Workforce Challenges & DDS Waiver Services Analysis
Modernizing the DD Definition to Recognize Adaptive Social Deficits
•
•
.
.
FUTURE STATE
Update definition of developmental disability to match AAIDD, DSM-5, & ICD-11 definition.
Continue to require that a person meet at least 3 functional limitations.
Add requirement that functional limitations cross two adaptive areas.
North Dakota currently uses the federal definition of developmental disability from the Developmental Disabilities
Assistance and Bill of Rights Act of 2000 as part of determining eligibility for services. The definition aligns major life
activities with adaptive deficits that are conceptual: receptive and expressive language, learning, and self-direction; and
practical: self-care, mobility, capacity of independent living, and economic self-sufficiency.
The AAIDD, DSM-5, and ICD-11 definitions also consider adaptive deficits in social functioning. Examples include:
interpersonal skills, social responsibility, self-esteem, gullibility, naïveté (i.e., wariness), social problem solving, and the
ability to follow rules/obey laws and to avoid being victimized.
A&M recommends modernizing the statutory definition of developmental disability and, accordingly, level of care, to align
with these more modern definitions, requiring significant functional limitations in two of the following three areas of
adaptive functioning: conceptual, social, and practical.
Examples of peer states that use all three categories of adaptive deficits include: Nebraska, Iowa, Kansas, and South
Dakota.
26
ALVAREZ & MARSAL
LEADERSHIP ACTION. RESULTS.View entire presentation