Learning Disability Psychiatry

Question 1

Define a learning disability

Answer 1

A condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence i.e cognitive, language, motor and social abilities

Question 2

Criteria for a learning disability? (3)

Answer 2

1- intellectual impairment (IQ <70)
2- Social or adaptive dysfunction
Deficits/ impairments in 2 of the following adaptive
skills:
Communication, self-care, home Iiving, health and safety,
functional academics, leisure and work
3- Onset <18 years

Question 3

IQ is used to classify level of learning disability, what are those classes? (4)

Answer 3

Mild learning disability 50-69
Moderate LD 35-49
Severe LD 20-34
Profound LD <20

Question 4

Genetic conditions causing LD?

Answer 4

Single gene:
Fragile X,
PKU,
Retts syndrome

Microdeletion/duplication: DiGeorge syndrome,
Prader-Wili,
Angelman syndrome

Chromosomal abnormality: Down’s syndrome

Question 5

Important physical conditions associated with learning disability?

Answer 5

Epilepsy,
Sensory impairments,
Obesity,
GI- swallowing, reflux oesophagitis, helicobater pylorii, constipation
Resp- chest infections, aspiration pneumonia
Cerebral palsy,
Orthopaedic problems- joint contracture, osteoporosis
Dermatological and dental problems
Psychiatric disorders- Schizophrenia, psychosis, mood disorders, OCD, autism, over-activity syndromes (ADHD, some overactive, distractible and impulsive but not to the extent of ADHD), challenging behaviour, self injury

Question 6

Acquired conditions causing LD?

Answer 6

Infective:

• Rubella,
• Toxoplasmosis

Traumatic:

• Hypoxic brain injury at birth,
• Head injury in childhood

Toxic:
-Foetal alcohol syndrome

Question 7

Associated conditions with LD?

Answer 7

Cerebral palsy,
Autism spectrum disorder,
Epilepsy

Question 8

What is “The 3 point Test” for adults at risk?

Answer 8

16 or over:

• Are unable to safeguard their own wellbeing, property, rights or other interests AND
• Are at risk of harm AND
• Because they are affected by disability, mentaller; disorder, illness, or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.