MILD INTELLECTUAL DISABILITY –
RESEARCH AND BEST PRACTICES
Allyson G. Harrison, Ph. D., C. Psych.
Alana Holmes, Ph. D., C. Psych.
13-May-2009
MILD INTELLECTUAL DISABILITY (MID):
A QUESTION OF DEFINITION
 Term
coined by Ministry of Education (2001) to
capture a group of students not falling into
recognized disability categories, but still
deemed in need of special education supports to
succeed.

i.e., not Learning Disabled, not Intellectually
Deficient
TERM = DISABILITY
 The
term MID is not in any recognized diagnostic
codebook
 If
MID cannot be diagnosed by registered
professionals how can it be considered disabling?
 Furthermore,
the Ministry of Education definition
is of limited use with respect to diagnostic
possibilities as it is bereft of operationally defined
criteria.

Ministry leaves it to EACH school board to determine how
they will actualize the term for use in identifying students
within their board.
CONSIDER:
CURRENT RANGE OF DEFINITIONS
 Ministry
of Education
 Four different Ontario School Boards
 Provinces of Alberta & BC
 United States
 College Committee on Disability Issues
 American Medical Association
 Diagnostic and Statistical Manual of Mental
Disorders
How do you think the boards define MID?
MINISTRY OF EDUCATION OF ONTARIO
(2001)
MID is a learning disorder characterized by:
 -an ability to profit educationally within a
regular class with the aid of considerable
curriculum modifications and supportive
services;
 -an inability to profit educationally within a
regular class because of slow intellectual
development; and
 -a potential for academic learning, independent
social adjustment, and economic self-support.”
LONDON DISTRICT CATHOLIC SCHOOL
BOARD
Criteria for identification of MID
 Typically
based on intellectual and
achievement results within the 1st to
17th percentile range”

(that is, an IQ between 85-65)
RAINBOW DISTRICT SCHOOL BOARD
Diagnosis of MID requires:
Assessment by regulated qualified professional
 Mild level of general intellectual ability
 Adaptive functioning and/or academic skills above lower
cognitive ability
 Difficulty learning and understanding new concepts
 Able to meet limited Ontario curriculum expectations with
support
 Need for alternative curriculum
 Potential for academic learning, social adjustment and
economic support
 Cognitive abilities within the 55 to 70 (+/- 5) range;
academic and social skills >70 to 75 range

NORTHWEST CATHOLIC DSB

Mild Intellectual Disability
 An intellectual assessment administered by a
member of the College of Physicians and Surgeons or
a member of the College of Psychologists that
indicates full scale intellectual potential within
the deficient range (i.e. below 70);
 An assessment report indicating the student’s
adaptive functioning is within the deficient
range;
 An educational assessment indicating that academic
achievement is at or below the first percentile
(i.e. 65);
 A speech/ language assessment and health history
provided by a qualified medical practitioner may be
considered.
Northeastern Catholic DSB says to identify a
child as MID you need…






Classroom documentation
Educational Assessment indicating academic achievement in core
subjects will be 2 or 3 grade levels below that expected based on
chronological age
• Psychological Assessment
- indicating the student functioning in the mild to borderline
(2nd to 8th percentile) intellectual range as measured by a
WISC-III
Students would have a modified program based on the Ontario
Curriculum, have access to additional support in the classroom or
require a small class setting for parts of the day.
Behaviour is not the key focus for these students.
Note: Interpretation of grade scores must be done within the
context of general daily achievement.
Practices throughout Ontario Boards
below 17th percentile ((IQ below 86)
mild cognitive delay + mild-mod impaired
adaptive
2 yrs or more behind age
2
1
1
2-8th percentile (70-79)
3
Below 2nd percentile (IQ 70 or less)
7
Below 1st percentile
1
ministry definition only (no IQ given)
40
0
10
20
30
40
Number using criteria
50
And to add to the ambiguity….


One board calls them Mild Intellectual
Exceptionality - General Learning Disabilities
(Airy & Sabine District School Area,
http://www.nexicom.net/~airy/Speced/specedrep
06.pdf
Durham District School Board calls MID a Mild
Developmental Disability.
http://ddsb.durham.edu.on.ca/Pdf/Spec_Ed_Plan
_2005/B07_Categories%20and%20Definitions.pdf
WHAT DOES THIS TELL YOU?
Why there is such variability in the academic outcomes
of students labeled as MID at post-secondary level!
 No consistent way of determining who is MID or what
characteristics they may have.
 Given measurement error, could have one child with
IQ of 85 whose actual IQ was 90 (and who had no
adaptive functioning deficits), and another child whose
IQ was 65 (and who has severe impairments in all
areas of adaptive functioning and required intensive
support and course modification), both of whom were
labeled MID.
 Of the boards who use IQ criteria, most are under 70.

