Learning Disability

Question 1

What are types of learning disability?

Answer 1

Dyslexia refers to a specific difficulty in reading, writing and spelling.

Dysgraphia refers to a specific difficulty in writing.

Dyspraxia, also known as developmental co-ordination disorder, refers to a specific type of difficulty in physical co-ordination. It is more common in boys. It presents with delayed gross and fine motor skills and a child that appears clumsy.

Auditory processing disorder refers to a specific difficulty in processing auditory information.

Non-verbal learning disability refers to a specific difficulty in processing non-verbal information, such as body language and facial expressions.

Profound and multiple learning disability refers to severe difficulties across multiple areas, often requiring help with all aspects of daily life.

Question 2

Classification of learning disability?

Answer 2

The severity of the learning disability is based on the IQ (intelligence quotient):

55 – 70: Mild
40 – 55: Moderate
25 – 40: Severe
Under 25: Profound

Question 3

Causes of learning disabilities?

Answer 3

Often there is no clear cause for the learning disability. A family history of learning disability increases the risk. Environmental factors such as abuse, neglect, psychological trauma and toxins can all increase the risk.

Certain conditions are strongly associated with learning disability:

Genetic disorders such as Downs syndrome
Antenatal problems, such as fetal alcohol syndrome and maternal chickenpox
Problems at birth, such as prematurity and hypoxic ischaemic encephalopathy
Problems in early childhood, such as meningitis
Autism
Epilepsy

Question 4

Management of learning disability?

Answer 4

The key to managing learning disability is with a multidisciplinary approach to support the parents and child. This involves:

Health visitors
Social workers
Schools
Educational psychologists
Paediatricians, GPs and nurses
Occupational therapists
Speech and language therapists

TOM TIP: Examiners may test you on your communication with someone that has learning disability. Remember to involve the child in any discussions where appropriate, regardless of their intellectual ability. When talking to someone with learning disability it becomes more important to make things simple to understand, give only small amounts of information at a time and always check understanding. Use tools to assist your communication, such as pictures and emojis. For example, there is a pain scale with a series of faces from happy to sad that can be used to help patients with learning disabilities communicate their level of pain.

Question 5

How can capacity be determined?

Answer 5

To have capacity a patient must demonstrate the ability to:

Understand the decision that needs to be made
Retain the information long enough to make the decision
Weight up the options and the implications of choosing each option
Communicate their decision

TOM TIP: Remember the four key words for demonstrating capacity, as these are very frequently tested in exams. Remember that capacity is decision specific, meaning someone may have capacity to decide what they want for breakfast but not to decide whether to undergo complex surgery.