Learning disabilities

Question 1

Definition of learning disability (what are the 3 components)

Answer 1

a significant impairment of intelligence (IQ <70) and impairment of adaptive functioning evident before 18
instrumental adls: finance, meds, transport, house keeping, food prep
adls: bath, toilet, eating, dressing

Question 2

ICD10 criteria for degree of learning disability:

• Mild
• Moderate
• Severe
• Profound

Answer 2

ICD10 criteria for degree of learning disability:

• Mild: 50-69, full indep, good speech, some help learning, some social immaturity
• Moderate: 35-49, limited communication, supervision with adls, inc risk epilepsy
• Severe: 20 -35, few words, always supervised, incontinent, not working, msk aborm
• Profound: <20, no self care

Question 3

Causes of LD:

• Genetics
• Antenatal
• Perinatal
• Neonatal
• Post natal

Answer 3

• Genetics: downs, fragile x, pku, prada willi, cri du chat
• Antenatal: TORCH, alc, nutrition, pre-eclampsia, hypoxia
• Perinatal: sepsis, intravent haem
• Neonatal: hypoglycemia, meningitis
• Post natal: meningitis/encephalitis, hypothyroidism, cerebral palsy, head injury, NAI, autism
  idiopathic!!

Question 4

Physical health conditions in LD (13)

Answer 4

constipation
dental
epilepsy
gord
mobility
obesity
incontinence
mental health
reduced life expectancy

Question 5

How to assess someone with a potential LD:

1. Hx: what to ask?
2. MSE, simple cognitive assessment (AMT), IQ test
3. General exam: cvs, resp, neurolog, growth + development assessment, ears/eyes check
4. Bloods: which ones?
5. Imaging: which ones?

Answer 5

fbc, tfts, glucose, torch, ct/mri, iq, salt, physio, OT, specialist nurse, gp

Question 6

Management of LD:

• Who’s involved
• Behaviour techniques - examples?
• Medications?

Question 7

Challenging behaviour in LD patients:

• Definition
• Symptoms
• Causes
• Management

Question 8

Communication issues in LD