Cognitive Assessment: Perspectives from Adults with Intellectual Disability

Cognitive assessment is frequently used in the process of the diagnosis of intellectual disability (ID) in adults. However, there is little known about the subjective experience and discourses surrounding this process of assessment. This study therefore aims to explore this experience, and the specific discursive devices utilised by people when describing the experience, from the perspective of adults with ID. Information was gathered using semi-structured interviews with four clients with a recently diagnosed ID. These were analysed using both Interpretative Phenomenological Analysis (IPA) and Discourse Analysis (DA), to examine various aspects of discourse alongside the phenomenological experience.
The IPA results highlighted a variety of experiences that participants had and suggested that they did not experience their tests as emotionally neutral. For example, participants described experiences of disconnected services, namely through having seen various professionals over the assessment period, having experienced multiple similar types of assessment over their lifetime, and through experiencing poor communication from services. Participants experienced their assessors as being nice, empathetic, and listening to them, and were left with a feeling of hope that they would get support. However, there was also confusion about the purpose of the assessment and surrounding what the outcomes would be. DA results examined the language and discursive devices used by participants within the discussions about their experience. This latter part of the analysis revealed four main themes, namely surrounding the system holding the power, reliance on others, resilience, and having to do something versus choosing to do it.
The results of this study are considered in the context of the surrounding literature. Potential implications and suggestions for future research are also discussed.