ADHD and learning disability

Author/s
Karen Bretherton
Citation
Issue 2 Spring 2012
CEPiP.2012.1.113-117
Abstract

Learning disability (mental retardation) can be defined as IQ <70 combined with impairment in social functioning. ADHD is more common in people with learning disability and the prevalence increases as the degree of learning disability increases. However, assessment of ADHD in people with learning disability can be problematic and needs to be undertaken carefully. ADHD occurs more commonly in specific syndromes associated with learning disability. It is also common in people with epilepsy, a condition which occurs more frequently in people with learning disability. Correct management of ADHD in an individual with learning disability depends on careful assessment followed by an approach that is both comprehensive and pragmatic; for example, people with learning disability may be unable or unwilling to swallow tablets, implying that a different formulation or different strategy of medication administration may be required. Despite the challenges, treating ADHD in people with learning disability can be both effective and worthwhile.

Cite as: Cutting Edge Psychiatry in Practice 2012, 2(1):113-117; https://doi.org/10.65031/phmg1800

References

  1. World Health Organisation (1992), The International Classification of Disease 10th Revision (ICD 10) Classification of Mental and Behavioural Disorders – Clinical Descriptions and Diagnostic Guidelines, WHO, Geneva. https://doi.org/10.1177/146642409311300118
  2. Sparrow SS, Balla D, Cicchetti DV & Doll EA. Vineland Adaptive Behaviour Scales II. American Guidance Service. Circle Pines, Minn
  3. Harrison PL & Oakland T. (2010) Adaptive Behaviour Assessment System II. Western Psychological Services. 12031 Wilshire Blvd, Los Angeles, California
  4. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM IV). American Psychiatric Association, Washington DC. https://doi.org/10.1017/s0033291700035765
  5. Royal College of Psychiatrists (2001) DC-LD. Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/ Mental Retardation. Gaskell Press. London. https://doi.org/10.1080/13668250305781
  6. Turk J, Graham P, Verhulst F. (2007) Child and Adolescent Psychiatry: A developmental approach. Oxford University Press.
  7. Hastings RP, Beck A, Daley D & Hill C. (2005) Symptoms of ADHD and their correlates in children with intellectual disabilities. Research in Developmental Disabilities. 26, 456-468. https://doi.org/10.1016/j.ridd.2004.10.003
  8. O’Brien G (2000) Learning Disability. In Developmental Disability and Behaviour Clinics in Developmental Medicine. No 149 (eds CGillberg and G O’Brien) pp12-26. MacKieth Press, London.
  9. Simon V, Cozobor P, Balint S et al (2009) Prevalence and correlates of adult attention deficit hyperactivity disorder: meta- analysis. Br J Psychiatry; 194; 204-11 https://doi.org/10.1192/bjp.bp.107.048827
  10. Neece CL, Baker BL, Blacher J, Crnic KA. (2011) Attention-deficit/hyperactivity disorder among children with and without intellectual disability: an examination across time. J of Intellect Disabil Res. Jul;55 (7): 623-35. https://doi.org/10.1111/j.1365-2788.2011.01416.x
  11. Xenitidis K, PaliokostaE, Rose E, Maltezos, S Bramham J. (2010) ADHD symptom presentation and trajectory in adults with borderline and mild intellectual disability. Journal of Intellectual Disability Research. Vol 54. Part 7. 668-677. https://doi.org/10.1111/j.1365-2788.2010.01270.x
  12. Besag F (2002) Childhood epilepsy in relation to mental handicap and behavioural disorders. Journal of Child Psychology and Psychiatry. 43:1 (2002), pp 103-131. https://doi.org/10.1111/1469-7610.00006
  13. Seager M.C &O’Brien G (2003) ADHD and learning disability. Journal of Intellectual Disability Research. 47 (Suppl.1), 26-31
  14. Reilly C & Holland N (2001) Symptoms of attention deficit hyperactivity disorder in children and adults with intellectual disability: a review. J of Applied Research in Intellectual Disabilities, 24, 291-309. https://doi.org/10.1111/j.1468-3148.2010.00607.x
  15. Linnet KM, Wisberg K, Agerbo E, Secher NJ, Thomsen PH, Henriksen TB (2006) Gestational age, birth weight, and the risk of hyperkinetic disorder. Arch Dis Child ; 91:655-660 https://doi.org/10.1136/adc.2005.088872
  16. Autti-Ramo I (2002) Foetal alcohol syndrome – multifaceted condition. Dev Med Child Neurol 44: 141-4 https://doi.org/10.1017/s0012162201001839
  17. Tan M & Appleton R. (2005) Attention deficit and hyperactivity disorder, methylphenidate, and epilepsy. Arch Dis Child; 90: 57-59. https://doi.org/10.1136/adc.2003.048504
  18. Deb S, Dhaliwal A-J, Roy M. (2008) The usefulness of Conners Rating Scales-Revised in screening for Attention Deficit Hyperactivity Disorder in children with intellectual disabilities and borderline intelligence. Journal of Intellectual Disability Research Vol 52, part 11, 950-96 https://doi.org/10.1111/j.1365-2788.2007.01035.x
  19. Stores G (2007) Clinical diagnosis and misdiagnosis of sleep disorders. J Neurol Neurosurg Psychiatry; 78: 1293-1297. https://doi.org/10.1136/jnnp.2006.111179
  20. National Institute for Health and Clinical Excellence (NICE) (2009) Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guideline 72. London https://doi.org/10.1136/bmj.a1239