Learning Disability Flashcards
What is mental handicap and mental disorder?
Mental handicap = “a state of arrested or incomplete development of mind”
Mental disorder = mental illness or mental handicap
Describe the intellectual disability criteria?
- Intellectual impairment (IQ < 70)
- Such as Wechsler Adult Intelligence Scale
- 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 and work
- Onset in the developmental period (before age 18)
What scale can be used to measure IQ?
- Such as Wechsler Adult Intelligence Scale
What scale can be used to measure social or adaptive dysfunction?
- Vineland Adaptive Behaviour Scale
What are examples of adaptive skills?
- Communication
- Self-care
- Home living
- Social skills
- Community use
- Self-direction
- Health and safety
- Functional academics
- Leisure and work
Intellectual disability - epidemiology
(prevalence)
- Prevalence of IQ < 70 is 1-2%
Intellectual disability - severity
Severity (based on both intellectual and adaptive functioning):
- Mild LD
- IQ 50-69 or functional age 9-12 years
- Moderate LD
- IQ 35-49 or functional age 6-9 years
- Severe LD
- IQ 20-34 or functional age 3-6 years
- Profound LD
- IQ < 20 or functional age <3 years
What is the severity of intellectual disability based on?
Severity (based on both intellectual and adaptive functioning):
- Mild LD
- IQ 50-69 or functional age 9-12 years
- Moderate LD
- IQ 35-49 or functional age 6-9 years
- Severe LD
- IQ 20-34 or functional age 3-6 years
- Profound LD
- IQ < 20 or functional age <3 years
Intellectual disability - aetiology
- Inherited
- Single gene
- Fragile X, PKU, Retts syndrome
- Microdeletion/duplication
- DiGeorge Syndrome, Prader-Willi, Angelman syndrome
- Chromosomal abnormalities
- Down syndrome (most common)
- Single gene
- Acquired
- Infective
- Rubella, Zika virus
- Traumatic
- Hypoxic injury during birth, head injury in childhood
- Toxic
- Foetal alcohol syndrome
- Infective
- Idiopathic (for most patients the cause of LD is unknown)
What are some genetic cause of intellectual disability?
- Single gene
- Fragile X, PKU, Retts syndrome
- Microdeletion/duplication
- DiGeorge Syndrome, Prader-Willi, Angelman syndrome
- Chromosomal abnormalities
- Down syndrome (most common)
What are some common conditions associated with intellectual disability?
- Epilepsy
- Sensory impairments
- Obesity
- Gastrointestinal
- Swallowing problems, reflux oesophagitis, Helicobacter pylori, constipation
- Respiratory
- Chest infections, aspiration pneumonia
- Cerebral palsy
- Orthopaedic problems
- Dermatological and dental problems
- Psychiatric conditions
- High prevalence in people with LD and more severe
- Presentation differs the more severe the LD
- Where less communication is available, observable signs are relied on more to make diagnosis such as weight loss, withdrawal, agitation, tearfulness in depression
How do psychiatric illnesses compare in people with learning disability to those without?
- High prevalence in people with LD and more severe
- Presentation differs the more severe the LD
- Where less communication is available, observable signs are relied on more to make diagnosis such as weight loss, withdrawal, agitation, tearfulness in depression
What are assessment areas for the psychiatry of learning disability?
- Presence and severity of LD
- Aetiology of LD
- Associated biomedical conditions
- Psycho-social assessment
- Psychiatric disorders, their cause and consequences
What are differences in the following between people with learning disabilities and those without:
- schizophrenia/psychosis
- mood disorders
- anxiety disorders
- over-activity syndromes
- challenging behaviour and self-injury
- forensics
How many people with autism have learning disability?
- Half of people with autism have LD
