Neurodevelopmental & Learning Difficulties

Question 1

Learning Difficulty

Answer 1

✓ There are 4 levels of learning difficulty. Mild (an IQ of 50– 69), moderate (an IQ of 35–49), severe (an IQ of 20–34) and profound (an IQ of less than 20).
✓ The main criticism behind this classification is that it does not take into account the person’s social or adaptive functioning.
✓ Also the concept that IQ scores are not ‘fixed’ for life is another criticism for this method of classification.
✓ Challenging behaviour is managed by medication and behavioural techniques including applied behaviour analysis and cognitive behavioural therapy.
✓ When taking a history from an individual with learning difficulties, clear unambiguous language should be used and adjustments should be made for any sensory impairments, whilst being mindful about the pace of communication.

Question 2

Autism

Answer 2

✓ Impaired social interaction and communication and stereotyped behaviour and interests are the main features of Autism.
✓ Language impairment and associated learning disability are poor prognostic factors.
✓ Although shared care agreements are sometimes in place for medications like Methylphenidate, initiation is always by a specialist.
✓ Antipsychotic medication should also be initiated by a specialist and reviewed at 3-4 weeks and discontinued if no response by 6 weeks.
✓ Anticonvulsants should not routinely be used in managing challenging behaviour in adults with Autism.