Degree |
Preschool (maturation & development) |
School age (training & education) |
Adult (social & vocational adequacy) |
Profound |
Gross retardation, minimal capacity for functioning |
Some motor dev present, may respond to minimal or limited training in self help |
Some motor/speech development & usually requires nursing care |
Severe |
Poor motor dev, speech min, little comm. skills |
Can talk or learn to comm., can be trained in health habits |
May contribute partially to self maintenance |
Moderate |
Can talk or learn to learn to comm. poor social awareness, fair motor dev |
Good from training in social & occupational skills, unlikely to progress beyond yr 2 studies |
May achieve self – maintenance in unskilled work in sheltered conditions |
Mild |
Can dev social & communicational skills, min retardation in motor areas, hard to distinguish from non – LD |
Can learn up to yr 6 level |
Can achieve social & vocational skills adequate to support self to the minimum |
Sub-groups:
Mild: IQ 50-70. 80% of people with LD fall into this class, their appearance is normal & sensory/motor deficits are slight. Most develop normal language abilities and social behaviour during the pre-school years, so delaying detection until the child starts school. Adulthood – most can live independently, although aid with housing & employment may be required & support when experiencing stress.
Moderate: IQ 35-49. Accounts for 12% of those affected, most having enough language development to communicate & most can learn to cope for themselves with help from services, most adults are able to undertake simple routine work
Severe: IQ 20-34. Accounts for 7% of those affected, in pre-school years their progress is greatly slowed & with special help many can learn to look after themselves with supervision. Communication possible, but in simple ways. Adults able to undertake simple tasks & limited social activities. Some have a single highly developed cognitive ability of a kind normally associated with superior intelligence: “idiots savants”
Profound: IQ below 20. Accounts for 1% of those with LD, few learn to care for themselves & a few achieve some simple speech & social behaviour. Physical disorders are very frequent.
Clinical features:
- Poor Learning
- Poor short term memory
- Problem-solving impairment
- Specific function impairment e.g. use of language
Assessment of LD
- Severe LD usually diagnosed in early infancy as is usually associated with physical disability
- Full assessment includes;
- history taking: FHx of LD, abnormalities in the pregnancy, developmental milestones, behavioural disorders, interview parent
- physical examination: head circumference, height & weight, hearing & vision assessed
- behavioural assessment: child’s ability to communicate, sensorimotor skills, unusual behaviour, ability for self care
- developmental testing: clinical observation combined with standardized measurements of intelligence, language development, motor performance, social skills – usually done in specialised unit
- examination of mental state:
- Overall assessment: distinguishes LD from other conditions e.g. delayed development, blindness, deafness, childhood autism. Any medical & social factors that contribute to the overall handicaps are recorded, together with the attitudes of people who are involved in the child’ care.
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