Semester 1 Week 4 - Learning Disability pt 1 Flashcards
what is a learning disability
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.
what is a learning disability
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.
what was measured and used to define learning disability
IQ
What IQ score defines a mild learning disability and what percentage of the learning disabled population
50-75
85%3
What IQ score defines a moderate learning disability and what percentage of the learning disabled population
35-50
10%
What IQ score defines a severe learning disability and what percentage of the learning disabled population
20-35
3-4%
What IQ score defines a profound learning disability and what percentage of the learning disabled population
below 20
1%
what is taken into account in the UK when describing and classifying learning disability?
both IQ/cognition and social functioning
what is the current terminology used in the UK?
learning difficulty
mild/moderate/severe/profound learning disability
intellectual disability (more modern term for learning disability that is gaining in popularity)
definition of learning difficulty
a label used to refer to children/adults where IQ is not in the low or learning disability range e.g., dyslexia
definition of learning disability
a label used to refer to children/adults with general difficulties or impairments in learning of different severity
2 types of aetiology that are determinable
organic
genetic
is there a determinable medical cause for learning disability
For the majority of individuals with mild (especially) or moderate learning disability, there is no determinable aetiology/medical cause
definition of syndrome
A collection of abnormalities of anatomic structure and/or behaviours and/or developmental patterns which are found to cluster together more often than chance.
how does a syndrome affect the phenotype
a syndrome will have its own physical phenotype and behavioural phenotype
4 causes of congenital syndromes
- genetic
- chromosomal
- metabolic
- environmental
who indentified Down Syndrome and when?
First identified by John Langdon Down in about 1866
what Down Syndrome caused by?
chromosomal abnormality called trisomy 21 (third copy of chromosome 21)
is there a genetic basis for trisomy 21?
no, not yet
risk factors for DS
advanced maternal age
smoking in pregnancy
prevalence of DS
1 in 1000
physical phenotype of DS
• 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
what do the craniofacial differences in people with DS lead to?
small oral cavity - protruding tongue
EDS difficulties
ear anomalies and hearning difficulties
oral-motor difficulties
why do babies with DS often spend first 3-6months in hospital?
heart and resp difficulties
as people with DS have been living longer what has been discovered?
more at risk of early onset dementia/DAT
what are the 3 areas of a behavioural phenotype to consider when looking at development of people with DS
cognition
speech, language and communication
social-emotional and behavioual functioning
3 parts of cognition
working memory
executive function
cognitive flexibility
what is working memory?
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
what is executive function
a term used to describe the process involved in how we plan, initiate and execute behaviours, e.g., planning an action, inhibiting a response
what is cognitive flexibility
a term used to describe the process by which we can adapt our thinking to accommodate new information, e.g., problem solving
how is cognition affected in DS (5)
• 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
why are babies with DS more likely to sign before they can talk?
• Visual abilities are stronger than verbal and auditory abilities
SLC development in people with DS
• 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
when are the first words likely to be in someone with DS
2+ years
when does SLC development begin to plateau
around 7 years
speech development in DS (3)
• 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
what are hearing problems in DS normally caused by
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
strength in DS
Majority of people with DS show strengths in social relatedness in the early years
what comorbid diagnosis has been increasing recently in DS
autism
what % of children with DS also have autism
5-10%
social-emotional and behavioural functioning in DS (4)
• 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
mothers are less responsive with DS infants in the pre-verbal stage than mothers of TD infants - why?
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
how is the specific pattern of language and cognitive behaviours found in DS characterised?
strengths - receptive language, visual memory, using gesture to communicate and social interaction
weaknesses - expressive language, speech, auditory memory and grammatical abilities
