Learning Disability Flashcards
3 Criteria to diagnose Learning Disability
(IQ<70) Intellectual Impairment
Social and Adaptive Dysfunction
Onset in developmental period
Which scale is used for Intellectual Impairment?
Weshcler
Which scale is used for Social and Adaptive dysfunction?
Vineland
How is Lower IQ classified?
Mild 50-69
Moderate 35-49
Severe 20-34
Profound <20
5 Aetilogical Factors for learning disabilities
Genetic Trauma Toxic Infective Unknown
Which Genetic conditions are associated with learning disabilities?
Fragile X
PKU
Retts DI George
Downs
Which infections are associated with risk for learning disability?
Rubella
Encephalitis
Meningitis
Which toxic syndrome is linked to learning disabilties?
Foetal alcohol syndrome
Which traumatic events can lead to developing a learning disability?
Birth asphyxia
Head injury - developmental period
List some comorbidities that coincide with learning disabilities
Epilepsy
Sensory impairments
Obesity
GI- Swallowing, reflux, helicobacter, constipation
Respiratory - chest infections, aspirational pneumonia
Cerebral palsy
Orthopaedic - joint contractures, osteoporosis,
Dermatological
Dental
In absence of communication what other symptoms may be observed in diagnosing psychiatric disorders and learning disabilities
Weight loss Withdrawal Agitation Tearfulness in depression Behavioural disturbance in psychotic disorder
4 Assessment factors in psychiatric disorders with learning disabilities
Aetiology of learning disability
Associated biomedical conditions
Severity of learning disability
Psychiatric disorders - causes and consequences
What symptoms may be seen in schizophrenia with LD?
Change in personality
Reduced functional ability
Self-talk
Overactivity Syndromes
Distracted
Impulsive
Not always to extent of ADHD
Why are mood disorders harder to recognise in patients with learning disabilities?
Less likely to complain of mood changes
Need to note behavioural and biological changes
Why might patients with OCD take longer to present with Learning disabilities?
Cannot describe compulsions
What behaviours can be common in patients with more severe learning disability?
Challenging
Mannerisms - rocking, head banging
Strategies to approach consultation
Non-verbal cues
Alternative communication
Rapport
Carers
Which factors must be considered to avoid Diagnostic overshadowing?
Social
Psychological
Physical
Psychiatric
Fragile X, PKU and Rett’s are what type of genetic conditions?
Single deletion
Which conditions are microdeletion genetic abnormalities?
DiGeorge
Prader Willi
Angelman
What genetic conditions are an example of imprinting in humans?
Prader Willi and Angelman
most common causes of mortality in patients with LD
Pneumonia, aspiration pneumonia
Cancers - but of genetic origin rather than toxic carcinogens eg tobacco
Health inequalities in LD
Social exclusion
Socio-economic deprivation (most impacted group by austerity)
Inaccessible services
Discrimintation
Lack of appropriate knowledge and skills in professionals
Minimal evidence base from research
How might services be inaccessible to patients with LD?
Many services require use of technology
Reliance on carers to make appointments, travel to appointments etc
Case study
45 y/o F lives alone
Little social interaction
Attended special school but no formal diagnosis and no LD contact
Working as domestic in hospital for 20 years
At GP appointment - low mood, feeling tearful, struggling to sleep
Explore low mood course
- mother died
- had managed money and housework ; now in debt
- in trouble with rota, not turning up on time
- hasn’t been able to complete fire safety
- in trouble with manager
What are the next steps in case study?
Thinking mother is the carer
Mild LD unidentified
Could possibly be grief reaction and depressive episode
