Learning Disabilities

Question 1

define IQ of profound LD

Answer 1

<20

Question 2

define mild LD IQ

Answer 2

50-69

Question 3

define IQ of moderate LD q

Answer 3

35 - 50

Question 4

define LD of severe IQ

Answer 4

20-35

Question 5

how is LD diagnosed

Answer 5

clinical assessment
- IQ
- ask about reading / writing

Question 6

list indicators of LD

Answer 6

difficulty reading writing
difficulty achieving skills
LD register
attended special school
communication issues

Question 7

prevalence of mild LD

Answer 7

2-3/100

Question 8

cause of mild LD

Answer 8

no specific cause

Question 9

prevalance of mod/severe/profound LD

Answer 9

3/1000

Question 10

what are downs people at risk of in their 40-50s

Answer 10

early alzheimers

Question 11

boys
large ears
long face
smiley

Answer 11

fragile X syndrome

Question 12

physical illness issues of LD

Answer 12

higher risk of obesity due to poor diet
increased epilepsy risk
hearing / visual loss

Question 13

psychiatric co-morbidities of LD

Answer 13

schizophrenia 3% vs 1% general
4x more likely to have depression/anxiety
autism - 75% have LD

Question 14

biological vulnerability factors for mental illness

Answer 14

brain damage / epilepsy
vision / hearing impairments
genetics- autism, behavioural
drugs / alchol abuse
medication - epilepsy meds can cause behaviour / IQ issues

Question 15

family vulnerability factors for mental illness

Answer 15

diagnostic issues causing bereavement like Sx
isolated - limited networks
overbearing parents
difficulties letting go

Question 16

psychological vulnerability factors for mental illness

Answer 16

rejection / deprivation
low self esteem
communication issues
abuse

Question 17

social vulnerability factors for mental illness

Answer 17

prejudice
poor support due to social skills
inappropriate services / environment
financial disadvantage

Question 18

challenging behaviour in LD

Answer 18

culturally abnormal behaviour
persistent behaviour
limits use of community services

Question 19

how to communicate with LD patient

Answer 19

no jargon
speak slower
use signs to indicate what you mean
open questions as they can be suggestible
allow plenty of time

Question 20

Mx of mental health problems in LD

Answer 20

monitor efficacy of meds +/- side effects
MDT
work with social networks eg family
capacity to consent with MCA

Question 21

Mx of mental health problems in LD q

Answer 21

use same meds as normal
start low, go slow
- ?higher sensitivity to drugs / side effects

Question 22

psychological interventions for LD

Answer 22

behavioural - ABC
CBT
family education / therapy
psychodynamic psychotherapy
creative / complementary therapies - art / drama / aromatherapy

Question 23

what is the ABC approach in psych therapy

Answer 23

antecedents - behaviour - consequences

Question 24

social interventions in LD

Answer 24

community inclusion - valued social role, dignity, meaningful activities
avoid under/overstimulation
safe guard against abuse

Question 25

what is ASD

Answer 25

neurodevelopmental disorder with social communication issues

Question 26

describe the ASD spectrum

Answer 26

severe --> autism --> high functioning / aspergers

Question 27

3 core domains of ASD Sx

Answer 27

- reciprocal social interactions - verbal / non verbal communication - restricted / repetitive behaviours or interests

Question 28

what variability is shown in ASD

Answer 28

cognitive ability severity of Sx language skills

Question 29

describe ASD development pattern

Answer 29

delay in development regression of milestones achieved

Question 30

describe milestones missed in ASD

Answer 30

no social smile atypical attachment pattern - don't attach to carer don't interact with peers / family

Question 31

presentation features of ASD

Answer 31

routines - can not deviate from this repetitive behaviour fixations on certain things sensory seeking behaviour

Question 32

presentation features of ASD in adults

Answer 32

unable to interpret gestures / idioms fixed routines

Question 33

what is aspergers

Answer 33

similar to ASD/part of ASD spectrum but they have no issues with expressive language

Question 34

prevalence of ASD

Answer 34

1% UK / 0.6% globally

Question 35

why have prevalence of ASD increased

Answer 35

more awareness of ASD to get more diagnoses improved survival rates of genetic conditions associated with ASD

Question 36

what is heritability % of ASD

Answer 36

80-90%

Question 37

why is heritability so high in ASD

Answer 37

due to wide range of phenotypes, and some multigenetic causes

Question 38

pathology causes of ASD

Answer 38

abnormalities in major cortical / subcortical brain structures increased cerebellar volume - ?too many synapse connections elevated serotonin in blood

Question 39

gold standard tool for diagnosis of ASD

Answer 39

autism diagnostic observatory schedule (ADOS) - examiner sits with patient and tried to elicit ASD behaviour

Question 40

min age for ADOS to be used to diagnose ASD

Answer 40

2 years old

Question 41

genetic conditions associated with ASD

Answer 41

fragile X Di george mitochondrial disorder downs prader-willi angleman epilepsy ?

Question 42

Mx for ASD

Answer 42

bio - manage medical conditions, psychopharmacology social - reasonable adjustments, edicational interventions psych - therapy

Question 43

what meds & when can be used in ASD

Answer 43

only if comorbid conditions - SSRIs - fluoxetine for obsessions - irritability = aripiprazole / risperidone - dopamine antagonists for stereotypical motor behaviour