Learning Disability

Question 1

What is learning disability?

Answer 1

Arrested or incomplete development of the mind, characterised by impaired skills, onset during the developmental period, that contribute to intelligence i.e. cognitive, language, motor and social abilities
NOT LEARNING DIFFICULTY

Question 2

What is the criteria for diagnosing learning disability?

Answer 2

IQ less than 70
Developmental aetiology <18 years
Deficits in adaptive functioning

Question 3

What are the IQ parameters for mild learning disability? List features of mild learning disability

Answer 3

IQ 50-69
Delayed speech
Full independence
Difficulty reading/ writing
Social/ emotional immaturity

Question 4

What are the IQ parameters for moderate learning disability? List features of moderate learning disability

Answer 4

IQ 35-49
Slow comprehension/ language
Delayed self care
Reduced motor skills
Carry out simple practical tasks
Mobile
Usually organic cause

Question 5

What are the IQ parameters for severe learning disability? List features of severe learning disability

Answer 5

IQ 20-34
Marked impairment
Restricted achievements

Question 6

What are the IQ parameters for profound learning disability? List features of profound learning disability

Answer 6

IQ less than 20
Severe limitation in ability to understand or follow instructions
Little/ no self care
Usually mobility restriction
Acquires basic tasks

Question 7

What is the most common form of learning disability?

Answer 7

Mild learning disability

Question 8

What are the possible prenatal causes of learning disability?

Answer 8

Genetic mutations, chromosomal abnormality
Maternal intrauterine infection
Poor diet
Toxicity (substance misuse)

Question 9

What are the possible perinatal causes of learning disability?

Answer 9

Birth injury
Extreme prematurity
Cerebral anoxia

Question 10

What are the possible postnatal causes of learning disability?

Answer 10

Infection
Metabolic disturbance (hypoglycaemia)
Congenital hypothyroidism
Hyperbilirubinaemia 
Toxins
NAI/ Trauma

Question 11

What scale can be used during psychiatric assessment to diagnose learning disability?

Answer 11

Wechsler Adult Intelligence Scale (WAIS)

Question 12

Which disease of cognitive impairment is associated with Down’s Syndrome?

Answer 12

Alzheimer’s dementia

Question 13

What are the three important aspects of management in learning disability?

Answer 13

1. Initial impairment e.g. brain injury from perinatal trauma
2. Resulting disability e.g. inability to read
3. Resulting social handicap e.g. problems with occupational, leisure and relationship opportunities

Question 14

List supportive measures used in the management of learning disability

Answer 14

Therapeutic environment (general support - school, specific support - psych problems)
Education for patients, carers, family
Social support - unmet needs, social skills training, support network
Communication - hearing aid, glasses, pictorial

Question 15

List psychological therapy used in learning disability

Answer 15

Behavioural (positive reinforcement, relaxation)
Cognitive (problem solving, anxiety/depression, CBT)
Psychodynamic therapy (relationships, adjust to life events)

Question 16

List pharmacological therapy used in learning disability

Answer 16

Antipsychotics (psychosis, behaviour disturbance, autism, ADHD)
Antidepressants (depression, anxiety, self injury, autism)
Anticonvulsants (bipolar, episodic dyscontrol)
Mood stabilisers for aggression

Question 17

What is the main symptom of schizophrenia in learning disability?

Answer 17

Behaviour change

Question 18

Why is psychiatric disorder more common in LD?

Answer 18

Organic vulnerability (brain damage)
Social deprivation
Life events
Psychological reasons - learned helplessness