disabilites?
- Epilepsy – increased incidence and complexity with severity of learning disability (10-50%)
- Sensory impairments – hearing (40 %) and vision (20%), earwax
- Obesity – predisposes to other health problems
- Gastrointestinal – swallowing problems, reflux oesophagitis, Helicobacter pylorii, constipation
- Respiratory problems – chest infections, aspiration pneumonia
- Cerebral palsy – especially with severe learning disability
- Orthopaedic problems – joint contractures, osteoporosis
- Dermatological and Dental problems- 33% unhealthy gums, for Down’s Syndrome, 80%
Why is there a psychiatric specialty for those with a LD?
Higher incidence of psychiatric disorders in those with LD
- The more severe the LD - higher prevalence of psychiatric disorder
- People with mild learning disability may present in broadly similar way to the general population
- Presentation of mental illness different especially in moderate-profound LD
- Those with lower IQ/ communication difficulties often present with ‘challenging behaviour’
- Where there is less verbal communication, observable signs are relied on more in making the diagnosis
How prevalent is Schizophrenia / Psychosis in those with learning disabilities?
3% Point Prevalence compared to 1% in general population
How does Schizophrenia / psychosis present in LD patients?
- Associated with change in personality and reduction in functional abilities
- ‘Self-Talk’ common in LD
How are mood disorders in LD patients commonly picked up?
People with learning disabilites are less likely to complain of mood changes and so they are noted by change in their behaviour ie biological symptoms instead
