Should we use the term mental retardation (MR) or intellectual disability (ID) in clinical documentation?

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Last updated: February 16, 2026View editorial policy

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Use "Intellectual Disability (ID)" in All Clinical Documentation

Clinicians should use the term "Intellectual Disability (Intellectual Developmental Disorder)" or ID/IDD in all clinical documentation, as "mental retardation" was officially replaced by the American Psychiatric Association in DSM-5 (2013) and is no longer acceptable terminology. 1

Official Terminology Standards

The terminology change reflects both modern understanding and the explicit goal of reducing stigma:

  • The American Psychiatric Association adopted "Intellectual Disability (Intellectual Developmental Disorder)" as the official diagnostic term in DSM-5, completely replacing "mental retardation" 2, 1
  • The American Association on Intellectual and Developmental Disabilities (AAIDD) initiated this paradigm shift in 1992, emphasizing the disability construct rather than a fixed deficit 1
  • The World Health Organization adopted "intellectual developmental disorders" as preferred terminology, recognizing these as neurodevelopmental disorders occurring during the developmental period 1

Required Language Framework

When documenting, you must use person-first language:

  • State "a person with intellectual disability" rather than labeling the individual by their condition 1
  • This approach is mandated by the American Academy of Child and Adolescent Psychiatry practice parameters 2, 1

Age-Specific Terminology Distinctions

The terminology varies based on the child's age and assessment feasibility:

  • Under age 5: Use "Global Developmental Delay" when clinical severity cannot be reliably assessed 2, 1
  • Over age 5 with assessment difficulties: Use "Unspecified Intellectual Disability (Intellectual Developmental Disorder)" when other impairments make assessment difficult 2, 1
  • Standard cases: Use "Intellectual Disability (Intellectual Developmental Disorder)" or ID/IDD 2, 1

Historical Context for Understanding the Change

The evolution of terminology reflects society's changing perception:

  • "Mental retardation" was itself introduced in 1961 to replace earlier pejorative terms 1
  • The shift to "intellectual disability" represents not just semantic change but a fundamental reconceptualization from a fixed deficit model to a disability construct that emphasizes support needs 1, 3
  • The change also modified diagnostic criteria, moving away from IQ predominance toward broader clinical criteria, neuropsychological evaluation, and daily functioning assessment 3

Common Pitfall to Avoid

Never use "mental retardation" or "MR" in any clinical documentation, verbal communication with families, or professional correspondence. This term is outdated, stigmatizing, and no longer reflects current diagnostic standards 2, 1. The only acceptable abbreviation is ID/IDD for Intellectual Disability (Intellectual Developmental Disorder) 2, 1.

References

Guideline

Intellectual Disability Terminology

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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