Cognition, Language, Learning

Question 1

What is required to be considered to have an intellectual disability?

Answer 1

Limitations in intellectual functioning as well as adaptive/behavior skills originating before age 18

(within context of community/cultural/linguistic factors)

Question 2

What are the five components of going about identifying a potential cause for intellectual disability?

Answer 2

1. History: Behavioral patterns
2. Family History: Stillborns, miscarriages, consanguinity
3. PE: Dysmorphism/unusual features
4. Genetic Testing
5. Imaging: Microcephaly, ect

Question 3

What is the imaging study of choice with concern for intellectual disability?

Answer 3

MRI

Question 4

True or False: EEG is part of the workup for intellectual disability

Answer 4

False: In absence of seizures, EEG isn’t indicated

Question 5

What are the 3 most common known causes of intellectual disability?

Answer 5

1. Fetal alcohol syndrome
2. Fragile X syndrome
3. Down syndrome

Question 6

What is the most common preventable cause of intellectual disability?

Answer 6

Fetal alcohol syndrome

Question 7

What problems can kids with fetal alcohol syndrome who have IQs in normal range have?

Answer 7

1. Neurobehavioral deficits

2. Increased risk for psychiatric disorders

Question 8

What two mental health problems are kids with Down syndrome at increased risk for?

Answer 8

1. ADHD

2. Oppositional-defiant disorder

Question 9

What should you think if there is a family three filled with uncles with learning problems?

Answer 9

X-linked disorder like Fragile X

Question 10

When is metabolic screening done in the workup of intellectual disability?

Answer 10

Only if there is PE findings or history to support testing

Question 11

What is the most common cause of intellectual disability?

Answer 11

Genetics

Question 12

Besides genetics, what are 2 other causes to consider for intellectual disability?

Answer 12

1. Perinatal infection

2. Teratogen exposure

Question 13

What IQ constitutes mild intellectual disability?

Answer 13

55-70

Question 14

What IQ constitutes moderate intellectual disability?

Answer 14

40-55

Question 15

What IQ constitutes severe intellectual disability?

Answer 15

25-40

Question 16

What IQ constitutes profound intellectual disability?

Answer 16

Below 25

Question 17

True or False: Severe intellectual disability is usually picked up at a younger age

Answer 17

True

Question 18

What % of cases of intellectual disability fall in the mild range?

Answer 18

Up to 85%

Question 19

When is mild intellectual disability usually picked up?

Answer 19

Time of entry into school (later than more severe intellectual disability)

Question 20

What type of development can visual impairment delay?

Answer 20

Motor

Question 21

What type of development in young children is often a better gauge of cognitive function?

Answer 21

Language (versus gross motor)

Question 22

Up to what age can an infant with profound hearing loss demonstrate normal language development?

Answer 22

6-9 months: Babbling won’t progress to definite “mama” and “dada”

Question 23

What is needed for a child younger than 6 who is having difficulty pronouncing certain consonants?

Answer 23

Reassurance

Question 24

How is ASD diagnosed?

Answer 24

Clinically

Question 25

Name 4 characteristics of ASD

Answer 25

1. Serious impairment of social skills 2. Delayed language development (except Asperger) 3. Repetitive behaviors/restricted interests 4. Presentation prior to 36 months

Question 26

What is an important component of autism which distinguishes it from of forms of language delay?

Answer 26

1. Lack of eye contact | 2. Lack of social engagement

Question 27

What is an important part of history in diagnosing ASD?

Answer 27

Child's interactions with other family memeber

Question 28

What are 2 things which can help distinguish ASD from intellectual disability?

Answer 28

1. Delayed/atypical language | 2. Odd interests/activities

Question 29

What rules out ASD (for the most part)?

Answer 29

Good social interaction

Question 30

True or False: With Asperger syndrome, there is no language delay

Answer 30

True

Question 31

In what syndrome is development normal until age 1, then begins to regress?

Answer 31

Rett

Question 32

What syndrome should you think of with acquired microcephaly?

Answer 32

Rett

Question 33

What is a requirement for any child undergoing evaluation for a speech delay?

Answer 33

Hearing test

Question 34

What is important to screen for in family history with workup for a learning disability?

Answer 34

Others with speech, language, learning, or behavioral problems (ADHD) (may be a clue to specific disorders like Fragile X)

Question 35

True or False: A child can have a learning disability with normal or even superior intelligence

Answer 35

True

Question 36

Learning disability is defined as a gap between the expected and observed performance in any of which 6 areas?

Answer 36

1. Listening 2. Speaking 3. Reading 4. Writing 5. Reasoning 6. Math skills

Question 37

Up until what age can a findings of a child who reverses letters (like b/d) be a normal finding?

Answer 37

Age 7

Question 38

What is key for learning disabilities?

Answer 38

Early intervention *Delay in diagnosis can cause repeated academic failures and decreased school motivation

Question 39

Name 4 red flags for a learning disorder

Answer 39

1. Delay in speech and language development 2. Can't recognize letters/numbers by the end of kindergarten 3. Speech delay in preschooler 4. Can't read simple words by end of 1st grade

Question 40

True or False: There can be significant negative social impact when kids are held back a grade

Answer 40

True *But moving someone on who is failing doesn't address academic problems either

Question 41

Name 2 drugs which can alter school performance

Answer 41

1. Anticonvulsants | 2. Antihistamines

Question 42

What mental health problem can cause poor school performance?

Answer 42

Depression *But, poor school performance can also cause depression

Question 43

Children with learning disabilities are at increased risk for what two things?

Answer 43

1. Behavioral disorders | 2. Mood disorders

Question 44

True or False: Learning disabilities can be outgrown

Answer 44

False

Question 45

What can be important for self esteem of a child with a learning disability?

Answer 45

Extracurricular activities

Question 46

What is encouraged for kids with learning disabilities?

Answer 46

Use of special tools: Private tutoring, resource room, ect.

Question 47

True or False: Most common eye disorders don't impact ability to read

Answer 47

True

Question 48

When are things like tinted eyeglasses or eye gymnastics helpful to improve reading ability?

Answer 48

Never

Question 49

What should you consider with a child who is struggling in something like history or social studies?

Answer 49

Reading difficulty or problems with short term memory

Question 50

What do achievement tests distinguish between?

Answer 50

IQ (potential) and achievement (actual) intellectual peformance

Question 51

Name some factors which can influence intelligence testing

Answer 51

1. Genetics 2. Cultural/language bias 3. Emotional/psychosocial factors 4. Ability to focus/pay attention

Question 52

Which is more important on IQ tests (like the WISC-IV)... overall score or sub-test profile scores?

Answer 52

Subtest- this allows for more detailed information on child's difficulties

Question 53

What does the WISC-IV stand for?

Answer 53

Wechsler Intelligence Scale for Children

Question 54

What should you think with a child who has below normal scores on an achievement test despite a normal IQ?

Answer 54

Specific learning disability

Question 55

True or False: The predictive value of IQ testing increases with age

Answer 55

True

Question 56

What are the first 5 things to consider when you have a child with school failure?

Answer 56

1. Medical history (signs of things like asthma, IBD, or neurological disorders like Tourette's) 2. Educational history 3. Physical exam 4. Family history 5. Emotional issues (Recent divorce or move)

Question 57

Once you have gotten a good history and exam, what is the next thing to do for a child with school failure?

Answer 57

Testing