16 Chapter 1 diagnosis. Now that I have introduced some of the individuals that this dissertation is about, it is time to describe who they are as a group. In this section, I will outline the definition of a mild intellectual disability, the prevalence rates of this diagnosis in the Netherlands, and "common" behavioral problems in this group. Definition A mild intellectual disability is – unlike severe and profound intellectual disability – not recognizable just by a person’s looks. According to the DSM-5, there are three criteria for diagnosing a mild intellectual disability (American Psychiatric Association [APA], 2013). The first criterion is a deficit in intellectual functioning, such as reasoning, problem-solving, abstract thinking, and judgment – as evidenced by intelligence tests and clinical judgment. In the Netherlands (and worldwide) there are many healthcare practices that require this criterion to be met through standardized tests revealing an intelligence quotient (IQ) between 50 and 69 (Landelijk Kenniscentrum LVB, 2024). However, the DSM-5 (APA, p. 33) as well as the ICD-11 (World Health Organization, 2022) discourage a strong emphasis on full-scale IQ scores. Instead, it is recommended that the second criterion – deficits in adaptive functioning – is decisive in the diagnostic process. Adaptive functioning deficits make a person fail to meet standards of social responsibility in one or more aspects of daily life, including communication, social participation, academic or occupational achievement, and personal independence at home or in community settings. Third, the aforementioned intellectual and adaptive deficits already manifested before the age of 18 (not as a result of acquired brain injury; APA, 2013). A mild intellectual disability often goes unrecognized during childhood or adolescence. As such, when diagnosing an adult, problems that happened during their youth can in hindsight be attributed to a mild intellectual disability. In the Netherlands, people with a so-called borderline intellectual functioning diagnosis have access to the same specialized care as their peers who, solely based on IQ might otherwise be considered as having a mild intellectual disability. The only difference between these diagnoses is that those with borderline intellectual functioning have a slightly higher IQ – typically ranging between 70 and 85. Similar to those with mild intellectual disability (i.e., IQ below the 70 cut-off) they struggle with the adaptive skills to meet the demands of everyday life, and thus need care that is considerate of their limited adaptive and intellectual abilities (APA, 2013; Emerson, 2011; Wieland & Zitman, 2016). Due to them both receiving the same specialized care, researchers typically study people with mild intellectual disability and borderline intellectual functioning as one group. This dissertation will do the same. To avoid an excess of the lengthy term ‘mild intellectual disability or
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