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Experts divide the types of cognitive impairment into four categories: mild intellectual disability, moderate intellectual disability, severe intellectual disability, and profound intellectual disability. The degree of impairment from an intellectual disability varies widely. DSM-V places less emphasis on the degree of impairment (i.e. IQ scores) and more on the amount and type of intervention needed. While IQ scores are still relevant and important in assessing the level of intellectual disability, the new DSM-V adds another layer of diagnostic criteria (Intellectual Disability: Causes and Characteristics). Mental health professionals must consider the person's ability or impairment across three skill areas: conceptual, social, and practical life skill. The category details are as follows: Mild intellectual disability
About 85 percent of people with intellectual disabilities fall into the mild category and many even achieve academic success. A person who can read, but has difficulty comprehending what he or she reads represents one example of someone with mild intellectual disability. Moderate intellectual disability
People with moderate intellectual disability have fair communication skills, but cannot typically communicate on complex levels. They may have difficulty in social situations and problems with social cues and judgment. These people can care for themselves, but might need more instruction and support than the typical person. Many can live in independent situations, but some still need the support of a group home. About 10 percent of those with intellectual disabilities fall into the moderate category. Severe intellectual disability
Only about 3 or 4 percent of those diagnosed with intellectual disability fall into the severe category. These people can only communicate on the most basic levels. They cannot perform all self-care activities independently and need daily supervision and support. Most people in this category cannot successfully live an independent life and will need to live in a group home setting. Profound intellectual disability
People with profound intellectual disability require round-the-clock support and care. They depend on others for all aspects of day-to-day life and have extremely limited communication ability. Frequently, people in this category have other physical limitations as well. About 1 to 2 percent of people with intellectual disabilities fall into this category. According to the new DSM-V, though, someone with severe social impairment (so severe they would fall into the moderate category, for example) may be placed in the mild category because they have an IQ of 80 or 85. So the changes in the DSM-V require mental health professionals to assess the level of impairment by weighing the IQ score against the person's ability to perform day-to-day life skills and activities. (Read about the types of intellectual disabilities.) article references APA Reference Last Updated: January 16, 2022 Learning Objectives
Understanding IntelligenceFigure 1. Children with high scores on intelligence tests tend to learn more of what is taught in school than their lower-scoring peers Intellectual functioning, generally called intelligence, includes a wide range of mental activities such as the ability of logical reasoning and practical intelligence (problem-solving), ability in learning, verbal skills, and so on. It manifests and expresses itself through a numerous set of capabilities, behaviors, thoughts, and emotions. In other words, intellectual functioning is definable as the global ability that allows the individual to understand reality and interact with it. Intellectual functioning is commonly measured by the intelligence quotient (IQ), which represents a total score obtained from standardized tests (IQ tests) developed for evaluating human intelligence. IQ test score has a median of 100 and a standard deviation of 15. Intellectual Development Disorder (Intellectual Disability)Intellectual development disorder, also called intellectual disability (ID) or a general learning disability, is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. Intellectual development disorder (intellectual disability) is defined by an IQ under 70 (two standard deviations below the median), in addition to deficits in two or more adaptive behaviors that affect everyday, general living. Once focused almost entirely on cognition, the definition now includes both a component relating to mental functioning and one relating to an individual’s functional skills in their daily environment. As a result of this focus on the person’s abilities in practice, a person with an unusually low IQ may still not be considered to have intellectual development disorder. Intellectual development disorder is subdivided into syndromic intellectual development disorder, in which intellectual deficits associated with other medical and behavioral signs and symptoms are present, and non-syndromic intellectual development disorder, in which intellectual deficits appear without other abnormalities. Down syndrome and fragile X syndrome are examples of syndromic intellectual development disorders. Intellectual development disorder (intellectual disability) affects about 2%-3% of the general population, of which 75–90% of the affected people have mild intellectual disability. Intellectually Disabled Criminals and Capital PunishmentThe case of Atkins v. Virginia was a landmark case in the United States Supreme Court. On August 16, 1996, two men, Daryl Atkins and William Jones, robbed, kidnapped, and then shot and killed Eric Nesbitt, a local airman from the U.S. Air Force. A clinical psychologist evaluated Atkins and testified at the trial that Atkins had an IQ of 59. The mean IQ score is 100. The psychologist concluded that Atkins was mildly intellectually disabled. The jury found Atkins guilty, and he was sentenced to death. Atkins and his attorneys appealed to the Supreme Court. In June 2002, the Supreme Court reversed a previous decision and ruled that executions of mentally retarded criminals are “cruel and unusual punishments” prohibited by the Eighth Amendment. The court wrote in their decision:
