FPC: intellectual disorders

Question 1

What is the most common developmental disability?

Answer 1

ADHD

Question 2

What percentage of people have developmental disability?

Answer 2

17%

Question 3

What is global developmental delay?

Answer 3

Children aged 0-5 with significant delay in 2 or more areas of development.

Question 4

What are outcomes of global development delay?

Answer 4

It may be transient and may transition to intellectual disability diagnosis after 5. Severity, number of areas, and genetic causes may impact the outcome.

Question 5

What is intellectual disability?

Answer 5

Deficits in cognitive functioning with onset prior to 18 but usually after 6. There may also be a lag in adaptive functioning that impacts everyday social and practical skills.

Question 6

Those with intellectual disability tend to have what IQ?

Answer 6

Less than 70.

Question 7

What is defined by IQ between 70-85 in pediatric patients?

Answer 7

Borderline intellectual functioning (slow learners). They’ll need extra help and tutoring to keep up.

Question 8

What is the average IQ score?

Answer 8

100.

Question 9

What are the 3 domains of adaptive behavior?

Answer 9

Conceptual (memory, language, academics), social (gullibility, follow rules, social responsibility, etc.), and practical.

Question 10

What are the main buckets for causes of intellectual disability?

Answer 10

Genetic and acquired.

Question 11

What are some acquired causes of intellectual disability?

Answer 11

Prenatal exposures like infections and maternal substance use, prematurity, complicated labor/delivery, severe infection post-birth, TBI, neglect, malnutrition.

Question 12

What is the most common cause of genetic disability?

Answer 12

Down syndrome.

Question 13

When does intellectual disability in down syndrome start?

Answer 13

Within the first year.

Question 14

What is the age of walking in down syndrome?

Answer 14

26 months (normal is 9-15).

Question 15

What is the age of speaking in down syndrome?

Answer 15

18 months (normal is 12-15).

Question 16

What happens with IQ in down syndrome?

Answer 16

It declines through the first 10 years of life; this isn’t due to regression, but as kids grow and gain all of these skills, kids with down syndrome are a little slower than the norm which makes their comparative IQ lower.

Question 17

What is the most common inherited cause of intellectual disability?

Answer 17

Fragile X.

Question 18

What is the inheritance pattern of fragile X?

Answer 18

X-linked dominant.

Question 19

Who has more severe cases of fragile X?

Answer 19

Males; they only have one X.

Question 20

What is seen in premutation levels of fragile X?

Answer 20

Emotional problems, ovarian insufficiency, fragile X ataxia.

Question 21

What are behavioral features of fragile X?

Answer 21

Social anxiety, poor eye contact, sensory sensitivity, delays in motor and adaptive skills.

Question 22

What is the most common preventable/acquired intellectual disability?

Answer 22

Fetal alcohol syndrome.

Question 23

What behavioral issue is highly associated with fragile X?

Answer 23

Autism.

Question 24

What behavioral issue is highly associated with fetal alcohol syndrome?

Answer 24

Severe ADHD.

Question 25

What are some risks associated with intellectual disability?

Answer 25

Accidental injury, untreated conditions, exploitation, risk for abuse, disruptive behaviors.

Question 26

What have young adults with intellectual disability shown higher incidence of?

Answer 26

Passing away younger, substantiated maltreatment, more likely to be in the ED.

Question 27

What primary preventions are those with ID less likely to have?

Answer 27

Screening! Pap smears, mammograms, dental appointments, vision screening etc. This leads to a higher likelihood of developing health problems.

Question 28

Why can treating adults with intellectual disabilities be hard?

Answer 28

There are no standard clinical guidelines, and the current primary care setting doesn’t allow for complex visits.

Question 29

What interventions exist for kids under 3?

Answer 29

Individualized family service plan through statewide early intervention.

Question 30

What interventions exist for kids 3-21?

Answer 30

Individualized education plan or 504 plan through public schools.

Question 31

What is an IEP?

Answer 31

A legal document covered by special education law and lasting through high school that provides interventions that require money.

Question 32

What is a 504 plan?

Answer 32

A civil rights law focused on providing accommodations and modifications based on medical diagnosis; does not include funding for special services. This can extend beyond high school and through college/grad school!