Synopsis
Establish whether intellectual and adaptive impairments began during development, describe the person's individual support needs and strengths, and avoid reducing a lifelong functional assessment to a single IQ score.
- UK practice defines learning disability through three linked features: reduced intellectual ability, significant impairment of adaptive or social functioning, and onset during childhood or the developmental period.
- An IQ result may contribute to assessment but cannot establish the diagnosis alone; validity, confidence intervals, language, education, culture, sensory needs and test engagement all affect interpretation.
- Adaptive functioning describes real-world conceptual, social and practical skills, including communication, money, safety, relationships, travel, self-care and use of health services.
- Assess what the person can do independently, what becomes possible with prompting or equipment, and what support is reliably available across ordinary settings.
- Developmental records, school history and informants can establish early onset, but the adult must remain central and consent or information-sharing rules still apply.
- Distinguish global learning disability from a specific learning difficulty, autism without intellectual impairment, acquired cognitive decline, severe mental illness, language difference and missed sensory impairment.
- Translate findings into reasonable adjustments, a health record and register where criteria are met, a strengths-based support plan, and review when demands or health change.
Key red flags
Any abrupt decline from the person's established communication, mobility, self-care or behaviour requires a search for delirium, pain, infection, seizure, injury, medicine toxicity or abuse.
Regression accompanied by focal neurological signs, prolonged seizure, head injury, fever, dehydration or altered consciousness needs urgent medical assessment.
A history supplied only by services, without offering the person accessible participation or seeking appropriate family and developmental evidence, can misclassify both ability and need.
Possible coercion, neglect, financial exploitation or unexplained injuries must trigger proportionate safeguarding action rather than being recorded as difficult behaviour.
Investigation priorities
Establish onset and course of intellectual and functional differences before adulthood.
Management branches
Global learning and everyday coping difficulties raise a possible learning disability.
- Clarify the referral question, explain the process accessibly and obtain the person's account with the communication and decision support they need.
- Gather developmental, educational, health and functional evidence while considering sensory, language, cultural and environmental influences on performance.
- Arrange appropriately qualified intellectual and adaptive assessment when existing evidence is insufficient, then state uncertainty rather than forcing a binary conclusion.