Rethinking cognitive assessment in mild intellectual disability: evidence-based recommendations for a person-centered diagnostic framework

This article proposes a multidimensional, person-centered framework for diagnosing mild intellectual disability (MID), chal-lenging the traditional reliance on fixed IQ thresholds as the primary diagnostic criterion. Anchored in the Cattell-Horn-Carroll (CHC) theory of intelligence, the framework advocates for an integrative assessment approach that combines broad (Stratum II) and narrow (Stratum I) cognitive abilities with evaluations of adaptive behavior, clinical observation, and in-formant reports. This comprehensive model reflects the complexity and heterogeneity of MID, emphasizing that intellectual functioning cannot be accurately captured by a single numerical score. The framework underscores the importance of using ecologically valid and culturally sensitive tools, particularly for assessing functionally relevant domains such as memory, language, and literacy. It highlights the need for clinical judgment to be informed by structured tools that map individual cognitive profiles and guide intervention planning in alignment with real-world demands. Central to this approach is the recognition of intra-group variability and the presence of distinct cognitive subprofiles, which call for tailored interventions based on individual strengths and needs rather than rigid diagnostic categories. Drawing on recent empirical studies, the article provides evidence supporting the existence of these cognitive subtypes within MID populations and advocates for individualized, strength-based assessment and support strategies. It calls for a longitudinal, multi-method, and context-sensitive diagnostic process grounded in both theoretical models and clinical expertise. Ultimately, the proposed paradigm promotes diagnostic accuracy, ethical integrity, and equity by shifting from reductionist classification toward a nuanced understanding of cognitive functioning and human potential.

Authors

Publication Details

Journal
Health Psychology Report
Published
2025-09-23
DOI
https://doi.org/10.5114/hpr/207702
Primary Topic
Williams Syndrome Research
Type
article
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article

Rethinking cognitive assessment in mild intellectual disability: evidence-based recommendations for a person-centered diagnostic framework

Urszula Sajewicz‐Radtke
Health Psychology Report
Williams Syndrome Research
article

Rethinking cognitive assessment in mild intellectual disability: evidence-based recommendations for a person-centered diagnostic framework

Urszula Sajewicz‐Radtke
article en

Abstract

This article proposes a multidimensional, person-centered framework for diagnosing mild intellectual disability (MID), chal-lenging the traditional reliance on fixed IQ thresholds as the primary diagnostic criterion. Anchored in the Cattell-Horn-Carroll (CHC) theory of intelligence, the framework advocates for an integrative assessment approach that combines broad (Stratum II) and narrow (Stratum I) cognitive abilities with evaluations of adaptive behavior, clinical observation, and in-formant reports. This comprehensive model reflects the complexity and heterogeneity of MID, emphasizing that intellectual functioning cannot be accurately captured by a single numerical score. The framework underscores the importance of using ecologically valid and culturally sensitive tools, particularly for assessing functionally relevant domains such as memory, language, and literacy. It highlights the need for clinical judgment to be informed by structured tools that map individual cognitive profiles and guide intervention planning in alignment with real-world demands. Central to this approach is the recognition of intra-group variability and the presence of distinct cognitive subprofiles, which call for tailored interventions based on individual strengths and needs rather than rigid diagnostic categories. Drawing on recent empirical studies, the article provides evidence supporting the existence of these cognitive subtypes within MID populations and advocates for individualized, strength-based assessment and support strategies. It calls for a longitudinal, multi-method, and context-sensitive diagnostic process grounded in both theoretical models and clinical expertise. Ultimately, the proposed paradigm promotes diagnostic accuracy, ethical integrity, and equity by shifting from reductionist classification toward a nuanced understanding of cognitive functioning and human potential.

Health Psychology Report
Openalex Percentile: Top 70%
Williams Syndrome Research
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