The court also decided that there was a state legislature consensus against the execution of the mentally retarded and that this consensus should stand for all the states. The Supreme Court ruling left it up to the states to determine their own definitions of mental retardation and intellectual disability. The definitions vary among states as to who can be executed. In the Atkins case, a jury decided that because he had many contacts with his lawyers and thus was provided with intellectual stimulation, his IQ had reportedly increased, and he was now smart enough to be executed. He was given an execution date and then received a stay of execution after it was revealed that lawyers for co-defendant, William Jones, coached Jones to “produce a testimony against Mr. Atkins that did match the evidence” (Liptak, 2008). After the revelation of this misconduct, Atkins was re-sentenced to life imprisonment. Atkins v. Virginia (2002) highlights several issues regarding society’s beliefs around intelligence. In the Atkins case, the Supreme Court decided that intellectual development disorder does affect decision-making and therefore should affect the nature of the punishment such criminals receive. Where, however, should the lines of intellectual disability be drawn? In May 2014, the Supreme Court ruled in a related case (Hall v. Florida) that IQ scores cannot be used as a final determination of a prisoner’s eligibility for the death penalty (Roberts, 2014). Measuring IntelligenceThe value of IQ testing is most evident in educational or clinical settings. Children who seem to be experiencing learning difficulties or severe behavioral problems can be tested to ascertain whether the child’s difficulties can be partly attributed to an IQ score that is significantly different from the mean for her age group. Without IQ testing—or another measure of intelligence—children and adults needing extra support might not be identified effectively. In addition, IQ testing is used in courts to determine whether a defendant has special or extenuating circumstances that preclude him from participating in some way in a trial. People also use IQ testing results to seek disability benefits from the Social Security Administration. Bell CurvesThe results of intelligence tests follow the bell curve, a graph in the general shape of a bell. When the bell curve is used in psychological testing, the graph demonstrates a normal distribution of a trait, in this case, intelligence, in the human population. Many human traits naturally follow the bell curve. For example, if you lined up all your female schoolmates according to height, it is likely that a large cluster of them would be the average height for an American woman: 5’4”–5’6”. This cluster would fall in the center of the bell curve, representing the average height for American women. There would be fewer women who stand closer to 4’11”. The same would be true for women of above-average height: those who stand closer to 5’11”. The trick to finding a bell curve in nature is to use a large sample size. Without a large sample size, it is less likely that the bell curve will represent the wider population. A representative sample is a subset of the population that accurately represents the general population. If, for example, you measured the height of the women in your classroom only, you might not actually have a representative sample. Perhaps the women’s basketball team wanted to take this course together, and they are all in your class. Because basketball players tend to be taller than average, the women in your class may not be a good representative sample of the population of American women. But if your sample included all the women at your school, it is likely that their heights would form a natural bell curve. Figure 2. Are you of below-average, average, or above-average height? The same principles apply to intelligence tests scores. Individuals earn a score called an intelligence quotient (IQ). Over the years, different types of IQ tests have evolved, but the way scores are interpreted remains the same. The average IQ score on an IQ test is 100. Standard deviations describe how data are dispersed in a population and give context to large data sets. The bell curve uses the standard deviation to show how all scores are dispersed from the average score (Figure 3). In modern IQ testing, one standard deviation is 15 points. So a score of 85 would be described as “one standard deviation below the mean.” How would you describe a score of 115 and a score of 70? Any IQ score that falls within one standard deviation above and below the mean (between 85 and 115) is considered average, and 82% of the population has IQ scores in this range. An IQ score of 130 or above is considered a superior level. Figure 3. The majority of people have an IQ score between 85 and 115. Only 2.2% of the population has an IQ score below 70 (American Psychological Association [APA], 2013). A score of 70 or below indicates significant cognitive delays, major deficits in adaptive functioning, and difficulty meeting “community standards of personal independence and social responsibility” when compared to same-aged peers (APA, 2013, p. 37). An individual in this IQ range would be considered to have an intellectual development disorder and exhibit deficits in intellectual functioning and adaptive behavior (American Association on Intellectual and Developmental Disabilities, 2013). Formerly known as mental retardation, the accepted term now is intellectual development disorder (intellectual disability), and it has four subtypes: mild, moderate, severe, and profound. The DSM lists criteria for each subgroup (APA, 2013). Table 1. Characteristics of Cognitive Disorders
