Mental Retardation Determining Eligibility for Social Security Benefits (2002) / Chapter Skim
Currently Skimming:
Executive Summary
Executive Summary
Pages 1-14
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
The committee was also asked to suggest new procedures that may be necessary to ensure that SSA eligibility determinations are based on procedures and criteria that conform to best professional practices and to identify promising areas of research that may help to clarify unaddressed or incompletely answered questions. Mental retardation is a condition characterized by significant deficits in intellectual capabilities and adaptive behavior.
|
From page 2... ...
discuss the issue of adaptive behavior and its assessment consistent with current science and widespread professional practice, (~) provide advice on the most appropriate ways of
|
From page 3... ...
However, it diverges from the standard diagnostic nomenclature in some ways, including the nature and assessment of deficits in adaptive behavior, its basis for determining subaverage intellectual functioning, and the age of onset. In addition, the SSA definition goes beyond the criteria used by these other organizations in identifying individuals as having mental retardation if they have both deficits in intellectual functioning and comorbid medical or psychiatric disorders a circumstance addressed by no other definition of mental retardation.
|
From page 4... ...
In the committee's judgment, composite scores from intelligence tests should be used routinely in mental retardation diagnosis, except when the composite IQ score's validity is in doubt, in which case an appropriate part score may be used in its place. Significant and meaningful variation among an instrument's respective part scores may indicate evidence of compromised validity for one or more of them (for example, a low verbal scale score for an individual with a suspected speech disorder)
|
From page 5... ...
Many intelligence tests access several facets of intelligence, but not all facets are equally important or predict life events equally well. Those intellectual facets that are heavily "g-saturated" provide the best sources for replacing the composite IQ score when its validity is questionable.
|
From page 6... ...
ADAPTIVE BEHAVIOR AND ITS ASSESSMENT Deficits in adaptive behavior, together with deficits in intelligence, are also central to current definitions of mental retardation. SSA and the major professional organizations disagree on the nature and degree Therefore, a score of 70 or below on either of these part scores from any standardized, individually administered intelligence test that reports such scores should be deemed sufficient to meet the listings for low general intellectual functioning regardless of the level of the composite score, providing that the part scores have adequate psychometric properties (e.g., high reliability, low standard error of measurement)
|
From page 7... ...
Recommendation: Standardized adaptive behavior instruments should be used to determine limitations in adaptive functioning. In general, the cutoff scores for adaptive behavior should be one standard deviation below the mean in two adaptive behavior areas or one and one-half standard deviations below the mean in one adaptive behavior area.
|
From page 8... ...
. COMBINING lQ AND ADAPTIVE BEHAVIOR DATA Interpreting the combination of data on intelligence and adaptive behavior functioning is at the crux of making mental retardation disability determinations, particularly for individuals whose intellectual functioning hovers around an IQ of 70.
|
From page 9... ...
· Measures of adaptive and intellectual functioning should be carefully selected and interpreted in order to minimize the negative effects of low validity, low reliability, floor and ceiling effects, and steep item gradients. · The norms for measures of adaptive behavior and intellectual functioning must be suitably contemporary.
|
From page 10... ...
. Social Security Disability Determination Specialists may differentiate individuals with borderline intellectual functioning and learning disability from those with mental retardation by reviewing cognitive and adaptive behavior test results and determining whether the individual meets diagnostic criteria for
|
From page 11... ...
. · Objective data on intellectual and adaptive functioning to determine mental retardation should be collected for individuals with mild neurodevelopmental or psychiatric disabilities who might have impairments that are consistent with or functionally equivalent to mental retardation.
|
From page 12... ...
The committee makes the following recommendation to assist SSA and disability benefit recipients in achieving this balance. Recommendation: The Social Security Administration should remove disincentives for people with mental retardation to seek employment by: · Considering individuals with mental retardation to be presumptively re-eligible for benefits throughout their lives, if they have previously received benefits, subsequently secured gainful employment, and then lost that employment.
|
From page 13... ...
The committee's recommendation for needed research is intended for SSA and other federal agencies that work on education, vocational training, health and mental health, and disability-related issues. Recommendation: Federal agencies, including the Social Security Administration, should fund studies to evaluate the accuracy of program eligibility decisions and foster research on adults with mental retardation, including their adaptive behavior.
|
From page 14... ...
SSA should make available for use by legitimate researchers tapes of Supplemental Security Income and Disability Insurance program utilization, comparable to public use tapes available for Medicaid program utilization. SSA should link its data on individual benefit awards to other agency data on health care and service costs for those same beneficiaries.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.