Learning Disability Flashcards
What is a learning disability?
Below average intelligence and adaptive behaviour
Who are ID more common in?
males (3:2 ratio)
What is prevalence for ID like?
RISING
Due to increased survival of premature babies
What are causes of ID classified as?
50% have no clear cause (environment + polygenic)
ANTENATAL
PERINATAL
POSTNATAL
What are antenatal causes of ID?
Genetic
- chromosomal disorder e.g. Down’s, Turner’s
- mendelian inheritance e.g. Tuberous sclerosis, PKU, Tay-Sachs, Fragile X syndrome
Exposure during pregnancy
- drugs
- medications
- smoking
- infection
What are perinatal causes of ID?
- neonatal hypoxia
- birth trauma
- hypoglycaemia
- prematurity
- infection
What are postnatal causes of ID?
- social deprivation
- malnutrition, iodine deficiency > congenital hypothyroidism
- lead
- infection e.g. meningitis
- head injury
- child abuse /neglect
When does ID usually first present?
In childhood
What are examples of behavioural difficulties that can occur in ID?
overactivity
withdrawal
aggression
disinhibition
What are behavioural phenotypes?
Commonly recognised behaviours in particular syndromes
Give 2 examples of behavioural phenotypes
compulsive eating in Prader willi
self harm in Lesch-Nyhan syndrome
What are ddx for ID?
ASD Epilepsy Adult brain injury Psychiatric e.g schizophrenia Educational disadvantage/neglect
How do you investigate ID?
IQ testing
Functional assessment of skills, strengths, weaknesses by social worker
Developmental history from parents
Investigations for associated physical illness
Genetic testing if appropriate / Brain MRI
How do you prevent ID?
Education e.g. reduce risk of alcohol drinking during pregnancy
Improved antenatal/postnatal care
genetic counselling
early detection and treatment of reversible causes e.g. exclude phenylalanine in PKU baby
How to you manage ID?
Treat physical comorbidity
Treat psychiatric comorbidity
Educational support (special needs)
Psychological therapy (CBT, Behavioural Therapy)
