Learning Disability

Question 1

What is the definition of learning disability?

Answer 1

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 e.g. cognitive, language, motor and social abilities

Question 2

What is the criteria for a diagnosis of learning disability?

Answer 2

• Intellectual impairment (IQ < 70 and Wechsler)
• Social or adaptive dysfunction (Vineland scale): deficits/impairments in 2 or more of the following adaptive skills: communication, self-care, home living, social skills, community use, self direction, health and safety, functional academics, leisure and work
• Onset in the developmental period

Question 3

How are learning difficulties classified?

Answer 3

• Mild: IQ of 50 -69
• Moderate: IQ of 35-49
• Severe: IQ of 20-34
• Profound: IQ of <20

Question 4

What are the causes of LD?

Answer 4

• Genetics: fragile X, PKU, Retts syndrome, DiGeorge syndrome, Prader-Willi and Down syndrome
• Infective: rubella, meningitis and encephalitis
• Toxic: foetal alcohol syndrome
• Trauma: birth asphyxia, head injury etc.
• Unknown

Question 5

Which common/important physical conditions are associated with learning difficulties?

Answer 5

• Epilepsy
• Sensory impairments
• Obesity
• GI: swallowing problems, reflux oesophagitis, H. pylori and constipation
• Respiratory problems
• Cerebral palsy
• Ortho: joint contractures and osteoporosis
• Dermatological and dental problems

Question 6

How is Schizophrenia different in LD?

Answer 6

• Increased prevalence

- Associated with change in personality and reduction in functional abilities

Question 7

How are mood disorders different in LD?

Answer 7

• Increased incidence

- Less likely to complain of mood changes and noted by change in behaviour

Question 8

How is OCD different in LD?

Answer 8

• Ritualistic behaviour and obsessional themes significantly increased in LD
• Obsessions are hard to describe by people with LD
• Compulsions are more readily observed

Question 9

How is autism different in LD?

Answer 9

2/3 of people have a LD

Question 10

How are over-activity syndromes different in LD?

Answer 10

• Much higher incidence of ADHD
• Many children with severe LD are overactive, distractible and impulsive but not to the extent that would indicated a diagnosis of ADHD

Question 11

How is challenging behaviour and self injury different in LD?

Answer 11

• Mannerisms, head banging and rocking common in severe LD

- General trend of greater prevalence of problem behaviour in more severe LD

Question 12

How are forensic problems different in LD?

Answer 12

• Mild LD have similar rates of offending

- IQ below 70 over represented for arson and sexual offences (usually exhibitionism) in prison population