173 General Discussion 7 a mild intellectual disability. In the fourth and final part, I end with some humble future suggestions for the intellectual disability field. Revisiting intellectual and adaptive deficits People with a mild intellectual disability have deficits in intellectual functioning, which is a multifaceted construct that involves problem-solving, planning, judgment, verbal comprehension, working memory, perceptual reasoning, quantitative reasoning, learning from instruction and experience, abstract thought, and cognitive efficacy (APA, 2013). Most of the information provided on Dutch knowledge institute websites (Kennisplein Gehandicaptensector, 2024; Landelijk Kenniscentrum LVB, 2024) state that intellectual functioning is evidenced by cut-off scores of 50-70 and 71-85 for borderline intellectual functioning. Perhaps this still stems from the DSM-4, because the DSM-5 does not explicate what the boundaries are specifically for a mild intellectual disability, even explicitly discouraging using IQ cut-off scores to determine the level of intellectual disability (APA, 2013; pp. 33, 37). My impression is that many clinicians in practice do not particularly value or use strict IQ cut-offs when diagnosing an intellectual disability. Moreover, the use of IQ scores in diagnostics is increasingly scrutinized by the scientific community (Bertelli et al., 2018; van Hoogdalem & Bosman, 2024). Nevertheless, I find it strikingly sloppy that most scientific articles (my own work included) and knowledge institute websites advocate that the severity of intellectual disability is amongst others evidenced by certain IQ cut-off scores and refer to the DSM-5, while the manual actually states the opposite. There appears to be consensus in science and practice that a second criterion is at least equally important when diagnosing intellectual disability: deficits in adaptive functioning. This construct is equally multifaceted. It pertains to the failure to meet developmental and sociocultural standards for personal independence and social responsibility, requiring support in communication, participation, and independent living, across multiple environments, such as home, school, work, and community (APA, 2013). Similar to intelligence, adaptive functioning should be assessed through combined clinical judgment and standardized tests involving the person and knowledgeable informants (e.g., family members, teachers, counselors, and care providers). The severity of intellectual disability is to be determined based on descriptions of adaptive functioning in conceptual, social, and practical domains (APA, 2013). Descriptions of adaptive problems of a mild intellectual disability for example read "Compared with typically developing age-mates, the individual is …" or "There is a somewhat concrete approach to problems and solutions compared with age-mates" or "Individuals need some support
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