Diagnostic CriteriaAccording to both the American Association on Intellectual and Developmental Disabilities (Intellectual Disability: Definition, Classification, and Systems of Supports (11th Edition) and the DSM-5, three criteria must be met for a diagnosis of intellectual development disorder (intellectual disability):
It is formally diagnosed by an assessment of IQ and adaptive behavior. A third condition requiring onset during the developmental period is used to distinguish intellectual development disorder from other conditions, such as traumatic brain injuries and dementias (including Alzheimer’s disease). Levels of intellectual disability vary greatly in children. Children with intellectual development disorder might have a hard time letting others know their wants and needs, and taking care of themselves. Intellectual development disorder could cause a child to learn and develop more slowly than other children of the same age. It could take longer for a child with intellectual development disorder to learn to speak, walk, dress, or eat without help, and they could have trouble learning in school. Intellectual development disorder (intellectual disability) can be caused by a problem that starts any time before a child turns 18 years old—even before birth. It can be caused by injury, disease, or a problem in the brain. For many children, the cause of their intellectual development disorder is not known. Some of the most common known causes of intellectual development disorder—like Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections—happen before birth. Others happen while a baby is being born or soon after birth. Still other causes of intellectual development disorder do not occur until a child is older; these might include serious head injury, stroke, or certain infections. What are some of the signs of intellectual development disorder (intellectual disability)?Usually, the more severe the degree of intellectual development disorder (intellectual disability), the earlier the signs can be noticed. However, it might still be hard to tell how young children will be affected later in life. There are many signs of intellectual development disorder. For example, children with intellectual development disorder (intellectual disability) may
Dig Deeper: What’s in a Name? Mental RetardationIn the past, individuals with IQ scores below 70 and significant adaptive and social functioning delays were diagnosed with mental retardation. When this diagnosis was first named, the title held no social stigma. In time, however, the degrading word retard sprang from this diagnostic term. Retard was frequently used as a taunt, especially among young people, until the words mentally retarded and retard became an insult. As such, the DSM-5 now labels this diagnosis as intellectual development disorder (intellectual disability). Many states once had a Department of Mental Retardation to serve those diagnosed with such cognitive delays, but most have changed their name to Department of Developmental Disabilities or something similar in language. The Social Security Administration still uses the term mental retardation but is considering eliminating it from its programming (Goad, 2013). Earlier in the module, we discussed how language affects how we think. Do you think changing the title of this department has any impact on how people regard those with developmental disorders? Does a different name give people more dignity, and if so, how? Does it change the expectations for those with developmental or cognitive disorders? Why or why not? Try ItGlossaryintelligence: one’s intellectual functioning, the overall ability to gain and apply knowledge, including a wide range of mental activities such as logical reasoning, problem-solving, learning, verbal skills, etc. intellectual development disorder (intellectual disability): a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. It is defined by an IQ under 70 (two standard deviations below the median), in addition to deficits in two or more adaptive behaviors that affect everyday, general living intelligence quotient (IQ): score on a test designed to measure intelligence non-syndromic intellectual development disorder: intellectual deficits that appear without other abnormalities norming: administering a test to a large population so data can be collected to reference the normal scores for a population and its groups representative sample: subset of the population that accurately represents the general population standard deviation: measure of variability that describes the difference between a set of scores and their mean standardization: method of testing in which administration, scoring, and interpretation of results are consistent syndromic intellectual development disorder: intellectual deficits associated with other medical and behavioral signs and symptoms that are present, such as in the case of those with Down syndrome or fragile X syndrome Which of the following is not one of the conditions that leads to the impulse to use heuristics?Which of the following is not one of the conditions that leads to the impulse to use heuristics? NOT: The time to make the decision is limited.
What impact did genies early isolation have?The extent of her isolation prevented her from being exposed to any significant amount of speech, and as a result she did not acquire language during her childhood.
What does representational bias mean?Representativeness heuristic bias occurs when the similarity of objects or events confuses people's thinking regarding the probability of an outcome. People frequently make the mistake of believing that two similar things or events are more closely correlated than they actually are.
What is an example of an abstract complex concept?Personality is a complex, abstract concept that refers to characteristic patterns of thinking, feeling, and behaving including motivations, emotions, beliefs, and typical approaches to interacting with others.
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Which of the following is not one of the four subtypes of intellectual disability?
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