175 General Discussion 7 Describing problems does not equal explaining problems The essence of my critique of how mild intellectual disability is conceptualized is that the conceptualization is no more than a description of problems. Indeed, a mild intellectual disability is a name that describes several intellectual and adaptive problems, but this name does not explain those problems. It would explain the problems if some natural kind would root “within” the person, causing intellectual and adaptive problems through a mechanism. The DSM-5 (APA, 2013) hints that some natural kind or mechanism may exist, as they list this intellectual disability under the umbrella term neurodevelopmental disorders. To me, “neuro” implies where the root supposedly is and “developmental” when the mechanism took place (i.e., in the brain and during childhood or adolescence). However, there is too little neuroscientific evidence to suggest a mild intellectual disability roots in the brain. The few neuroimaging studies in this area only find small group-level differences, for example, brain volume differences between those with an intellectual disability and controls (e.g., Baglio et al., 2014, Manning et al., 2018) but how brain volume would impact or explain behavioral problems remains unclear. Moreover, such group-level findings do not generalize back to the individual (Fisher et al., 2018), which means we cannot put a random person in a brain scanner and identify the presence or absence of a mild intellectual disability. I interpret the “developmental” part to indicate when something went awry, but it remains vague what this something (a natural kind) then is and how it developed during childhood or adolescence. In medical sciences, such natural kinds do exist. For example, the Covid-19 virus may be the root cause of observable symptoms like a headache, loss of taste, or shortness of breath. However, a medical doctor will not ascertain the presence of the Covid-19 virus by administering a standardized questionnaire that assesses whether someone belongs to the 16% of people with a specifically high experience of headache, loss of taste, or shortness of breath. That is in part because Covid-19 can be present without symptoms. The virus is a natural kind. It is, however, dubious whether (and if so, how) a mild intellectual disability could be present without intellectual and adaptive deficits. You cannot have a mild intellectual disability like you can have Covid-19. A mild intellectual disability is not a nosological entity causing intellectual and adaptive deficits. Instead, the term mild intellectual disability was reified, meaning that we went from describing a collection of problems as "mild intellectual disability" to colloquially perceiving that description to cause the problems "the problems are due to the mild intellectual disability” (cf. Dehue, 2014). Before I point out the potential consequences of this reification, I want to state two things. First, I would like to repeat that my doubts of a mild intellectual disability not being a natural kind, in no way equals me denying
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