Learning disability

Question 1

Define.

a) Impairment
b) Disability

Answer 1

a) Impairment: any loss or abnormality of psychological,
physiological or anatomical structure or function

b) Disability: any restriction or lack (resulting from an
impairment) of ability to perform an activity in the
manner considered normal for a human being

Question 2

Learning disability: define (3)

Answer 2

• Cognitive impairment (low IQ)

- resulting in restricted ability to perform everyday tasks- - with onset before age 18.

Question 3

Causes of LD

Answer 3

– genetic factors; syndromes (e.g. Down’s)
– maternal use of alcohol, drugs and tobacco during
pregnancy;
– complications during pregnancy;
– environmental toxins, such as cadmium and
lead.

Question 4

Down’s syndrome.

a) Cause
b) 10 physical features
c) Related diseases

Answer 4

a) Trisomy 21

b) Head:
- brachycephaly,
- low set ears,
- Brushfield spots (iris speckles),
- epicanthic folds,
- oblique palpebral fissures,
- flat nasal bridge,
- apparent macroglossia,
- high arched palate

MSK:

• kleinodactyly,
• single palmar crease,
• short hands,
• sandle gap,
• hypotonia,
• hyperflexibility

c) - Thyroid disease,
- Alzheimers,
- myelodysplasia and ALL,
- congenital heart disease,
- duodenal atresia (double bubble)

Question 5

Consequences of LD

Answer 5

• More risky health behaviours (smoking, obesity, alcohol, poor oral health)
• Poor access to /uptake of health services
• More sensory & physical impairments (deafness, visual impairment, MSK disorders, etc.)
• Poorer physical health:
– Respiratory disease, linked to pneumonia, swallowing and feeding impairments
• Shorter life expectancy and premature mortality
– Life expectancy of people with LD lower than the general population by up to 20 years

Question 6

How to provide optimal care for those with LD

Answer 6

– Registration with a GP is important in accessing screening programmes
– Primary care mandated in GP contract to offer people
with learning disabilities an ANNUAL HEALTH CHECK
– Easy read formats for patient information leaflets
– Patient champions
– Be aware and mindful of their needs (e.g. communication - sign language/Makaton, etc.)
– Prevent and manage comorbid disorders
– Treat equitably and presume capacity unless proven otherwise