In 2002, the U.S. Supreme Court ruled in Atkins v. Virginia that a person with an intellectual disability cannot be legally executed because it would offend the Eighth Amendment’s prohibition against cruel and unusual punishment. In that decision, the court made clear that the metric for determining whether an individual has an intellectual disability should be determined by reference to authoritative clinical texts, such as "Intellectual Disability: Definition, Classification, and Systems of Supports" (2010) published by the American Association on Intellectual and Developmental Disabilities. In 2017, in Moore v. Texas, the court clarified two key points relevant to Atkins. First, courts must use current medical standards for intellectual disability when deciding whether an individual is ineligible for execution. And second, a court cannot offset an assessment of a person’s intellectual deficit by focusing on that person’s adaptive strengths, unless there are clinical standards that call for such a balancing in arriving at a diagnosis.
Now, a petition to the U.S. Supreme Court (Hill v. Anderson, 2018) is asking the court to decide what information an expert psychologist can use as a basis for an opinion about a capital defendant’s intellectual ability. In this case, Danny Hill was indicted for the 1985 rape and murder of a juvenile, and the state of Ohio sought the death penalty. At trial, all parties agreed that Hill’s measured IQ was sufficiently low to satisfy the IQ prong of an intellectual disability diagnosis. As a result, the contested issue in the case became whether Hill’s adaptive functioning showed sufficient deficits to support a finding of intellectual disability in conjunction with his low IQ. Several experts testified about Hill’s adaptive functioning, and it was noted that the highly structured prison environment was not well adapted to demonstrate his actual ability. Nevertheless, the state courts accepted the conclusions of nonexperts who reported that Hill was not intellectually disabled, based upon their judgment of his adaptive functioning strengths. The 6th Circuit concluded that this was in error because the guidelines for the clinical assessment of intellectual disability focus on assessment of adaptive skill deficits, such as Hill’s inability to learn basic skills and hygiene. In its appeal, the state of Ohio argues that the nonexpert judgments of relative strengths—such as Hill’s record of good behavior in prison—should be accepted by the court, regardless of the guidelines’ focus on the presence of adaptive deficits.
Hill v. Anderson presents a specific question about intellectual disability assessments for forensic practitioners, but it also serves as a reminder for all clinicians to be vigilant in their adherence to published guidelines and best practices. If a guideline or diagnostic criteria calls for the clinician to evaluate a deficit but the clinician conducts an evaluation of strengths, the psychologist should be prepared to justify that decision and cite empirical evidence supporting the consideration of strengths in lieu of evaluation of deficits.
"Judicial Notebook" is a project of APA Div. 9 (Society for the Psychological Study of Social Issues).
