Intellectual Impairment Flashcards
Define a learning disability
‘A significantly reduced ability to understand new or complex information, to learn new skills, and with a reduced ability to cope independently which started before adulthood’
What is eugenics?
Philosophical and social movement sought to improve human race
Positive eugenics = desirable traits to reproduce more
Negative = discourage those with undesirable traits to reproduce less
What are some possible causes of learning disability
Genetics and genotype
Infection
Maternal health
Nutrition
Toxic agents
Premature birth
Sensory social deprivation
What is Down’s syndrome?
Neurodevelopmental disorder of genetic origin affecting chromosome 21
What are some clinically associated diseases with Down’s syndrome?
Congenital heart disease
Alzheimer’s and dementia
Diabetes
Coeliac
Epilepsy
What dental implications can Down’s syndrome have?
Reduced ability to carry out oral hygiene
Decreased oral function
Impaired migration of gingival fibroblasts
Unregulated production of inflammatory mediators
- increased risk of periodontal disease
What are some characteristics of prader-willi syndrome?
Chromosome 15
- aka downy stoddart syndrome
Constant desire to eat
Restricted growth
Reduced muscle tone
Lack of sexual development
Behavioural problems
Learning difficulties
What typically presents in those with ASD?
A range of possible developmental impairments in reciprocal social interactions and communications and also a stereotyped, repetitive or limited behavioural repertoire
What dental implications may arise from someone with ASD?
Sensory atypia
- sounds of handpiece
- feeling of air in 3in1
- bright light from the dental unit
The hypersensitivity along with multiple stimuli in the clinic can act as a trigger
What is cerebral palsy?
Neurological condition affecting movement and co-ordination
Results in muscle stiffness or floppiness
Random uncontrolled movements
Balance issues
Not always a learning difficulty component
What are some individual characteristics that are barriers to dental care for those with learning difficulties?
Cognitive, physical or behavioural difficulties
- not understanding need for oral hygiene or treatment
- limited mobility
- sensory issues
Dependence on others
- lack of care giver training
- limited awareness of dental services available
What features of dental practices and medical practices alike may inhibit access to those with learning difficulties?
Not having regular dentist
Difficulty getting NHS dentist
Cost of treatment can be high
Complex referral systems
Longer delays for those with specific needs
What are some overall barriers to access for those with learning difficulties?
Individual characteristics
Access
Pain, recognition and response
Attitudes, skills and knowledge of dental staff
Transition between health services
Why might pain recognition and response be a barrier?
Those with LD may find it hard to communicate they’re in pain or the source
Untreated pain is often manifested in behaviour that can be challenging
Give some ways to acclimatise someone with a LD to a dental environment
- pre-visit to get acclimatised
- multiple visits with slow progress to build rapport
- visual supports (good with autism)
- book start of session so not running late and person has less time waiting in room
- speak clearly and naturally so you can be understood
- create the right atmosphere with no triggers
