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University of Huddersfield Repository Whitaker, Simon Some problems with the definition of intellectual disability and their implications Original Citation Whitaker, Simon (2013) Some problems with the definition of intellectual disability and their implications. In: British Psychological Society Division of Clinical Psychology (DCP) annual conference, 4 to 6 December 2013, York, UK. (Unpublished) This version is available at http://eprints.hud.ac.uk/19301/ The University Repository is a digital collection of the research output of the University, available on Open Access. Copyright and Moral Rights for the items on this site are retained by the individual author and/or other copyright owners. Users may access full items free of charge; copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational or not-for-profit purposes without prior permission or charge, provided: The authors, title and full bibliographic details is credited in any copy; A hyperlink and/or URL is included for the original metadata page; and The content is not changed in any way. For more information, including our policy and submission procedure, please contact the Repository Team at: E.mailbox@hud.ac.uk. http://eprints.hud.ac.uk/

Simon Whitaker Some problems with the definition of intellectual disability and their implications

Intellectual disabilities is a condition created by definition a social construct

BPS (2000) there are three core criteria for learning disability: Significant impairment of intellectual functioning; Significant impairment of adaptive/social functioning; Age of onset before adulthood. Page 4

BPS (2000) significant impairment of intellectual functioning More than two standard deviations below the mean thus corresponds to an Intelligence Quotient (IQ) of 69 or less. Page 5.

Concerns about this IQ 70 is arbitrary. There is no specific mention of need. No specific test is specified so are we talking about measured IQ or true intellectual ability? There is a clear IQ cutoff point.

Can we measure true intellectual ability in the low range accurately enough to have a cutoff point?

95% confidence interval If the degree of chance error is known then a 95% confidence interval (95% CI) can be calculated by: 95% CI = 1.96 хsd х (1-r) SD is the standard deviation of the test and r is the reliability coefficient. It is reported to be about 4-5 points for the WISC-IV and WAIS-IV

Concerns about WISC and WAIS 95% Chance error only. confidence interval It is based on the performance of the standardization sample, who on the whole had average IQs so may not be representative of people with low IQs It is based on one source of error only per subtest, usually that due to a lack of internal consistency.

Sources of error in the measurement of IQ Chance errors: Lack of internal consistency. Temporal error. Scorer error. Systematic error: Flynn effect. Floor effect (low range only). Lack of consistency between tests.

Internal Consistency Error Wechsler (2008) in the WAIS-IV manual. Given to 75 adults with mild ID and 35 with mod. The internal consistency was about.98 which gives a 95% confidence interval of about 4 points.

Temporal Error The test re-test reliability check.

A meta-analysis Whitaker (2008) A meta-analysis of the literature on the test re-test reliability of intelligence tests when applied to people with low intellectual ability (IQ<80). The mean correlation between first and second test was 0.82. This corresponds to a 95% confidence interval of 12.47 points.

It was also found that 14% of IQs change by 10 points or more. Which is close to what a 95% confidence interval of 12.5 would predict.

Systematic error

The Floor effect

Floor effect: Scaled score of 1 for low raw scores WISC-IV Digit Span Age group 16:00 to 16:30 Raw Score: 18 17 16 15 14 13 12 11 10 0-9 Scaled Score: 10 9 8 7 6 5 4 3 2 1 Age group 6:00 to 6:30 Raw Score: 11 10 8-9 7 6 5-4 3 0-2 Scaled Score: 10 9 8 7 6 5 4 3 2 1

Whitaker and Wood (2008) 50 WISC-III: Mean FSIQ 58.04; SD 9.92 49 WAIS-III: Mean FSIQ 65.20; SD 7.03

Frequency of WAIS-III scaled scores 1 2 0 1 0 0 Frequency 8 0 6 0 4 0 2 0 0 2 4 6 8 1 0 1 2 1 4 s c a l e d s c o r e

Frequency of WISC-III scaled scores 2 0 0 Frequency 1 5 0 1 0 0 5 0 0 2 4 6 8 1 0 1 2 s c a l e d s c o r e s

Criteria for 16 yr olds to get a Scaled Score 2 on WISC-III and WAIS-III WISC-III Coding WAIS-III raw score 39 raw score 14

Criteria for Scaled Score 2 on WISC-III and WAIS-III (16 year olds) WISC III Vocabulary Raw score 22 What does brave mean? WAIS-III Vocabulary Raw score 4 Tell me what ship means.

