4th March 2024

A 21-year-old male presents with intellectual difficulties and is currently under investigation

A 21-year-old male presents with intellectual difficulties and is currently under investigation for possible ADHD symptoms. His mother noted that he was floppy as a baby and only began to walk at 2.5 years old. He had recurrent ear infections throughout his childhood.

On examination today, he was noted to have an elongated face with prominent ears, high arched palate and bilateral flat feet. He was noted to have hyperlaxity in the joints of his thumbs and fingers. He was recently diagnosed with macroorchidism. His mother had mild learning difficulties, but his grandparents were well.

What is the underlying cause of his intellectual difficulty?

Select the SINGLE most appropriate option from the list below. Select ONE option only.