Comprehensive Assessment of Individuals With Significant Levels of Intellectual Disability: Challenges, Strategies, and Future Directions.

DiStefano et al. (2020) looked at every hurdle when we test people with severe or profound intellectual disability.

They read dozens of past papers and spoke with clinics.

The team asked: why do scores crash to the bottom and what can we do about it?

Most IQ and language tests floor-out. That means the person gets a zero even if they know the answer.

Motor, vision, or hearing issues hide what clients really know.

The fix: shorten tasks, use pictures, give extra time, and watch for small responses like eye gaze or a finger lift.

Meuris et al. (2014) give a ready-made tool: a five-minute story task that works for adults who speak or use key-word sign. It shows the same idea in action—swap the test so the client can show skill.

Bellon-Harn et al. (2020) push further. They say future trials should drop IQ scores and use brain waves or daily-life ability scales instead. Charlotte’s paper sets the stage; L et al. show the next step.

Holburn (2001) warned us twenty years ago: always screen vision and hearing first. Charlotte repeats that warning, proving the rule still holds.

If you test a client and they score zero, you may cut their services. Use the paper’s checklist: check senses, pick short items, allow any response mode, and stop at first sign of fatigue. You will get truer scores and better goals on Monday.