Learning Disability

Question 1

What is the ICD 10 definition of intellectual disability?

Answer 1

‘A condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence i.e. cognitive, language, motor and social abilities’

Question 2

What is the criteria for intellectual disability?

Answer 2

1. Intellectual impairment (IQ < 70) (e.g., Wechsler Adult Intelligence Scale)
2. Social or adaptive dysfunction (Vineland Adaptive Behaviour Scale)
   Deficits/Impairments in 2 or more of following adaptive skills: communication, self-Care, home living, social skills, community use, self-direction, health and safety,
   functional academics, leisure & work
3. Onset in the developmental period (before age 18)

Question 3

What is the severity rating of intellectual disability?

Answer 3

Both Intellectual and Adaptive functioning is used to classify
severity of LD
• Mild LD IQ: 50 - 69 or functional age 9-12yrs
• Moderate LD IQ: 35 - 49 or functional age 6-9yrs
• Severe LD IQ: 20 - 34 or functional age 3-6yrs
• Profound LD IQ: <20 or functional age <3yrs

Question 4

What are the inherited causes of learning disability?

Answer 4

Single gene: Fragile X, PKU, Retts Syndrome
• Microdeletion/duplication: DiGeorge Syndrome, Prader-Willi, Angelman syndrome
• Chromosomal abnormality: Down Syndrome

Question 5

What are the acquired causes of learning disability?

Answer 5

Infective: e.g Rubella, Zika virus
• Traumatic: hypoxic injury during birth, head injury in childhood
• Toxic: Foetal alcohol syndrome

Question 6

What physical conditions are associated with learning disabilities?

Answer 6

Epilepsy, sensory impairments (hearing and vision), obesity, swallowing problems, reflux h.pylori, chest infections, aspiration pneumonia, cerebral palsy, orthopaedic problems (osteoporosis), dermatological and dental problems

Question 7

Why is psychiatry associated with learning disability?

Answer 7

Higher incidence of psychiatric disorders in those with LD. the more severe the learning disorder, the higher prevelance of psychiatric disorder.

Question 8

What mental health problems are common in those with learning disability?

Answer 8

Schizophrenia, mood disorders, anxiety disorders, autism, over activity syndromes (ADHD)

Question 9

What is diagnostic overshadowing?

Answer 9

Presenting symptoms are put down to their learning disability, rather than seeking another, potentially treatable cause