Learning Disability

Question 1

Definition of LD

Answer 1

A condition of arrested or incomplete development of the mind, which is especially characterised by the impairment of skills manifested during the developmental periods, which contribute to the overall level of intelligence i.e. cognitive, language, motor and social abilities

Question 2

Criteria for LD

Answer 2

1. intellectual impairment (IQ < 70
2. social or adaptive dysfunction
   - deficits/impairments in 2 or more of adaptive skills (e.g. communication, self care, home living, social skills, community use, self direction, health and safety, functional academics, leisure and work)
3. Onset in the developmental period

Question 3

What is used to classify LD?

Answer 3

IQ

Question 4

Classification of LD

Answer 4

Mild = 50-69
Moderate = 35-49
Severe = 20-34
Profound <20

Question 5

Causes of LD

Answer 5

Genetic
- single gene (fragile X, PKU)- microdeletion/duplication (digeorge, Prader willi)
- angleman syndrome
- chromosomal abnormality (e.g. downs syndrome)
Infective
- ante natal (rubella)
- post natal (meningitis/encephalitis) 
toxic
- foetal alcohol syndrome
trauma
- birth asphyxia 
- head injury 
Unknown

Question 6

What is the most common cause of LD?

Answer 6

UNKNOWN cause

Question 7

Common conditions associated with LD

Answer 7

Epilepsy
- increased incidence and complexity with severity of LD
Sensory impairments (hearing and vision)
Obesity
GI (swallowing, reflux, H pylori, constipation)
Resp ( chest infections, aspiration pneumonia)
CP (esp with severe LD)
Orthopaedic problems (joint contractures, osteoporosis)
Dermatological and dental problems

Question 8

Associations of psychiatry and LD

Answer 8

Higher incidence of psychiatric disorders in those with LD
More severe the LD - higher the prevalence of a psychiatric disorder
Mild LD = psychiatric problems present normally
Moderate to profound LD = psychiatric problems present differently
Difficulties in describing the internal world e.g. less complex delusions
Those with lower IQ/communication difficulties often present with ‘challenging behaviour’

Question 9

2/3 of people with autism have what?

Answer 9

LDs

Question 10

Challenging behaviour observed in Severe LD

Answer 10

Mannerisms
head banging
rocking

Question 11

What potential causes are there is someone with a LD presents with a new behaviour or if existing ones escalate?

Answer 11

Social 
- change in carers
- lack of support 
- lack of social activities 
Psychological 
- bereavement 
- abuse
Physical 
- pain or discomfort 
Psychiatric 
- depression 
- anxiety
- psychosis
- dementia