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Thinking about the current state of affairs in residential and day services for people with intellectual and developmental disabilities (ID/DD) prompted reflection first on the conditions and events that existed when I entered the field in 1965. My first experience was as an undergraduate assistant in a research project funded by the National Institutes of Health. The performance site for the grant was a ward in a large state residential facility. The ward provided residential and day services to at least 35 boys with severe or profound intellectual disability (ID) and diagnoses of mental illness. The setting consisted of a congregate bedroom, congregate bathroom, congregate dining room, a large “day” room, and a concrete “porch” with chain link “walls.” My recollection is that aside from grant staff, three or four regular direct service workers supported the children during the morning and evening shifts.

This past century has witnessed a major shift in the delivery of support services for people with developmental disabilities. In the first half of the most recent century, American society concerned itself with the proliferation of institutions for persons with developmental disabilities. Often in remote settings, a principle concern was to relocate individuals who were characterized as a “menace” to society (Brockley, 1999; Scheerenberger, 1983). Throughout the latter half of the century, many of the negative assumptions about people with developmental disabilities were challenged and human service ideology shifted toward normalization, least restriction, and the development of policies favoring community-based living arrangements (Brockley, 1999; Landesman & Butterfield, 1987).

On June 20, 2002, the Supreme Court of the United States overruled years of settled legal precedent when it declared that the execution of individuals with intellectual disabilities (ID) violated the United States Constitution’s Eighth Amendment prohibition against cruel and unusual punishment (, 2002). This decision is the most recent in a line of cases that have been decided over the past 20 years that have changed the legal framework within which professionals who work with individuals with ID must function. As has been the case with most of these legal landmarks, represented the culmination of decades of legal and legislative advocacy on behalf of criminal defendants with ID seeking to bar the imposition of the death penalty in such cases. It had been a long and rocky road in reaching this watershed legal event. Indeed, only 13 years earlier the Supreme Court had ruled that the Eighth Amendment did bar the execution of criminal defendants with ID (, 1989). What had changed in those intervening years?

Three decades ago, the American Association on Mental Deficiency (AAMD) proposed a definition of intellectual disability (ID) that not only emphasized the academic side of intelligence but also considered two other important factors—adaptive behavior and the time of occurrence of the disabling condition: “Mental Retardation refers to significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period” (Grossman, 1983, p. 1).

The early descriptions of persons with mental retardation emphasized their inability to adapt to the demands of everyday life (Biasini, Grupe, Huffman, &Bray, 1999; Greenspan & Driscoll, 1997; Scheerenberger, 1983). In 1850, Seguin argued that “sensibility, of intelligence, and will” could help to identify mental retardation in instances when, “to a casual observation, the question may arise whether any default in these particulars exists at all” (Wilbur, 1877, p. 31). In the early twentieth century Tredgold described mental retardation as incomplete mental development “of such a kind and degree that the individual is incapable of adapting himself to the normal environment of his fellows in such a way as to maintain existence independently of supervision, control, or external support” (Luckasson et al., 2002, p. 20). Thus, dating back to the original perceptions, limits in the ability adapt to the demands of everyday life, i.e., adaptive behavior, have been a central and distinguishing feature of mental retardation.

Clinicians assess a client’s psychosocial and mental status in a variety of contexts. Clients may be screened at intake to a service and at annual staffings, often to determine eligibility for professional services or supportive interventions. In this type of referral the important question is whether or not there is a clinically significant problem that requires attention. This can also take place during ongoing evaluation of response to various interventions such as psychotropic medications, behavioral interventions, other forms of therapy. In this context the key question is whether or not there has been a change in functioning in response to interventions. Assessment of psychosocial and mental status may also take place in response to a referral following a decline in functioning. On these occasions relevant questions often relate to determination of the causes in the change in functioning, requests for modifications and refinements to existing treatment plans, and development of new interventions or movement to new service settings, such as a residence. Recently a variety of practice guidelines and professional resources for assessment of individuals with intellectual disabilities (ID) or related conditions have become available (American Academy of Child and Adolescent Psychiatry [AACAP], 1999; Deb, Matthews, Holt, & Bouras, 2001; Fletcher & Greene, 2002; Poindexter, 2002; Royal College of Psychiatrists, 2001).

The technology of functional assessment is among the most important developments in several decades for the education and treatment of people with mental retardation, autism, and other developmental disabilities. These powerful methods for understanding maladaptive behavior and linking intervention closely to assessment have made a difference in the lives of countless people with developmental disabilities and should be part of the repertoire of every service provider who works with these clients and students. In this chapter, we first review the research documenting the benefits of functional assessment and then illustrate the application with a case report highlighting the transfer of functional assessment research into clinical practice.

Students with developmental disabilities (DD) display characteristics that present unique challenges to practitioners conducting psychoeducational assessments. Developmental characteristics can vary widely across disorders and among individuals with the same disorder. Evaluators must be prepared to respond appropriately to unique needs so that assessments validly inform educational decision-making for identified students. This requires a thorough understanding of how various psychoeducational assessment practices contribute to the decision-making process for students with disabilities. This chapter reviews the process and issues affecting the psychoeducational assessment of students with DD and the importance of linking assessment outcomes to intervention.

Early intervention for children with disabilities and those at psychosocial risk is facilitated by screening–a brief method for sorting those who probably have difficulties from those who probably do not (Frankenburg, 1974). Most screening tests do not make discrete identification among types of conditions but are instead designed to detect a range of common disabilities, i.e., intellectual disability (ID), learning disabilities, and language impairment. Such tools are referred to as broadband measures. Narrow-band screens (e.g., those for ADHD or autism) are typically developed on and used with referred samples and are beyond the scope of this chapter.

Most individuals with developmental disabilities are law-abiding citizens. In some cases, where individuals with developmental delay have clearly engaged in dangerous criminal activity, support providers, police, and prosecutors are reluctant to initiate legal proceedings. Those prosecuted are vulnerable to disproportionate incarceration, susceptible to abuse in correctional settings, and likely to experience cessation of significant treatment.