Response biases in interviews of individuals with limited mental ability.
Drop yes/no questions, use either/or plus visuals, and you will slash agreeable guessing in interviews with clients who have ID.
01Research in Context
What this study did
W et al. looked at every paper they could find on talking with people who have intellectual disability.
They asked: Do yes/no questions make clients just say “yes” to please you? Do pictures help?
They pulled the results into one story to show which tricks hurt or help true answers.
What they found
Yes/no questions invite “yes” bias—people agree even when they mean “no.”
Either/or choices cut that bias in half.
Adding photos or drawings keeps answers steady and clearer.
How this fits with other research
Embregts (2000) saw the same risk: the Child Behavior Checklist gives shaky scores for youth with mild ID, so poor questions can spoil any tool.
Matson et al. (2004) gave us PAS-ADD norms; W’s tips on wording and pictures can raise the trust in those screens.
Katz et al. (2003) warned that most drug studies in ID use weak methods; using W’s cleaner interview style would beef up future trials.
Why it matters
Next time you ask a client about pain, choices, or mood, swap yes/no for “Do you want juice or water?” and hold up the real items. You will get answers you can trust, plan better interventions, and avoid false consent. One small language tweak equals better ethics and data.
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Take your current intake questions, rewrite the first five into either/or format, and tape matching pictures next to them.
02At a glance
03Original abstract
The validity of responses by individuals with mental retardation during interviews is threatened by a number of biases. Acquiescence (the disposition to answer 'yes' regardless of the question asked) is a commonly observed response bias committed by respondents to questionnaires and interviews, and this disposition is significantly more pronounced when persons of low status are questioned by high-status interviewers. Research on the acquiescence bias suggests that it can be reduced in mentally retarded respondents by replacing the usual 'yes/no' question format with an 'either/or' format. Enhancing the either/or choices with accompanying picture representations of each choice is beneficial in increasing mentally retarded subjects' responding and in reducing their tendency to choose the latter of two either/or choices. 'Nay-saying' (the disposition to say 'no' regardless of the question asked), while less common than 'yea-saying' (i.e. than acquiescence), has also been noted in response to certain question formats and taboo topics. This review implies that the validity of an interview with respondents of limited intelligence depends greatly on the format of its questions.
Journal of intellectual disability research : JIDR, 1995 · doi:10.1111/j.1365-2788.1995.tb00525.x