IDENTIFICATION OF MID IN OTHER
JURISTICTIONS:
Alberta Ministry of Education definition:
Mild Intellectual Disability is a categorization of
students
 Overall IQ score falls between 50 and 70
BRITISH COLUMBIA MINISTRY OF
EDUCATION DEFINES MID AS:


Intellectual functioning is 2.01 to 3.00 standard
deviations below the norm (i.e. 55-70) on an
individually administered psychological assessment,
and there is a delayed adaptive behavior and
functioning of similar degree.
Students with MID may require specific instruction for
the acquisition of gross and fine motor skills,
communication skills, assistance with development of
social skills, including personal independence, social
responsibility and life skills, as well as with reasoning
skills, memory, problem solving and conceptualization
skills.
UNITED STATES
Varying by state, MID is referred to as:
 mild
intellectual disability
 educable mental retardation
 mild cognitive disability
 developmental disability
These labels typically refer to children with IQ’s
between 50-75
COLLEGE COMMITTEE ON DISABILITY ISSUES
 Students
entering college with identifications of
Mild Intellectual Disability have IQ’s between
70-79 (2nd to 8th percentile)
 These
students may also have been referred to
as having Borderline Intellectual Functioning or
being a slow learner
 Such
students are eligible for accommodations
BORDERLINE INTELLECTUAL FUNCTIONING
A
classification of mental ability covering
persons with I.Q. scores in the range of 71 to 84,
with only slight impairments in adaptive
behavior
 Also
called, borderline mental retardation
The American Medical Association Encyclopedia of Medicine, 1989
BORDERLINE INTELLECTUAL FUNCTIONING


The DSM-IV includes Borderline Intellectual
Functioning, but as a “V” code on Axis II, which means
that it is not a recognized clinical disorder.
Within the V-Codes, Borderline Intellectual Functioning
is defined by DSM-IV as follows:
 This category can be used when the focus of clinical
attention is associated with borderline intellectual
functioning, that is, an IQ in the 71-84 range”, and is
coded on Axis II
American Psychiatric Association, 1994
RANGE OF DEFINITIONS
Where is the overlap?
 Use of IQ scores
What are the gaps?
 Identification vs diagnosis
 Range of IQ scores
 Measures of adaptive functioning
 Measures of academic skills
 Vulnerable to feigning
WHAT IS A DISABILITY AND DOES MID QUALIFY AS ONE?

Students with disabilities are entitled to reasonable and
appropriate accommodations at the post-secondary level
(Ontario Human Rights Code, 2004)
The OHRC defines a disability as:
 (b) a condition of mental impairment or a developmental
disability,
 (c) a learning disability, or a dysfunction in one or more
of the processes involved in understanding or using
symbols or spoken language,
 (d) a mental disorder

WHAT IS A DISABILITY AND DOES MID QUALIFY AS ONE?
 It
would therefore appear that, depending on
the way that MID is defined, it may qualify as a
disability.
 This
is a grey area!!
The OHRC does not specify how one defines a
mental impairment.
 No consensus on how to define MID
 In Canada at present, no one has dealt with the
issue of determining how severe an impairment
must be relative to the general population before it
can be construed as a disability
 Hence, difficult to address issue of whether MID
qualifies as a disability.

WHERE TO BEGIN?
•How do we determine what policies and supports should
be put in place if we can’t even agree on who they are?
•Start with a general understanding regarding how postsecondary institutions are defining this group
•what documentation they are requiring regarding
disability
•the types of programs into which they are going
•the typical supports they are using and whether
course content is being modified
•their success in completing programs at the postsecondary level
WHAT TO DO?
A
survey was undertaken to investigate these
questions
 It
is assumed that appropriate policies and
services can be developed only after service
providers have a better understanding of the
nature of the issues faced by such students,
and when an agreed-upon way to identify
these students is determined
THE SURVEY
 Survey
link e-mailed to all heads of Disability
Services Offices (DSO’s) in Ontario in the fall of
2008.
 Of
the 50 publicly funded institutions in Ontario:
28 are 2-year colleges
 22 are 4 year universities

