Intellectual Disability and How It Is Diagnosed 9
of the label itself (see Tassé & Mehling, in press). Old medical/professional
terms once used to identify the condition (e.g., moron, imbecile, idiot, men-
tally retarded) are part of the everyday vernacular to insult and hurt people
rather than diagnose for the purpose of providing care and assistance.
Hence, most people with intellectual disability will make every effort to “fit
in” and “pass” for someone who does not have a disability. The use of dif
ferent strategies to mask their deficits (e.g., pretending to read a newspaper
or book, acquiescing to questioning, avoiding situations that require aca-
demic skills that might be a deficit, etc.), or outright denial of a disability
has often been coined “cloak of competence,” following the important
work done by Edgerton (see Edgerton, 1967, 1993).
Edgerton (1967, 1993) followed a group of adults with intellectual dis-
ability who were integrated into community settings after having lived most
of their lives in an institution. Edgerton’s (1993) research showed that
adults with ID, when moved into more typical community settings, will
show improvements in their adaptive behavior, independence, community
engagement, and overall quality of life. In addition, these individuals often
do not advertise their disability and, when possible, find benefactors who
can help them in areas that they have deficits (e.g., banking, bill paying,
budgeting, organization, job searches, etc.). Like many others, when effec-
tive supports are in place, the person’s overall functioning will generally
improve (see Schalock et al., 2010) and appear to the naïve observer as
being more adapted and skilled. However, if these supports (e.g., benefac-
tors) are lost, the person’s adjustment and stress levels will be significantly
impacted. Hence, when conducting a comprehensive assessment for the
purpose of making an intellectual disability determination, one must be
cautious when using self-reported information from an individual being
assessed for intellectual disability.
Atkins v. Virginia
The Supreme Court of the United States ruled in 2002 that people with
intellectual disability needed special protections because of their disabil-
ity and that their execution would be a violation of the Eighth Amendment
of the U.S. Constitution, barring cruel and unusual punishment (Atkins v.
Virginia, 2002). The Supreme Court of the United States did not bar the
execution of people with intellectual disability because they do not under-
stand the difference between right and wrong or because murder is unac-
ceptable in any civilized society. Because people with intellectual disability
for the most part understand right from wrong and they understand that
hurting people is wrong, they are generally “competent” in the eyes of the
