Learning Disabilities - WB

Question 1

Causes of LD

Answer 1

• Genetic - down syndrome, fragile X
• Antenatal - TORCH, FASD, substance abuse, malnutrition
• Perinatal - asphyxia, premature, LBW, intrauterine growth restriction, infections eg HSV, GBstrep
• Neonatal - hypoglycaemia, jaundice, infections (meningitis), trauma
• Postnatal - traumatic brain injury, malnutrition, lead poisoning, infections
• Environmental - lead, air pollution, lower income (lower eductation, nutrition, lack stimulating environment)
• Psychiatric - ADHD, autism, depression, anxiety, schizophrenia

Question 2

Mild vs moderate vs severe/profound learning disabilities IQ

Answer 2

• Mild - 50-69
• Moderate 35-49
• Severe - 20-34
• Profound - below 20

Question 3

Self care, reading and writing, social skills and physical issues - mild, vs moderate vs severe/profound

Answer 3

• Mild - most self care independent, basic reading/writing level, good social skills, normal physical development
• Moderate - some assistance with self care, need specialised education interventions, challenged with social skills, moderate motor delays
• Severe - significant assistance, limited/no ability to read, difficulty understanding social cues, significant motor delays/coordination/balance
• Profound - full time assistance, unable to read/write, limited social interactions, non verbal, inability to walk or engage in physical activity

Question 4

5 common psychiatric co-morbidities in LD

Answer 4

• Depression
• Anxiety
• ADHD
• Autism
• Schizophrenia

Question 5

Why do people with LD have worse health than people without them?

Answer 5

• Limited access to healthcare - difficult to understand medical information, communicating needs, navigating system
• Underdiagnosis and ongoing medical problems - symptoms attributed to LD itself
• Lack adaptation in healthcare settings - poor communication, information not presented in understandable format
• Lifestyle - unhealthy diet, limited physical activity due to limited opportunity to engage in these.
• Vulnerable to abuse and neglect

Question 6

Winterborne view - what happened

Answer 6

• Severe abuse and mistreatment - physical assault, humiliation, restraint
• Management failures - lack oversight, high staff turnover, inadequate training
• Inadequate safeguarding
• Inappropriate placement - some people were not suitable for this hospital, needs were not suitable

Question 7

Lessons from Winterborne view enquiry

Answer 7

• Improved safeguarding and monitoring
• Better training for staff
• Early intervention and detection of abuse - whistleblowing, openness, accessible reporting systems
• Shift to community based care - cared for closer to families
• Inspections and better regulations
• Government action - transforming care program