Exploring speech comprehension and psychosocial outcomes from the perspective of adults with mild intellectual disability

This study investigates how adults with mild intellectual disability (ID) comprehend speech, their self-assessment of language skill proficiency, and the psychosocial impacts of these factors.
Ten participants with mild intellectual disability, aged between 22,0 and 39,0 years, participated in the study. Speech comprehension was evaluated using subtests from the CELF-5 battery. In accordance with the ICD-10 diagnostic criteria, testing was initiated with sections appropriate for developmental age of 9–10 years. Participants’ self-perception of their language skills was assessed using the WHODAS 2.0 36-item interviewer administered questionnaire.
The participants achieved the best results, with an average accuracy of 67 % in the Following Directions subtest (x‾ = 21,9, R = [12–27], d = 5,34.) The Recalling Sentences subtest (x‾ = 39,8, R = [31–53], d = 7,0) was more challenging, with an average accuracy of 51 %. The most demanding subtest was Understanding Spoken Paragraphs, where participants averaged 50 % accuracy (x‾ = 10,11, R = [0–16], d = 4,9).
In the Understanding Spoken Paragraphs test, participants performed best when making inferences (70 % correct answers), while recalling details and facts proved to be the most challenging task with 7 % accuracy. In the WHODAS 2.0 Disability Assessment the majority of participants reported that the greatest challenges in daily life were Understanding and communication (30 %), Interpersonal relationships (40 %), and Community participation (10 %).
Difficulties with language skills significantly affect the daily functioning of adults with mild intellectual disability. Participants performed best in tasks requiring following directions and making inferences from spoken content. They encountered more challenges with recalling sentences and remembering details and facts. Many participants reported that social interactions, particularly with strangers, were mentally exhausting and that listening itself was taxing. Some participants described themselves as “hard of hearing” or said they “cannot be bothered to listen", reflecting their difficulties with communication.

Landgren, V., Hedman, E., Lindblad, I., Gillberg, C. & Fernell, E. (2024). Adult psychiatric and psychosocial outcomes of children with mild intellectual disability: a register follow-up of a population-based cohort. Journal of Intellectual Disability Research, 68 (1), 33–44. https://doi.org/10.1111/jir.13087