“Mental retardation” is no longer a diagnosis. The term was officially replaced by “intellectual disability” in 2013 when the American Psychiatric Association published the fifth edition of its Diagnostic and Statistical Manual (DSM-5). The condition it described still exists and is still diagnosed, but under the updated name, with the same core criteria refined for modern use.
Why the Term Changed
The shift wasn’t just cosmetic. Over the two decades leading up to 2013, medical professionals, educators, advocacy groups, and families had increasingly moved away from “mental retardation” because the term had taken on deeply negative connotations. The word “retarded” had become a common insult, and its continued use in clinical settings carried that stigma into doctor’s offices, classrooms, and government paperwork. As the Federal Register noted when the Social Security Administration adopted the new language, advocates “rightfully asserted that the term has negative connotations, has become offensive to many people, and often results in misunderstandings about the nature of the disorder and those who have it.”
In 2010, Congress passed Rosa’s Law (Public Law 111-256), which replaced “mental retardation” with “intellectual disability” across federal health, education, and labor statutes. The DSM-5 followed suit three years later. The federal education system updated its language as well: the Individuals with Disabilities Education Act (IDEA) now lists “intellectual disability” as an eligibility category and explicitly notes it “was formerly termed ‘mental retardation.'” Today, the medical billing codes used by clinicians (ICD-10-CM codes F70 through F79) all use “intellectual disabilities” as the official heading.
What Intellectual Disability Actually Is
Intellectual disability is a condition that begins in childhood and involves meaningful limitations in both thinking ability and everyday life skills. It is not a single test score. A diagnosis requires three things to be present at the same time:
- Significant limitations in intellectual functioning. This is typically measured with an IQ test. A full-scale IQ score of roughly 70 to 75 signals a significant limitation, though the number alone doesn’t determine the diagnosis.
- Significant limitations in adaptive behavior. This means real difficulty with the practical, social, and conceptual skills people use every day. Conceptual skills include language, reading, math, and reasoning. Social skills include empathy, communication, and the ability to form friendships and follow social rules. Practical skills cover personal care, managing money, job responsibilities, and organizing daily tasks.
- Onset during the developmental period. The condition must have originated before the person turned 22. This distinguishes intellectual disability from cognitive decline that begins in adulthood, such as dementia.
A person who scores below 70 on an IQ test but functions well in daily life would not automatically receive a diagnosis. Likewise, someone struggling with life skills but testing in the average IQ range wouldn’t qualify. Both pieces have to be present, and both have to trace back to childhood or adolescence.
Severity Levels
Intellectual disability is diagnosed on a spectrum of four levels: mild, moderate, severe, and profound. In earlier editions of the DSM, these levels were defined almost entirely by IQ ranges. The DSM-5 shifted the emphasis. Severity is now based primarily on how much support a person needs in daily life, across those three domains of adaptive functioning.
Someone with a mild intellectual disability might live independently with occasional support for tasks like managing finances or navigating complex paperwork. Someone with a profound intellectual disability typically needs assistance with nearly all aspects of daily care. Most people diagnosed with intellectual disability fall into the mild category.
How It Differs From Other Conditions
Intellectual disability is sometimes confused with learning disabilities, autism, or developmental delay, but these are distinct diagnoses. A learning disability like dyslexia affects a specific academic skill while overall intellectual functioning remains in the typical range. Autism involves differences in social communication and behavior patterns but doesn’t necessarily involve below-average intellectual functioning. Some people have both autism and intellectual disability, but one doesn’t imply the other.
Developmental delay is a term used for young children, typically under five, who aren’t meeting milestones on schedule. Some children with early developmental delays go on to catch up with peers. Others are eventually diagnosed with intellectual disability once formal testing becomes reliable enough to confirm lasting limitations.
What This Means for Older Records
If you or a family member received a diagnosis of “mental retardation” years ago, that diagnosis translates directly to intellectual disability under current terminology. The diagnostic criteria haven’t fundamentally changed. No one needs to be re-evaluated solely because the name is different. School records, Social Security determinations, and medical files that use the older term are still recognized, though agencies have updated their forms and language to reflect the current terminology.
The support services and legal protections remain the same. Children still qualify for special education services under IDEA. Adults still qualify for Social Security disability benefits and vocational rehabilitation. The change in language didn’t alter eligibility for any of these programs.