Learning Disability

Question 1

What things are included as a mental disorder?

Answer 1

Mental illness
Learning disability
Personality disorder

Question 2

Define learning disability

Answer 2

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

Question 3

What is the learning disability criteria?

Answer 3

1. Intellectual impairment (IQ <70)
2. Social or adaptive dysfunction (deficits/impairments in 2 or more: communication, selfcare, home living, social skills, community use, self direction, health and safety, functional academics, leisure, work)
3. Onset in the developmental period (age 18)

Question 4

State the classification of level of LD

Answer 4

IQ is used:
Mild LD - 50-69
Moderate LD - 35-49
Severe LD - 20-34
Profound LD - <20

Question 5

What are the groups of causes of LDs?

Answer 5

Genetic
Infective
Toxic 
Trauma 
Unknown (most common)

Question 6

What are some genetic causes of LDs?

Answer 6

Single gene, e.g. fragile X, PKU, Retts syndrome
Microdeletion/duplication: DiGeorge, Prader-Willi, Angelman
Chromosomal abnormality: Down’s

Question 7

What are the infective causes of LDs?

Answer 7

Antenatal: Rubella

Post-natal: meningitis, encephalitis

Question 8

Give an example of a toxic cause of LD?

Answer 8

Foetal alcohol syndrome

Question 9

Give an example of a traumatic cause of LD?

Answer 9

Birth asphyxia

Head injury

Question 10

What physical conditions are commonly associated with LDs?

Answer 10

Epilepsy
Sensory impairments (hearing, vision)
Obesity
GI (swallowing problems, reflux oesophagitis, H. pylori, constipation)
Resp (chest infections, aspiration pneumonia)
Cerebral palsy
Orthopaedic problems (joint contractures, osteoporosis)
Dermatological and dental problems (e.g. unhealthy gums)

Question 11

How might schizophrenia present in a patient with a LD?

Answer 11

Change in personality

Reduction in functional abilities

Question 12

How might mood disorders present in a patient with a LD?

Answer 12

Less likely to complain of mood changes

Biological symptoms

Question 13

How might OCD present in someone with a LD?

Answer 13

Obsessions hard to describe but can observe compulsions

Ritualistic behaviour/obsessional themes slightly increased in LD anyway

Question 14

How common is autism in the LD population?

Answer 14

2/3 people with autism have a LD

Question 15

What challenging behaviour is common with severe LD?

Answer 15

Mannerisms, headbanging, rocking

Question 16

What may be other causes for someone with an LD presenting with new behaviour/escalation of existing behaviours?

Answer 16

Social cause - change in carers, lack of support, lack of social activities
Psychological issues - bereavement, abuse
Physical problems - pain, discomfort
Psychiatric cause - depression, psychosis, dementia