174 Chapter 7 with complex daily living tasks in comparison to peers" or "… support needed in one or more areas to meet age-related expectations". My impression is that a mild intellectual disability diagnosis is thus largely based on contrasts between the person and peers, perhaps more explicitly so than for other diagnoses like for example anxiety or depression, where it is more about the severity of symptoms and the frequency with which symptoms occur. Standardized tests measuring intelligence and adaptive functioning play into peer comparisons, as these tests are specifically developed to yield scores that vary between people. Normed IQ tests such as the often-used WISC are scored such that 2.5% of the population score between 50 and 70. In the Netherlands, where an IQ between 50 and 85 is the rule of thumb for the label of mild intellectual disability, implying that approximately 16% are considered a candidate for specialized care (Wieland & Zitman, 2016). The same logic applies to standardized measures of adaptive functioning (e.g., Sparrow et al., 2016). By definition, if normed cut-offs are followed, a certain predefined percentage of people will always meet these criteria, meaning that there will never be a world without mild intellectual disability. Even when the average population intelligence increases (Flynn, 1984), intelligence tests are rescaled (e.g., WISC 3 becoming WISC 4 and 5), so that the population average stays at 100 with a standard deviation of 15. Consequently, the same number of people remains eligible for this conventionally used criterion of a mild intellectual disability classification. It is also worth highlighting that society’s culture determines the appropriateness of a mild intellectual disability diagnosis: adaptive deficits are a failure to meet “sociocultural standards” (APA, 2013, p. 33). The DSM-5 thus considers the disability as a mismatch between the person’s abilities and societal demands. In my experience, many people with a mild intellectual disability are above average intelligent and adaptive, but in areas that society values less. For example, some of the clients I spoke to in the Take it Personal! project have intricate knowledge of various illicit drugs and their effects or adapted their skillset to rise in operational structures of the drug trade. I suspect that most academics in the subject lack such knowledge and skills, including aspiring academics such as myself. Obviously, this knowledge/ skillset does not match with what society values. A mild intellectual disability is thus a description of the fact that the person 1) ranks lower compared to peers on abilities that society values and 2) experiences problems because of this mismatch between their abilities and environmental demands.
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