Learning Disabilities

Question 1

What is an intellectual disability? (ICD-10)

Answer 1

A condition of arrested or incomplete development of the mind that results in impairment of skills acquired during the developmental period

This impairment contributes to overall level of intelligence (cognitive / language / motor)

Question 2

What is the criteria for diagnosing someone with an intellectual disability?

Answer 2

1. Intellectual impairment (IQ < 70)
2. Social or daptive dysfunction (defecits or impairments in 2 or more adaptive skills)
3. Onset in the developmental period (before 18 yrs)

Question 3

What are the adaptive skills that are useful in diagnosing individuals with an intellectual disability?

Answer 3

Communication
Self care 
Home living 
Social skills 
Community use 
Self direction
Health and safety 
Functional academics 
Leisure and work

Question 4

What is the prevalence of learning disabilities in practice?

Answer 4

1-2%

should be around 2.5% but mortality kills off some and some people with IQ < 70 can function within society and therefore are not classified as having a learning disability

Question 5

How are learning disabilities classified by severity?

Answer 5

Mild LD IQ: 50 - 69 or functional age 9-12yrs
Moderate LD IQ: 35 - 49 or functional age 6-9yrs
Severe LD IQ: 20 - 34 or functional age 3-6yrs
Profound LD IQ: <20 or functional age <3yrs

Question 6

What causes learning disabilities?

Answer 6

Idiopathic (majority)

Genetic abnormalities (Fragile X / Di-George Syndrome / Downs)

Infections (rubella / zika virus)

Trauma (hypoxic injury during birth / head injury in childhood)

Toxic (Foetal alcohol syndrome)

Question 7

What are some common or important physical conditions that are commonly associated with intellectual disabilities?

Answer 7

Epilepsy
Sensory impairments (hearing / vision)
Obesity 
Gastrointestinal (swallowing issues / reflux oesophagitis)
Respiratory problems 
Cerebral palsy
Orthopaedic problems 
Dermatological and dental problems

Question 8

How does presence of intellectual disorders correlate with psychiatric disorders?

Answer 8

Higher incidence of psychiatric disorder in those with LD

More severe the LD the higher the prevalence of psychiatric disorders

Question 9

How can psychiatric disorders be discovered in those with profound learning disabilities that struggle to communicate?

Answer 9

Observable signs:

• Weight loss
• Withdrawal
• Agitation
• Tearfulness (depression)
• Behavioural disturbance (psychosis)

Question 10

What are some psychiatric problems that occur in higher prevalence in those with learning disabilities?

Answer 10

Schizophrenia / Psychosis 
Mood disorders 
Anxiety disorders 
Autism 
Over-activity syndromes

Question 11

What is diagnostic overshadowing and why is it necessary to be cautious of this in people with learning disabilities?

Answer 11

Occurs when presenting symptoms are just put down to the patients learning disability instead of looking for another, potentially curable, cause

When a person presents with a new symptom or existing ones escalate make sure to try figure out what the cause may be