Intellectual Disability

Question 1

What are learning disabilities called in ICD11?

Answer 1

Intellectual developmental disorder

Question 2

What is the definition of intellectual disability?

Answer 2

Condition of arrested or incomplete development of the mind characterised by impairment of skills manifested during the developmental period which contribute to the overall level of intelligence

Question 3

Name three characteristics of intellectual disability

Answer 3

• deficits in intellectual functioning (IQ<70)
• deficits in adaptive functioning
• developmental aetiology (occur if <18 years)

Question 4

What three parts of testing IQ?

Answer 4

1. psychometric assessment
2. clinical findings
3. adaptive behaviour

Question 5

What is the prevalence of learning disabilities?

Answer 5

1.5%

Question 6

What effect explains the increase in IQ over generations?

Answer 6

Flynn Effect

Question 7

Describe the five classifications of intellectual disability

Answer 7

Borderline 
Mild 
Moderate 
Severe 
Profound

Question 8

What is borderline ID?

Answer 8

Mental age 12-15 years old

IQ 70-84

Question 9

Describe mild ID

Answer 9

Mental age 9-12 years old
IQ 50-69
Delayed speech but able to use everyday speech, full independence but difficulties reading and writing capable of working.
Rarely organic aetiology

Question 10

What is moderate ID?

Answer 10

Mental age 6-9 years old
IQ 35-49
Slow with comprehension and language, delayed self care and motor skills but can learn to do simple tasks
Fully mobile and active, discrepant profiles
Organic aetiology, epilepsy and physical disability are common

Question 11

Describe severe ID

Answer 11

Mental age 3-6 years old
IQ 20-34
Marked impairment, restricted achievements, often have epilepsy

Question 12

What is profound ID?

Answer 12

IQ <20 Mental age <3 years old
Severe limitation in ability to understand/comply with requests.
Little/no self care, sever mobility restriction
Basic or simple tasks may be acquired - cannot live alone

Question 13

State the genetic factors that can cause ID

Answer 13

• chromosomal (down klinefelter, turner’s syndrome)
• X linked
• autosomal recessive
• autosomal dominant

Question 14

What antenatal factors can cause ID?

Answer 14

Infection, diet, substance abuse, hypoxia

Question 15

What perinatal factors can cause ID?

Answer 15

Prematurity, birth injury, cerebral anoxia

Question 16

What postnatal factors can cause ID?

Answer 16

Metabolic causes, hypoglycaemia, high bilirubin, infections, malnutrition, NAI, trauma, toxins

Question 17

How does intellectual disability change you life expectancy?

Answer 17

18 years lower if female

14 years lower if male

Question 18

Which diseases are people with ID more likely to get?

Answer 18

Epilepsy 
Severe mental illness 
Dementia 
Hypothyroidism 
Diabetes/CKD/HF

Question 19

What psychiatric co-morbidities are associated with ID?

Answer 19

Behavioural disturbance 
Depression 
Anxiety 
Dissociative symptoms 
Schizophrenia - 3%
Mania

Question 20

State the risk factors for psychiatric co-morbidities

Answer 20

Genetics, organic (epilepsy), psychological, social

Question 21

What social factors contribute to psychiatric co-morbidities?

Answer 21

Deprivation, life events, abuse, helplessness

Question 22

How much more common are psychiatric co-morbidities in patients with ID?

Answer 22

Three times

Question 23

What can behaviour change in people with ID indicate?

Answer 23

Physical - pain, epilepsy, constipation
Environmental - abuse, deaths/loss
Mental - depression, psychosis

Question 24

Describe the management of intellectual disabilities

Answer 24

• Therapeutic environment
• Psychoeducation
• Social
• Communication (hearing aids, glasses, makaton)
• Behavioural
• CBT
• Psychodynamic therapy (relationships and life events)