Semester 1 Week 4

Question 1

what is a learning disability

Answer 1

A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life.
People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated
information and interact with other people.

Question 2

what is a learning disability

Answer 2

A learning disability is a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life.
People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated
information and interact with other people.

Question 3

what was measured and used to define learning disability

Answer 3

IQ

Question 4

What IQ score defines a mild learning disability and what percentage of the learning disabled population

Answer 4

50-75
85%3

Question 5

What IQ score defines a moderate learning disability and what percentage of the learning disabled population

Answer 5

35-50
10%

Question 6

What IQ score defines a severe learning disability and what percentage of the learning disabled population

Answer 6

20-35
3-4%

Question 7

What IQ score defines a profound learning disability and what percentage of the learning disabled population

Answer 7

below 20
1%

Question 8

what is taken into account in the UK when describing and classifying learning disability?

Answer 8

both IQ/cognition and social functioning

Question 9

what is the current terminology used in the UK?

Answer 9

learning difficulty
mild/moderate/severe/profound learning disability
intellectual disability (more modern term for learning disability that is gaining in popularity)

Question 10

definition of learning difficulty

Answer 10

a label used to refer to children/adults where IQ is not in the low or learning disability range e.g., dyslexia

Question 11

definition of learning disability

Answer 11

a label used to refer to children/adults with general difficulties or impairments in learning of different severity

Question 12

2 types of aetiology that are determinable

Answer 12

organic
genetic

Question 13

is there a determinable medical cause for learning disability

Answer 13

For the majority of individuals with mild (especially) or moderate learning disability, there is no determinable aetiology/medical cause

Question 14

definition of syndrome

Answer 14

A collection of abnormalities of anatomic structure and/or behaviours and/or developmental patterns which are found to cluster together more often than chance.

Question 15

how does a syndrome affect the phenotype

Answer 15

a syndrome will have its own physical phenotype and behavioural phenotype

Question 16

4 causes of congenital syndromes

Answer 16

1. genetic
2. chromosomal
3. metabolic
4. environmental

Question 17

who indentified Down Syndrome and why?

Answer 17

First identified by John Langdon Down in about 1866

Question 18

what Down Syndrome caused by?

Answer 18

chromosomal abnormality called trisomy 21 (third copy of chromosome 21)

Question 19

is there a genetic basis for trisomy 21?

Answer 19

no, not yet

Question 20

risk factors for DS

Answer 20

advanced maternal age
smoking in pregnancy

Question 21

prevalence of DS

Answer 21

1 in 1000

Question 22

physical phenotype of DS

Answer 22

• Mild to moderate learning disability with a decline in IQ during the lifespan
• Hypotonia (low muscle tone)
• Craniofacial differences = brachcephaly (shortening of the front to back dimension of the face)
• Hyperflexibility of joints (due to hypotonia)
• Heart and respiratory problems
• Often eating, drinking and swallowing difficulties
• Ear anomalies and hearing difficulties
• Upper respiratory tract anomalies
• Oral-motor difficulties

Question 23

what do the craniofacial differences in people with DS lead to?

Answer 23

small oral cavity - protruding tongue
EDS difficulties
ear anomalies and hearning difficulties
oral-motor difficulties

Question 24

why do babies with DS often spend first 3-6months in hospital?

Answer 24

heart and resp difficulties

Question 25

as people with DS have been living longer what has been discovered?

Answer 25

more at risk of early onset dementia/DAT

Question 26

what are the 3 areas of a behavioural phenotype to consider when looking at development of people with DS

Answer 26

cognition
speech, language and communication
social-emotional and behavioual functioning

Question 27

3 parts of cognition

Answer 27

working memory
executive function
cognitive flexibility

Question 28

what is working memory?

Answer 28

a term used to refer to the process of how we store and manipulate complex information needed for learning, e.g., the process of learning new words

Question 29

what is executive function

Answer 29

a term used to describe the process involved in how we plan, initiate and execute behaviours, e.g., planning an action, inhibiting a response

Question 30

what is cognitive flexibility

Answer 30

a term used to describe the process by which we can adapt our thinking to accommodate new information, e.g., problem solving

Question 31

how is cognition affected in DS (5)

Answer 31

• Mild to moderate IQ with language abilities often below their level of non-verbal IQ
• Decline in IQ/cognition over time/age
• Memory difficulties including 1) working memory; 2) executive function and 3) cognitive flexibility
• Superior visual memory than auditory memory (Hodapp et al 1999)
• Visual abilities are stronger than verbal and auditory abilities

Question 32

why are babies with DS more likely to sign before they can talk?

Answer 32

• Visual abilities are stronger than verbal and auditory abilities

Question 33

SLC development in people with DS

Answer 33

• Very early language delay evident
• Variation in severity across children with DS
• Speech, language and communication development usually follows the typical sequence but is much slower and plateaus at a level very much below chronological age.
• Uneven patterns of development within speech, language and communication have also been identified.
• Significantly delayed onset, e.g., communicative intent is delayed and first words develop much later than typically expected
• Receptive language develops much faster than expressive language - vocabulary develops much more quickly than grammatical ability
•Most importantly, children with DS can learn to sign before they are able to say the words they can sign

Question 34

when are the first words likely to be in someone with DS

Answer 34

2+ years

Question 35

when does SLC development begin to plateau

Answer 35

around 7 years

Question 36

speech development in DS (3)

Answer 36

• Speech is slow to develop, e.g., babbling, protowords are much later or not at all
• When speech develops it is often unintelligible or difficult to understand - this is often due to articulation difficulties resulting from the oral structure
anomalies
• Phonological development is often slower to develop

Question 37

what are hearing problems in DS normally caused by

Answer 37

usually a result of the recurrent otitis-media which causes transient and repeated conductive hearing loss - recurrent otitis-media caused by the ear abnormalities which are a physical feature of DS

Question 38

strength in DS

Answer 38

Majority of people with DS show strengths in social relatedness in the early years

Question 39

what comorbid diagnosis has been increasing recently in DS

Answer 39

autism

Question 40

what % of children with DS also have autism

Answer 40

5-10%

Question 41

social-emotional and behavioural functioning in DS (4)

Answer 41

• Majority of people with DS show strengths in social relatedness in the early years e.g., intent to communicate, able to establish joint attention in the years
• Can be described as ‘over friendly’ which can be difficult in terms of increasing the individual’s vulnerability
• In adolescence, social and emotional difficulties can become more apparent due to increasing social demands
• More recently, increasing incidence of autism spectrum disorder (ASD) reported in DS

Question 42

mothers are less responsive with DS infants in the pre-verbal stage than mothers of TD infants - why?

Answer 42

Mothers may find it difficult to recognise behaviours that are communicative and to then respond to these e.g. ow rates of initiations and responses and slow response time

Question 43

how is the specific pattern of language and cognitive behaviours found in DS characterised?

Answer 43

strengths - receptive language, visual memory, using gesture to communicate and social interaction

weaknesses - expressive language, speech, auditory memory and grammatical abilities