Learning Disability Flashcards
What % of the population have a learning disability?
3%
Why is there – to some extent – an ‘invisibility’ of pts with learning disabilities within hospitals?
- Lack of effective flagging systems
* Lack of staff knowledge and willingness to flag this group
What is there a poor staff understanding of, in relation to learning disabilities?
- Specific requirements of people with learning disabilities
- Reasonable adjustments to services people may need
- Capacity issues
- Communication
What is a learning disability?
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.
What is the criteria for a learning disability?
- IQ < 70
- Developmental aetiology - <18 years
- Deficits in adaptive functioning
What is the most commonly used tool for psychometric assessment?
Wechsler Adult Intelligence Scale (WAIS).
What is the diagnosis of an LD based on?
Clinical findings (of adaptive behaviour)
What is the average IQ?
100
What is the prevalence of an IQ <70 in the general population?
2.5%
What does the Flynn effect refer to?
How average rate of increase in IQ seems to be about three IQ points per decade in the USS, as scaled by the Wechsler tests
Describe what trend in IQ scores the Flynn effect shows.
10 point increase per generation
Suggest possible causes of the Flynn effect.
- School
- Test familiarity
- Stimulation
- Nutrition
- Infections
What is happening to the Flynn effect now? Especially where?
It is slowing down
Developing countries
What is an LD not?
An educational difficulty e.g dyslexia
Mild
50-69 (i.e <70)
Moderate
35-49
Severe
20-34
Profound
<20
Borderline
70+
What is the mental age of someone with an borderline LD?
12-15 years old
What is the mental age for someone with a mild LD?
9-12
What type of LD is most common?
MILD
Describe the typical features of someone with a mild LD.
- Delayed speech – able to use everyday speech though.
- Full independence – self-care, practical and domestic skills.
- Difficulties in reading and writing.
- Capable of unskilled or semi-skilled work.
- Problems if social or emotional immaturity.
- Rarely organic aetiology
What is the mental age of someone with a moderate LD?
6-9 years old
Describe the typical features of someone with a moderate LD.
- Slow with Comprehension and Language
- Limited Achievements
- Delayed Self-care and Motor Skills
- Simple Practical Tasks - Often with Supervision
- Usually Fully Mobile - Physically Active
- Discrepant profiles
- Majority Organic Aetiology
- Epilepsy & Physical Disability common
“Generally MORE MARKED IMPAIRMENT than in moderate LD and achievements are more restricted” describes what type of LD?
Severe
What is the mental age of someone with a severe LD?
3-6 years old
What condition do people with severe LD often have?
Epilepsy
What is the mental age of someone with a profound LD?
<3 years old
Describe the features of someone with a profound LD.
- Severe limitation in ability to understand or comply with requests or instructions.
- Little or no self-care.
- Often severe mobility restriction.
- Basic or simple tasks may be acquired
‘Learning disability’ refers to an outcome based on what?
An outcome caused by a disparate disease process
What is the IQ range of someone with Down’s syndrome?
30-55
What other disease do people with Down’s get?
Alzheimer’s
Describe the Down’s mutation.
Trisomy 21
Patau syndrome has what genetic abnormality?
Trisomy 13
Edward’s syndrome has what genetic abnormality?
Trisomy 18
List some prenatal factors which contribute to someone having an LD.
- Maternal infection Rubella, CMV, Toxoplasmosis.
- Exposure to medication or drugs.
- Alcohol( Foetal Alcohol Spectrum Disorder may be the cause of 10-20% of cases of mild LD, association with ADHD)
- Poor diet, substance abuse.
List some perinatal factors which contribute to someone having an LD.
- Neonatal septicaemia
- Pneumonia
- Meningitis/encephalitis
- Other problems at delivery – birth injury
- Other newborn complications (respiratory distress, hyperbilirubinaemia, hypoglycaemia, extreme prematurity)
List some postnatal factors which contribute to someone having an LD.
- CNS infections, vascular accidents, tumours, hypoxic brain injury, head injury, NAI, exposure to toxic agents, psychosocial environment.
- Congenital hypothyroidism – now screened for neonatally, if untreated leads to mental and growth retardation.
- Other disorders of unknown aetiology.
- Cerebral palsies, epilepsy, autistic spectrum disorders, childhood disintegrative disorders.
Outline the 3 features of Angelman 15Q
- Maternally derived LD.
- Ataxia.
- Paroxysms of laughter
Outline the 3 features of Prader-Willi 15Q
- Paternally derived LD.
- Over-eating.
- Self-injurious behaviour
What % of people with Velo-Cardiofacial Syndrome 22Q will have a learning disability?
50%
What condition do people with Velo-Cardiofacial Syndrome 22Q have an increased risk of?
Schizophrenia
What sex chromosome arrangement is present in the following
a) Turner 45
b) Trisomy X
c) Klinefelter
a) XO
b) 47 XXX
c) XXY
Name 4 genetic causes of LD.
- Defects of protein (phenylketonuria), carbohydrate (mucopolysaccharidoses), lipid metabolism (neurolipidoses).
- Tuberous sclerosis.
- Congenital hypothyroidism.
- Lesch Nyhan Syndrome (x-linked)
