Learning Disability Flashcards

1
Q

What is mental handicap?

A

Mental handicap = “a state of arrested or incomplete development of mind”

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2
Q

What are mental disorders?

A

Mental disorder = mental illness or mental handicap

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3
Q

Describe the criteria for intellectual disability?

A
  • Intellectual impairment (IQ < 70)
    • Such as Wechsler Adult Intelligence Scale
  • Social or adaptive dysfunction
    • Vineland Adaptive Behaviour Scale
    • Deficits/impairments in 2 or more of 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 (before age 18)
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4
Q

What scale is used to measure IQ for diagnosing intellectual disability?

A
  • Intellectual impairment (IQ < 70)
    • Such as Wechsler Adult Intelligence Scale
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5
Q

What scale is used to measure social or adaptive dysfunction?

A
  • Vineland Adaptive Behaviour Scale
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6
Q

What are the different components of the Vineland adaptive behaviour scale?

A
  • Social or adaptive dysfunction
    • Vineland Adaptive Behaviour Scale
    • Deficits/impairments in 2 or more of following adaptive skills
      • Communication
      • Self-care
      • Home living
      • Social skills
      • Community use
      • Self-direction
      • Health and safety
      • Functional academics
      • Leisure and work
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7
Q

Epidemiology - intellectual disability

(prevalence)

A
  • Prevalence of IQ < 70 is 1-2%
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8
Q

Severity - intellectual disability

A

Severity (based on both intellectual and adaptive functioning):

  • Mild LD
    • IQ 50-69 or functional age 9-12 years
  • Moderate LD
    • IQ 35-49 or functional age 6-9 years
  • Severe LD
    • IQ 20-34 or functional age 3-6 years
  • Profound LD
    • IQ < 20 or functional age <3 years
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9
Q

Aetiology - intellectual disability

A
  • Inherited
    • Single gene
      • Fragile X, PKU, Retts syndrome
    • Microdeletion/duplication
      • DiGeorge Syndrome, Prader-Willi, Angelman syndrome
    • Chromosomal abnormalities
      • Down syndrome (most common)
  • Acquired
    • Infective
      • Rubella, Zika virus
    • Traumatic
      • Hypoxic injury during birth, head injury in childhood
    • Toxic
      • Foetal alcohol syndrome
  • Idiopathic (for most patients the cause of LD is unknown)
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10
Q

What are some common conditions associated with learning disability?

A
  • Epilepsy
  • Sensory impairments
  • Obesity
  • Gastrointestinal
    • Swallowing problems, reflux oesophagitis, Helicobacter pylori, constipation
  • Respiratory
    • Chest infections, aspiration pneumonia
  • Cerebral palsy
  • Orthopaedic problems
  • Dermatological and dental problems
  • Psychiatric conditions
    • High prevalence in people with LD and more severe
    • Presentation differs the more severe the LD
    • Where less communication is available, observable signs are relied on more to make diagnosis such as weight loss, withdrawal, agitation, tearfulness in depression
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11
Q

What are assessment areas for the psychiatry of LD?

A
  • Presence and severity of LD
  • Aetiology of LD
  • Associated biomedical conditions
  • Psycho-social assessment
  • Psychiatric disorders, their cause and consequences
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12
Q

Common on psychiatric illness in LD for the following:

  • schizophrenia/psychosis
  • mood disorders
  • anxiety disorders
  • autism
  • over-activity syndromes
  • challenging behaviour and self-injury
  • forensics
A
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13
Q

What are examples of health inequalities in people with learning disability?

A
  • Social exclusion
  • Socioeconomic deprivation
  • Inaccessible services
  • Discrimination
  • Challenges to communication
  • Lack of appropriate knowledge and skills of professionals
  • Minimal evidence base from research
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14
Q

What is diagnostic overshadowing?

A

This is where presenting symptoms are put down to learning disability, rather than seeking another potentially treatable cause

Consider when:

  • Presents with new behaviour
  • Existing behaviour escalates
  • Consider
    • Social cause – change in careers, lack of support, lack of social activity
    • Psychological issues – bereavement, abuse
    • Physical problems – pain or discomfort
    • Psychiatric cause – depression, anxiety, psychosis
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15
Q

When should diagnostic overshadowing be considered?

A

Consider when:

  • Presents with new behaviour
  • Existing behaviour escalates
  • Consider
    • Social cause – change in careers, lack of support, lack of social activity
    • Psychological issues – bereavement, abuse
    • Physical problems – pain or discomfort
    • Psychiatric cause – depression, anxiety, psychosis
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