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What do you see as the biggest challenge for you when evaluating an eight-year-old girl with an intellectual disability?

Ed Robson and Daniel Wilcox bring their daughter, Spring Robson-Wilcox, to see you for a psychiatric evaluation. Eight years old, Spring has an intellectual disability and has significant visual impairment. Ed and Daniel adopted her as a baby.
1. What do you see as the biggest challenge for you when evaluating an eight-year-old girl with an intellectual disability?
2. What you would expect relative to the normal intellectual development of an eight-year-old child?