Learning disability Flashcards
(35 cards)
define learning disability
developmental condition
characterised by global impairment of intelligence
and difficulties in socially adaptive functioning
what IQ denotes a profound learning difficulty?
<20
what IQ denotes a severe learning difficulty?
20-34
what IQ denotes a moderate leaning difficulty?
35-49
what IQ denotes a mild learning difficulty?
50-69
what is the presentation of learning difficulties?
reduced, delayed or absent skills in;
language, schooling, independent living, social ability
behavioural issues can arise due to issues with communication
name 3 syndromes associated with learning difficulties?
which are most common?
- Down syndrome
- trisomy 21
- most common
Fragile X
- mutation in FMR1 gene on X chromosome
- biggest genetic cause of Autism
- Causes ADHD type sx
Fetal alcohol syndrome
the following physical feautres are associated with which condition;
Upward-slanting palpebral fissures Epicanthic folds Protruding tongue Single palmar crease Hypotonia short neck short ears short stature
down syndrome
the following physical feautres are associated with which condition;
Wide palpebral fissure
Smooth philtrum
Thin top lip
fetal alcohol syndrome
the following physical feautres are associated with which condition;
Elongated face - looks slim Prominent ears High-arched palate Large testes Hyperextensible joints
fragile x
the following problems are associated with which condition;
Congenital heart abnormalities Thyroid problems Epilepsy Depression Early-onset Alzheimer’s disease Leukaemia
down syndrome
may meet such a patienet in exam and have to council them
the following problems are associated with which condition;
Autistic type behaviour Anxiety ! Depression Hyperactivity ! Expressive language deficits - speech issues Shyness !
fragile x
list differentials for learning difficulties
The following are condition that can be associated with learning difficulties
- Autistic spectrum disorders
- Epilepsy may cause transient cognitive impairment.
- Adult brain injury or progressive neurological conditions:
- Psychiatric: severe and enduring mental illness such
as schizophrenia can lead to chronic cognitive impairment. - Educational disadvantage/neglect: lacking the
opportunity to learn must be distinguished from a
learning disability.
ivx for learning difficulties?
- IQ testing: is there global intellectual impairment?
- Functional assessment of skills, strengths and
weaknesses. - Detailed developmental history from parents, e.g.
details of pregnancy and birth, language and motor
skills development, schooling, emotional development,
and relationships. School reports are helpful. - FBC, U&E, LFT, TFT, bone profile—to exclude
reversible disturbances. - genetics if needed
rx for learning disabilities?
- Early detection + Statement of Special Educational Needs (in the UK) allow appropriate support, whether in mainstream or specialized
schools, to maximize the child’s potential. - Psychological therapy
This may include counselling,
group therapy, and modified CBT.
Behavioural therapy
those with severe/profound learning disability likely to require support with ADLs and possibly mobility etc.
whats the difference between learning difficulty and disability?
they are not the same thing
learning difficulty - can probably still function eg in ADHD
in autism - 75% patients have learning disability
what are some scales for intellectual Disabiity?
WAIS III - Wechsler Adult Intelligence Scale
ABAS II
IQ - is an assessment of ability to think and reason.
Presence in childhood -was difficulty present in school?
what is the aetiology of fragile X
Xq27.3 CCG repeats
what is the aetiology of di George and relevance to psychiatry ?
high riisk of schizophrenia
also autism, ADHD in adolescents
schizophrenia like psychoses in adults
90% have learning difficulties
22q 11.2 deletion
what are the considerations in someone presenting with lerning disability?
Mental illness
Physical illness - sight, hearing problems
Behavioural difficulties
Assess them with a bio (physical problems) psycho social (adapting to a new situation, difficult to adapt to new social environment, abusee, low self esteem, rejection, relationships, finances) approach
what is diagnostic overshadowing
when the underlying diagnosis is overshadowed/overlooked due to th intellectual disability - it is assumed that thie presentation or odd behavuiour is just their baseline.
what are reasonable adjusments in the care of people with LD’s?
part of the Disability adjustment act 1995
“to avoid as far as possible the disadvantage they expeirence as part of their disability”
examples include:
longer appointment times
seen quicker in ED
Deisgn of waiting rooms to be LD friendly; less crowded and noisy
Given 1st appointment in day to avoid long wait times
choice board - have pictures to help them choose just in case they have difficulty verbalising
self help boards - sequence of pictures to show them what to do i.e getting dressed
what are some features of di george syndrome?
speech and language:
hypernasality, language delays, and speech sound errors
high risk of early onset parkinsons
Hearing loss
Seizures
amongst lots of congenital heart issues and others
what are some features of di george syndrome that may be relevant to adress in psych?
speech and language:
hypernasality, language delays, and speech sound errors
high risk of early onset parkinsons
Hearing loss
Seizures
amongst lots of congenital heart issues and others