Criteria for Scaled Score 2 on WISC-III and WAIS-III (16 year olds) WISC III Block Design Raw score 29 Completion of one 2-block model and six 4-block models gaining full bonus points for time on three of the models. WAIS-III Block Design Raw score 3 Completion of two 2-block models, being given a second trial on one model when an error occurred on the first trial.

Criteria for Scaled Score 2 on WISC-III and WAIS-III WISC III Similarities Raw score 11 In what way are an elbow and knee alike? WAIS-III Similarities Raw score 4 In what way are a dog and a lion alike?

Criteria for Scaled Score 2 on WISC-III and WAIS-III WISC III Arithmetic Raw score 13 Jim had 8 crayons and he bought 6 more. How many crayons did he have altogether? WAIS-III Arithmetic Raw score 4 If you have 3 books and give one away, how many do you have left?

Lack of agreement between tests We (Gordon et al 2010) compared the WISC-IV and the WAIS-III in an empirical study on seventeen 16-year-olds in special education.

Results WISC-IV WAIS-III dif r FS IQ 53.00 64.82 11.82.93

Grondhuis & Mulick (2013) A paper in which they compare the Leiter-R with the SB-5 in 47 children (aged 3 to 12 years) with ASD and find that the mean full scale score were: Leiter-R SB-5 dif r 87.11 64.66 22.45.55

Silverman et al (2010) A comparison of WAIS and SB on 74 individuals on a large data based used for studying older adults mainly with Downs. SB WAIS diff r 41.3 58.1 16.8.82

The Floor effect II

Distribution of Scaled Scores WAIS-III 30.0 25.0 Percentage 20.0 15.0 10.0 5.0 0.0 1 2 3 4 5 6 7 8 9 10 11 12 13 Scaled Scores

Distribution of Scaled Scores corrected for Floor Effect (WAIS-III) 30.0 25.0 Percentage 20.0 15.0 10.0 5.0 0.0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 Scaled Scores

Distribution of Scaled Scores (WISC-IV) 45.0 40.0 35.0 Percentage 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1 2 3 4 5 6 7 8 9 10 11 12 13 Scaled Scores

Distribution of Scaled Scores Corrected for Floor Effect (WISC-IV) 14.0 12.0 10.0 Percentage 8.0 6.0 4.0 2.0 0.0-10 -9-8 -7-6 -5-4 -3-2 -1 0 1 2 3 4 5 6 7 8 9 Scaled scores

The Flynn Effect The intellectual ability of the population as a whole is increasing at a rate of about 3 points a decade or 0.3 of a point per year.

Change in low IQ over the years Flynn (1985) found that the gains appeared to be higher at the low levels:.396 per year for IQs 55 to 70 as compared to.272 per year for IQs in the range 125-140.

Recent Evidence Teasdale and Owen (2005) looked at Danish military data, up to 2004, and found that there was a peak in average intellectual ability in 1998, followed by a decline until 2004. Also after 1995 there was an increased number of people scoring at the lower end of the tests, showing a decline in the intellectual ability for people with lower IQ.

There is therefore evidence that in Scandinavia for people with low IQs the Flynn effect may have gone into reverse. Not clear what is happening in the US and UK.

Conclusions re the measurement of low IQ Measured IQ is only a rough estimate of true intellectual ability and we need to maintain a clear distinction between the two. We cannot measure true intellectual ability in the low range accurately enough for a definition to have a measured IQ cut-off point.

Problems with the current definition People who are not able to cope with the intellectual demands of their world may not get a service. People who can cope may get a stigmatizing label.

Defining Intellectual Disability Intellectual disability is not something that can be precisely defined in terms of measurable variables. We need to develop a series of qualitative definitions that meet the needs of various stakeholders.