Cited by 148Down syndrome and intellectual disability researchGenetics and Neurodevelopmental DisordersCognitive Abilities and Testing

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Improving IQ measurement in intellectual disabilities using true deviation from population norms

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Sansone, Stephanie M, Schneider, Andrea, Bickel, Erika, Berry-Kravis, Elizabeth, Prescott, Christina, Hessl, David·2014·Journal of Neurodevelopmental Disorders

DOI 10.1186/1866-1955-6-16PMC PMC4613563

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Abstract

BACKGROUND: Intellectual disability (ID) is characterized by global cognitive deficits, yet the very IQ tests used to assess ID have limited range and precision in this population, especially for more impaired individuals. METHODS: We describe the development and validation of a method of raw z-score transformation (based on general population norms) that ameliorates floor effects and improves the precision of IQ measurement in ID using the Stanford Binet 5 (SB5) in fragile X syndrome (FXS; n = 106), the leading inherited cause of ID, and in individuals with idiopathic autism spectrum disorder (ASD; n = 205). We compared the distributional characteristics and Q-Q plots from the standardized scores with the deviation z-scores. Additionally, we examined the relationship between both scoring methods and multiple criterion measures. RESULTS: We found evidence that substantial and meaningful variation in cognitive ability on standardized IQ tests among individuals with ID is lost when converting raw scores to standardized scaled, index and IQ scores. Use of the deviation z- score method rectifies this problem, and accounts for significant additional variance in criterion validation measures, above and beyond the usual IQ scores. Additionally, individual and group-level cognitive strengths and weaknesses are recovered using deviation scores. CONCLUSION: Traditional methods for generating IQ scores in lower functioning individuals with ID are inaccurate and inadequate, leading to erroneously flat profiles. However assessment of cognitive abilities is substantially improved by measuring true deviation in performance from standardization sample norms. This work has important implications for standardized test development, clinical assessment, and research for which IQ is an important measure of interest in individuals with neurodevelopmental disorders and other forms of cognitive impairment.

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Figure 1 Quantile-quantile (Q-Q) plot of the standardized and deviation intelligence quotient (IQ scores). Open circles represent the actual data points. The solid, diagonal red line is the reference line for the expected, normal distribution. The dotted lines represent the upper and lower bounds of the 95% confidence interval. EXIQ, Extended IQ; FSIQ, Full Scale IQ; NVIQ, Non-verbal IQ; VIQ, Verbal IQ. For the EXIQ plot, standard Full Scale IQ is shown above IQ = 40 for presentation and plotting purposes.CC BY · PubMed Central

Figure 2 Bivariate association of deviation and standardized IQ scores with their corresponding criterion measures with marginal boxplots. EXIQ, Extended IQ; FSIQ, Full Scale IQ; NVIQ, Non-verbal IQ; PPVT, Peabody Picture Vocabulary Test; VABC, Vineland Adaptive Behavior Composite; VIQ, Verbal IQ.CC BY · PubMed Central

Figure 3 Subtest raw scores (open triangles), standardized scores (closed circles), and deviation (z) scores (closed squares) for two case examples. FR, fluid reasoning; KN, knowledge; NV, non-verbal; QR, quantitative reasoning; V, verbal; VS, visual spatial processing; WM, working memory.CC BY · PubMed Central

Figure 4 Profile of standardized and deviation (z) subtest scores by diagnosis group (mean ± SD). FR, fluid reasoning; KN, knowledge; NV, non-verbal; QR, quantitative reasoning; V, verbal; VS, visual spatial processing; WM, working memory.CC BY · PubMed Central

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Authors: Sansone, S. M., Schneider, A., Bickel, E., Berry-Kravis, E., Prescott, C., & Hessl, D.
Affiliations: University of California Davis Medical Center (US)
Rush University Medical Center (US)
Corresponding author: Hessl, David
ORCID: Schneider, Andrea
Hessl, David
Venue: Journal of Neurodevelopmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2014-07-08
Volume: 6
Issue: 1
Pages: 16-16
ISSN: 1866-1947 (ISSN-L)
1866-1955
DOI: 10.1186/1866-1955-6-16
PMC: PMC4613563
OpenAlex: W2122684341
Cited by: 148
References: 34
Citations by year: 2026: 5 · 2025: 15 · 2024: 14 · 2023: 19 · 2022: 26 · 2021: 24 · 2020: 17 · 2019: 13 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 3
FWCI: 3.98
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Neurodevelopmental Disorders (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders: Autism Speaks
National Fragile X Foundation
University of California, Davis
National Institute of Mental Health (U24MH081810)
University of California Davis School of Medicine
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
Keywords: intellectual disability, IQ assessment, floor effect, fragile X syndrome, autism spectrum disorder, neurodevelopmental disorders

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Improving IQ measurement in intellectual disabilities using true deviation from population norms

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