Learning disability

Question 1

What is the definition of learning disability?

Answer 1

IQ below 70, before the age of 18 (neurodevelopmental) and impairment across a wide range of functions eg motor, language, cognition and social function

Question 2

What do you include in the history and examination of learning disability?

Answer 2

History- gestational, obstetric, neonatal, developmental history

Examination- Neuro, language comprehension and communication, IQ assessment, assessment of autism spectrum disorder

Question 3

Lab invesitgations?

Answer 3

FBC, U and E’s, LFT’s, TFT’s, glucose infection screening, serology (TORCH)

X-ray of body- if dysmorphic features

Karytoyping and FISH

Question 4

Management of LD?

Answer 4

Psychological- CBT and psychodynamic therapies to help coping with loss etc

Pharmacological
Naltrexone: for self-injurious repetitive behaviour
B-blockers: for anxiety disorders which may be at root of aggressive behavioural disturbance

Question 5

What is the triad of autistic spectrum disorder?

Answer 5

1. Impaired communication and language abilities
2. Abnormal social interactions
3. Repetitive and stereotyped behaviours

other features- seizures, increased HC, increased sensory responsiveness, irritability, aggression, self injurious behaviour

Question 6

How do you assess and manage autism?

Answer 6

MDT approach

Do history, MSE, neuro history, psychometric testing, educational assessment. Use scale as ABC (autism behaviour checklist)

Management- structure- routine-predictability

• CBT, behavioural modification therapy, family therapy
• Pharmacological: SSRI’s for self injurious behaviour, anti-psychotics