Learning diffuiculty 1

Normalization: Developed in Scandinavia in the 1960s. Providing a pattern of life as near normal as possible (Nirje 1970). Accommodation and activities are adapted to promote as ordinary a life as possible in the community; can participate in normal activities and

relationships, experience choice and have full access to social opportunities.

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Learning Disability - Answers Diet II: 2008
In the UK the total prevalence of Mental Retardation (learning disability) is
20-30 per 1000,
with 3-4 per 1000 having an IQ < 50.
MR IQ % Care needs
Mild <70 85 may need help under unusual stress
Moderate <50 10 need some supervision
Severe <35 3-4 care for self with close supervision
Profound <20 1-2 very few learn to care for themselves
The inclusion of concurrent related limitations in two or more adaptive skill
areas was added
to the definition of mental retardation in 1992 by the American Association
on Mental
Retardation. Because standardized testing in very young children is less
predictive of future
cognitive outcome, the term "developmental delay" has been used to
characterize the
developmental status of children under age three.
Table 1: Developmental Characteristics Related to Level of Mental
Retardation (DSM-IV
Mild retardation
Moderate retardation
Severe retardation
Profound retardation
75% to 90% of all
cases of retardation
~10% to 25% of all
cases of retardation
~10% to 25% of all cases of
~10% to 25% of all cases
of retardation
Function at one half
to two thirds of CA
(IQ: 50 to 70)
Function at one third to

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CA (IQ: 35
to 49)
Function at one fifth to one third of
CA (IQ: 20 to 34)
Function at < one fifth of
CA (IQ: < 20)
Slow in all areas Noticeable delays,
especially in speech
Marked and obvious delays; may
walk late
Marked delays in all
May have no unusual
physical signs
May have some
unusual physical signs
Little or no communication skills
but may have some understanding
of speech and show some response
abnormalities often
Can acquire practical
skills…read more

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Need direction and supervision May respond to regular
physical activity and
social stimulation
Can acquire
vocational skills for
Can perform tasks in
sheltered conditions
-- Not capable of self-care
Integrated into
general society
Can travel alone to
familiar places
-- --
NOTE: Additional problems with vision, hearing or speech, congenital
abnormalities, seizures, emotional
problems or cerebral palsy may be present.
DSM IV = Diagnostic and Statistical Manual of Mental Disorders, 4th ed.;
CA = chronological age; IQ =
intelligence quotient.…read more

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Lesch-Nyhan by amniotic fluid enzyme estimation
Postnatal screening
Hypothyroidism (Appear normal at birth, becomes evident at 6 months with
growth failure,
puffy skin and lethargy)
Galactosaemia and Phenylketonuria
Lesch-Nyhan through hair sample enzyme estimation
Other preventative measures
Reduce head injuries: domestic and road traffic accidents, physical abuse
Folic acid supplementation
The Diagnostic Criteria for Adults with Learning Disability (DC­LD) was
published by the
Royal College of Psychiatrists in 2001 developed in recognition of the
limitations of using
ICD-10 (World Health Organization,…read more

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Frontal and temporal lobe epilepsy can be associated with psychosis,
although the epilepsy
usually precedes the psychosis. The presence of genetic conditions
associated with psychosis,
particularly velocardiofacial syndrome and Prader-Willi syndrome, should
also be
investigated. "Self-talk" is particularly common in children with Down's
2. Emotional disorders
Noted by change in behaviour, because less likely to complain of mood
changes or express
depressive ideas. A minimum verbal fluency (IQ>50) is needed to describe
3. Autism and over-activity syndromes
More common than among general population.…read more

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ordering is the
most common, with hand washing, cleaning and checking rarely seen.
6. Forensic
Mild LD have higher rates of criminal behaviour than general population.
This may be due
to family and social environment, impulsivity, suggestibility, exploitability,
desire to please
or because more likely to be detected and confess / falsely confess.
IQ<70 is not found to be over-represented in the prison population, but is
over represented
for arson (common index offence in secure hospital setting) and sexual
exhibitionism) offences.…read more

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LD children and adolescents and 15% of LD adults. Qureshi & Alborz
(1992) focused on
highly disruptive, seriously challenging behaviour and found a prevalence
rate of 5.7%. In a
similar study, Emerson et al (2001) found that 10-15% of people known to
local education,
social and healthcare services showed challenging behaviour.…read more

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MR. More long-term studies are needed6. ()
Valproate sodium may be useful for aggression in mentally retarded
patients, based on
anecdotal evidence (Ruedrich et al., 1999). A recent placebo-controlled
study showed efficacy
for valproate in a sample of non-retarded children and adolescents with
symptoms (Donovan et al., 2000). Phenytoin, which is one of the few
anticonvulsants that
has not been widely used, was effective for non-premeditated aggression
in a non-retarded
prison sample (Barratt et al., 1997).…read more

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Self injury may be related to opiod regulation. The opiate antagonists
naloxone and
naltrexone may reduce self-injurious behaviour like head-banging and self-
(Thompson T. 1994 Opioid antagonist effects on self-injury in adults with
mental retardation:
response form and location as determinants of medication effects.
American journal of
mental retardation 99 (1) 85-10) Carbamazepine and Valproic acid have
also been used.
Lithium and Risperidone are used for aggression and self injury.…read more

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CHD), usually vascular stenosis or patent ductus
arteriosus. CHD
is rarely seen with maternal infection beyond 11 weeks gestation. Up to
50% of individuals
with congenital rubella have resulting CNS abnormalities, including
microcephaly, as well as
behavioural and psychiatric disorders. Transient manifestations occurring in
the neonate
include hepatosplenomegaly, thrombocytopenia, hepatitis, corneal clouding
and bone
lucencies. Approximately 50% of infants with these types of malformations
also have
intrauterine growth retardation (IUGR).
Herpes: Intrauterine herpes is very rare.…read more


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