• diagnosis;
  • mental retardation;
  • cultural values

Purpose: To describe the new definition of mental retardation developed by the American Association of Mental Retardation (AAMR) published in 1992. The previous definition was based on a deficiency model that identified “subaverage intelligence” using an intelligence quotient (IQ) score equal to or less than 70. The new definition places greater emphasis on adaptive skills and environmental support needs.

Scope: Defining mental retardation according to AAMR criteria reflects a significant paradigm shift from an absolute trait to a functional conception. The new definition is dynamic, attends to context, is inherently holistic—and, therefore—closely aligned with nursing theory. Diagnosis is a three-step process by which functional strengths and weaknesses are identified along 4 dimensions and 10 adaptive-skill areas. Identification of needed supports is incorporated within the three-step process.

Conclusions: Nurses can enhance holistic care by working to have AAMR's new definition adopted by government legislators and administrators of state and county agencies that provide mental-retardation services. Nurses should become active participants as interdisciplinary diagnostic team members as well as case managers. Nurse researchers and educators can contribute toward further developing AAMR's definition by standardizing assessment instruments, working to make diagnostic procedures more user-friendly, and researching the construct validity of adaptive-skill areas. Finally, nurses should help legislators and policy makers understand the sociocultural ramifications of AAMR's new definition.