Learning Disability

Question 1

Define a LD?

Answer 1

Arrested/incomplete development of mind, esp characterized by impairment of skills manifested in developmental period e.g. cognitive, language, social or motor skills

Question 2

What are the criteria for diagnosing a LD?

Answer 2

1) Intellectual impairment (IQ<70)
2) Onsets in developmental period (i.e. <18)
3) Adaptive dysfunction - Deficit in 2+ of:
- Communication
- Self Care
- Home living
- Social skills
- Community use
- Self-Direction
- Health & Safety
- Functional academics
- Leisure & work

Question 3

How do we classify a LD?

Answer 3

By IQ:
<70  = mild
<50 = moderate
<35 = severe
<20 = Profound

In practice (esp at severe/profound level) this is a clinical judgement due to difficulty in testing

Question 4

Most LDs are unknown in causation, but what causes are there?

Answer 4

Genetics e.g. Down’s or Fragile X
Infection e.g. antenatal rubella or postnatal meningitis
Toxins e.g. FAS
Trauma e.g. Birth asphyxia or head injury

Question 5

Learning difficulties are associated with a lot of physical problems, list some of the major ones:

Answer 5

• Epilepsy
• Sensory impairment (sight/hearing)
• Obesity
• Cerebral Palsy
• LRTI
• Osteoporosis
• GI problems e.g. constipation

Question 6

Mental health problems are more common in people with LD

Answer 6

In fact they increase with severity of LD

Question 7

What’s different about how you assess someone with LD for a psychiatric disorder?

Answer 7

They tend to complain less of mood changes and express other problems less.

So there’s much more focus on noting behavioural changes e.g. compulsive actions in OCD

Question 8

LD can bring with it some challenging behaviours, some of which may cause self-harm, that are not part of a psych disorder such as..

Answer 8

Strange Mannerisms
Rocking
Head-banging

Question 9

Are people with LDs more likely to commit a crime?

Answer 9

No but they’re more likely to commit certain crimes e.g. arson & sexual exhibitionism

Question 10

How does diagnostic overshadowing apply to LD sufferers?

Answer 10

It’s important not to assume a behaviour/complaint from someone with a LD is because of their LD, also look for all the same problems as you would in anyone else.

But also LDs can cause some behaviours that may look like something else e.g. overactivity & impulsivity mistaken for ADHD