The Massachusetts Appeals Court recently ruled that the state had failed to justify its policy of using an IQ score of 70 as a cutoff for eligibility for service to persons with intellectual disability. The court ordered the state to re-evaluate its denial of services to 45-year-old Paula Tartarini, who had IQ scores of 71 at age 18, 49 at age 40, and 71 at age 42. The state’s Department of Developmental Services (“DDS,” formerly known as the Department of Mental Retardation), had found Ms. Tartarini to be a person with “borderline intelligence” rather than “intellectual disability” and had therefore denied her application for DDS services.
The DDS expert witness and the administrative hearing officer had found that Ms. Tartarini’s IQ score of 71 exceeded the cut-off score of 70, and that it was therefore not necessary to consider evidence of her adaptive functioning. Adaptive functioning includes cognitive, communication and social skills, as well as practical skills (i.e, the ability to live independently).
The appeals court acknowledged that the IQ score of 70 had been cited by some other national organizations as the cutoff for intellectually disability, but pointed out that the Diagnostic and Statistical Manual of Mental Disorders, widely used by psychiatrists and psychologists, refers to a score of “about” 70 as an upper limit of clinical mental retardation, without establishing that score as a “bright line.” Noting that its ruling did not “express a view whether Tartarini is a person with an intellectual disability,” the court ordered DDS to amend its regulations to identify the clinical authority on which they are based, re-evaluate Ms. Tartarini’s eligibility accordingly.
Advocates for the disabled welcomed the Tartarini decision, arguing that the state’s use of an IQ cut-off was too rigid. The court’s decision is consistent with a trend to consider the functional capacity of people with disabilities, rather than simplistic criteria like age, IQ or medical diagnoses. For example, early Massachusetts guardianship laws permitted a court to appoint a guardian for someone on the basis of “advanced age” alone. The law then changed to require a physician to diagnose someone as “incompetent.” Under the state’s new Probate Code, effective in 2009, the court must now consider an individual’s “capacity,” and take into account the person’s abilities as well as deficits before appointing a guardian.
Such holistic and individualized consideration is a welcome development for persons of all ages and levels of capacity.