learning disability

Question 1

What is the criteria for learning disability?

Answer 1

1. intellectual impairment (IQ < 70) (Wechsler)
2. social or adaptive dysfunction (Vineland Scale)
3. onset in the developmental period (age 18)

Question 2

What is social or adaptive dysfunction?

Answer 2

deficit/impairment in 2 or more of the following adaptive skills:

• communication
• self-care
• home living
• social skills
• community use
• self direction
• health and safety
• functional academics
• leisure
• work

Question 3

why is the prevalence of learning disabilities lower than expected

Answer 3

differential mortality: the more severe the degree of learning disability - the higher the mortality

role of functioning: those with IQ<70 but no problems functioning within their environment would not be defined as having a learning disability

Question 4

How are learning disability severity classified?

Answer 4

• intellectual functioning
• adaptive functioning

IQ <69, FA<12: mild

IQ <49, FA<9: moderate

IQ <34, FA<6: severe

IQ <20, FA<3: profound

Question 5

aetiology of LD

Answer 5

genetic

infective (rubella, zika virus)

toxic (foetal alcohol syndrome)

traumatic (hypoxia during birth, head injury)

unknown for most individuals

Question 6

What genetic conditions can result in LD?

Answer 6

single gene

• PKU (phenylketonuria)
• Fragile X
• Retts Syndrome

microdeletion/duplication

• Prader-Willi
• Angelman syndrome
• DiGeorge Syndrome

chromosomal abnormality

• Down Syndrome

Question 7

What infective causes of LD are there?

Answer 7

rubella, zika virus

Question 8

What common physical conditions often accompany LD?

Answer 8

• epilepsy
• cerebral palsy
• sensory impairments: hearing, vision
• dermatological and dental problems
• respiratory: chest infections, aspiration pneumonia
• obesity
• gastrointestinal: swallowing problems, reflux oesophagitis, helicobacter pylori, constipation
• orthopaedic problems: joint contractures, osteoporosis

Question 9

Why is there a speciality of psychiatry for those with learning disabilities?

Answer 9

higher psychiatric disorders prevalence

different presentation to general population

communication difficulties

specialist training required
-MDT working

Question 10

What are the assessment areas of LD psychiatry?

Answer 10

• presence
• severity
• aetiology
• associated conditions: biomedical
• psycho social assessment: psychiatric disorders

Question 11

what are some mental health problems seen in LD?

Answer 11

• schizophrenia
• mood disorders
• anxiety disorders
• autism
• over-activity syndromes
• challenging behaviour and self injury
• forensic