Development - Learning Disability

Question 1

What is a learning disability?

Answer 1

A significantly reduced ability to understand new or complex information and to learn new skills, with reduced ability to cope independently, starting before adulthood

Question 2

What is the difference between learning disability and specific learning difficulty?

Answer 2

Learning disability → global impairment of intellectual and adaptive functioning
Specific learning difficulty → normal intelligence with difficulty in specific skills (e.g. dyslexia)

Question 3

What are the different types of learning disability?

Answer 3

Mild learning disability
Moderate learning disability
Severe learning disability
Profound and multiple learning disability (PMLD)

Important: Dyslexia, dyspraxia, etc. are specific learning difficulties, not learning disabilities

Question 4

What domains are assessed in adaptive functioning?

Answer 4

Communication
Self-care
Social skills
Independent living

Question 5

How is dyspraxia also known?

Answer 5

Developmental co-ordination disorder

Question 6

Who is more affected by dyspraxia?

Answer 6

Boys 2x more common

Question 7

How does dyspraxia present?

Answer 7

Delayed gross and fine motor skills
Child appears clumsy

Question 8

How is severity of learning disability determined with IQ?

Answer 8

Mild: IQ 50–69

Moderate: IQ 35–49

Severe: IQ 20–34

Profound: IQ < 20

Question 9

When is formal IQ testing not required?

Answer 9

When functional impairment is clinically clear
In severe or profound learning disability

Question 10

What causes learning disabilities?

Answer 10

Genetic causes (e.g. Down syndrome)
Antenatal factors (e.g. fetal alcohol exposure)
Perinatal factors (e.g. hypoxic injury)
Postnatal factors (e.g. meningitis)
Often idiopathic

Question 11

What conditions are commonly associated with learning disability?

Answer 11

Epilepsy
Autism spectrum disorder
Mental health disorders
Sensory impairment

Question 12

What antenatal problems can cause learning difficulties?

Answer 12

Fetal alcohol syndrome
Maternal infections causing congenital brain injury (e.g. CMV)

Question 13

What problems at birth can cause learning difficulties?

Answer 13

Prematurity
Hypoxic ischaemic encephalopathy

Question 14

How are learning disabilities managed?

Answer 14

Multidisciplinary approach

• Health visitors
• Social workers
• Schools
• Educational psychologists
• Paediatricians, GPs
• Occupational therapists
• Speech and language therapists

Question 15

Do learning disabilities prevent patients from having capacity?

Answer 15

Decision specific
May require more time, effort and decision aids but they do not inherently lack capacity due to having learning disabilities

Question 16

What reasonable adjustments may be needed for patients with learning disabilities?

Answer 16

Longer appointments
Easy-read information
Carer involvement
Quiet environments

Question 17

How is capacity demonstrated?

Answer 17

Patient must
Understand
Retain
Weigh up
Communicate their decision