THE SURVEY . . .CONT’D
A 20 item questionnaire to determine:
 number of students with MID served at each
institution
 information about the objectives outlined for this
survey.
 a general understanding regarding definitions used
for this group of students
 documentation required regarding this “disability”
 types of programs these students enter
 typical supports these students are using
 whether course content is being modified
 success of these students in completing programs at
the post-secondary level
DEMOGRAPHICS:
Response rate = 68% (34 institutions of 50 surveyed)
 Colleges = 82% (23/28) (12 with CICE programs)
 Universities = 50% (11/22)
All sizes of institutions, primarily urban, all areas
16
14
14
12
10
8
6
7
7
6
4
2
0
Northern Ontario
Southwestern
Ontario
Central Ontario
Number responding
Eastern Ontario
DEMOGRAPHICS:
61.8% of respondents served 500-1,000
disabled students/year
38.2% of respondents served >1,000
disabled students/year
HOW MANY (ESTIMATED) STUDENTS WITH MID?
 Colleges
reported a range from 8-100 students
with MID/year (or this year)
 Universities
reported <6/year except one, which
reported 20-25
 So,
higher incidence in colleges but, still <10% of
all students with disabilities served
HOW DID THE INSTITUTIONS DEFINE MID?
no set criteria
1
Borderline/mild intellectual ability
1
80-90
1
70-85
1
67-80
1
70-80
22
IQ below 70
7
0
5
10
15
number reporting
20
25
Do you require any other proof of
impairment other than IQ scores?
90
78
80
70
65
60
50
40
30
colleges
35
21
20
10
0
require more than IQ scores
only need IQ score
percent reporting
universities
Diagnosis made in documentation
Depends
1
Does not meet criteria for SLD
1
LD
5
Slow learner
2
Developmental Delay
3
MID
13
BIF
6
Borderline
2
0
2
4
6
8
number reporting
10
12
14
DOCUMENTATION :
 Psychoeducational
reports most often use the
terms “diagnosis” of MID, borderline intellectual
functioning, or LD.
 Individual
Education Plans (IEP’s) use
descriptions of exceptionality like below
average, limited intellectual ability, or slow
learner.
 Documentation
provides a diagnosis
 33% of universities
 70% of colleges
SERVICES AND SUPPORTS PROVIDED TO STUDENTS WITH
MID
Modifications
 Provision
of modifications of both course AND
admission requirements:
 0 universities
 1 college
ACCOMMODATIONS :
COMMONLY PROVIDED BY BOTH COLLEGES
& UNIVERSITIES
Referral to mainstream campus study skills/supports
 70% of universities; 82.6% of colleges
 Tutoring, referral to ESF LS supports, AT on campus,
BSWD for technology
 40-60% of universities; 69.6-91.3% of colleges
 Extra time on exams, separate space, scribe/reader
 50-70% of universities provided extra time or
separate space, 10% provided a scribe/reader; 56.5100% of colleges did so
 Approval of P/T study, approval of 40% load for OSAP,
and BSWD for assessment
 50-60% of universities; 82.6-91.3% of colleges

ACCOMMODATIONS :
PROVIDED DIFFERENTLY BY COLLEGES & UNIVERSITIES
Universities:
 No clarification of exam questions; 10% (n=1) provided
educational assistants in class/lab and tutoring
>3hrs./week/course, and 20% approved BSWD for
coaching or learning strategies.
Colleges:
 34.8% of colleges provided clarification of exam
questions; 34.8% reported providing tutoring in > 3
hrs/week/course, 8.7% provided educational assistants
and BSWD for coaching; 34.8% reported approving
BSWD for a learning strategist.
SUCCESS RATES
How many succeed?
_% say less than 10% succeed
40%
__% say 10-25% succeed
35%
__% say 26-50% succeed
10%
__%say 50-75% succeed*
15%
COMMENTS OFFERED BY RESPONDENTS:



Students with MID who succeed:
 are generally highly motivated
 have realistic goals
 good organization and study skills
 seek assistance and support
 and take a reduced course load
Although students with MID often ask for course
modifications, these are almost always refused
A significant increase in students with MID has been
observed
OTHER COMMENTS




Often they complete after a prolonged period and with
much support from our office.
Difficulties due to over-accommodating/modifying in high
school. Very hard transition to postsecondary.
Sometimes receive grade 12 college English credit, but
aren't working at the level.
We have only had 2 students over the last 10 years to my
knowledge, both only lasted one semester and then
dropped out
Complete program when in less demanding academic
areas and commit to additional time
SUMMARY
 MID
area is presently in a state of disorder. No
consistently used or applied definition in
Ontario. Much heterogeneity.
 Definition
used by CCDI differs from school
boards & from other areas of Canada and the
USA.
 Assessors
criteria.
use different labels and different
SUMMARY CONT’D



Students with a label of MID represent less than
10% of students being served by disability offices in
Ontario’s colleges and universities.
75% of respondents estimated that one quarter or
fewer of MID students are successful in postsecondary school. The chance for failure appears
heightened for this group of students.
What of the 25% or so who are successful in their bid
for post-secondary credentials? Perhaps group who
are defined differently by various boards? Highlights
need to determine who these successful students are
and what characteristics help them to succeed.
SUMMARY CONT’D





While both colleges and universities are servicing this population,
colleges do so to a much greater extent
Universities and colleges provide similar types of accommodation,
but colleges do so to a greater extent
Both sectors approve BSWD funds and partial course loads for this
group, but colleges do so more frequently
Universities take a more conservative approach to the
documentation of MID, requiring supplementary information
regarding functional implications in addition to IQ scores to
determine MID
Universities offer fewer accommodations and supports
NEXT STEPS:
1.
Need an agreed upon and operationalized definition of the group
of traits currently being labeled MID (IQ and adaptive
functioning, evidence of longstanding nature of impairments)
2.
Investigate characteristics of those who succeed vs. those who do
not.
3.
Best practice guidelines with respect to assessment are needed as
well as an emphasis on the need for good background
documentation
4.
Would it be useful to conduct a similar survey with Ontario’s
school boards to gain an estimate of how many students with
MID are likely to be graduating in the next few years with intent
to enroll in post-secondary education?
5.
Should Ontario school boards be polled to determine what
supports (other than modifications) have enabled these students
to succeed in an educational setting?