In Part Two of our new blog series…Dissecting the DSM-5…What it Means for Kids and Families we’ll look at the changes in the evaluation and classification of intellectual disabilities.

The section of the DSM pertaining to intellectual disabilities was desperately in need of an upgrade. The pejorative term mental retardation no longer appears in the new criteria, bringing the criteria up to date with more inclusive language required by Federal law, and terminology used by most medical and educational professionals, advocacy groups,  and the vast majority of states.

The most important change in the new criteria involves a decrease in the emphasis upon intelligence tests in the classification of intellectual disability in favor of a severity of impairment classification based upon adaptive functioning along with intelligence testing. In the DSM-IV, scores from IQ tests were used to determine whether an individual was characterized with mild, moderate, severe or profound impairment. The new criteria are far more helpful to clinicians and families in determining the level of support kids and teens require to function in the least restrictive educational environment and achieve maximum autonomy and independence. This doesn’t represent a new development as much as it does psychiatry catching up with what already occurs in practice.

The new criteria emphasize the use of individualized, culturally appropriate, psychometrically sound measures from knowledgable informants (parents, teachers, caregivers) and the individual (to the extent possible) to assess adaptive functioning in addition to clinical evaluation.

Finally, the multiaxial diagnostic system in the DSM-IV has been eliminated…in the DSM-5, all diagnoses exist on a single axis and are given equal weight. In the DSM-IV, intellectual disabilities were considered on a separate axis (Axis II) from mental and medical disorders.

The take-home for a practice like mine is that we’re likely to be more diligent about requesting adaptive behavior ratings from schools for the kids we care for with intellectual disabilities, and we’re more likely to start administering such measures ourselves when appropriate for educational or vocational planning, and guardianship requests.

This Weekend: A look at the most controversial new diagnosis in the DSM-5…Disruptive Mood Dysregulation Disorder.

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Here’s a helpful download for church staff, volunteers and caregivers on the appropriate use of “People-first” language in disability ministry.