Is it possible to discover intellectual disability in adulthood?

March 22, 2025 1:18 AM

I have reasons to believe I have some level of intellectual or learning disability/persistent cognitive impairment, but I’m in my early 30s and not disenfranchised (i.e. I’ve had consistent and lifelong contact with educational and healthcare systems), so is it likely it could have been missed? On the other hand, things like autism, ADHD, and dyscalculia (while not necessarily the same) were apparently severely mis- or undiagnosed for a lot of people who are getting diagnoses as adults, so could this be possible in a similar way?

What are some next steps I could take to get more information on this? I’m really loath to take an IQ test because of my insecurity about my intelligence but if it needs to be done, that’s fine.

Has anyone ever known of someone with mild-moderate intellectual disability who was diagnosed later in life? If you have known someone with intellectual impairment, do my issues seem similar to theirs? I’ll outline some reasons for my suspicions below, but it’s totally fine to answer the question based just on the above, or theoretically.

Reasons I feel I might have some level of cognitive impairment:

(I understand that I don't have major issues with writing/expressing myself in text, so please don't be distracted by this--I believe it's possible to have normal verbal ability despite intellectual impairment).

Academic difficulties: It took me over a decade to graduate from college (I did not have a job or a personal life that interfered with this), and I struggled immensely with most academic concepts (especially in STEM)--I honestly feel like I've understood almost nothing since middle school, and that's when I started to really lag relative to my peers. I will say that I do not believe I had any serious academic issues in elementary school (but there’s a few confounding variables here) or any developmental delays in early childhood. I am taking some courses now and I find I have the same issues that I had when I was younger—I just need way more repetition than my (much younger) classmates to get the concepts to stick and candidly some really fundamental concepts just never have—I notice I have to Google & remind myself of basic definitions etc frequently. I often make mistakes that graders respond to with “???” and they often seem at a loss to deal with my low level of conceptual understanding.

Career difficulties: I have never been able to obtain or succeed in a professional career. I struggled in internships when I was young and got a lot of negative feedback from bosses, and the only long term job I’ve ever held was a remote/text-based customer service position that I got through a friend--truly, anyone could do that job.

General life issues/possible indicators?: I am really immature and have always felt like life just moved too fast for me. I am in my 30s and still have genuinely childish tastes, I’ve never had a romantic relationship and generally have difficulty maintaining friendships and family relationships because people outgrow me. I've always been really gullible and have a hard time rejecting ideas that people dismiss easily--I almost feel like I have no real way of evaluating truth or reality. I just feel like I’m missing something that I really struggle to name and the clinical descriptions of intellectual impairment really ring true for me. I have difficulty with a lot of basic functioning that I'm honestly too embarrassed to describe. I generally feel I have little ability to plan and execute complex tasks, and live a very limited and dependent life as a result.

Other health possibilities: I have been diagnosed with different forms of depression, anxiety disorders and possible cluster C personality disorders have been suggested, but I think these all stem from the underlying issue of poor performance and general incompetence. One provider ruled out ADHD with a computer test that said I was high on impulsivity but didn’t show other indicators. I have done many courses of therapy and tried many psychiatric medications with little-to-no success. I have no trauma history and only mild physical health issues like PCOS/metabolic syndrome and chronic migraine. My parents are highly educated and I had a stable upbringing so those are not factors. Despite those benefits, I was clearly more immature and less successful than my peer group and no matter how much I wanted to catch up, I just wasn't able to do so.

Sorry for the info dump; I’d be interested to hear from anyone with experience in this area! It’s really difficult to find serious information about this issue online—a lot of people discussing their “low IQ” in other forums seem to approach the issue in a very emotional or obsessive way that makes me feel like there are other issues at play.

posted by hejrat to Health & Fitness (20 answers total)

I have taught/parented kids with a range of IQs and learning disabilities mixed in. There is a definite difference in grasping some things - what one kid picks up after a walk through, another took weeks of repetition. It’s also highly variable - one kid who struggles with certain concepts is much faster at new languages, and their math ability had no seeming relationship to language. One kid with a high iq struggles with academics due to other learning disorders.

Which is to say yes, it matters and yes it is only part of the answer because moderate low iq plus strong social and work skills will get you far at school and life. Working memory is important too and hard to compensate for in modern life.

Modern good IQ testing is on about five different domains, measuring various areas. A really useful workup will also check for audio loss, vision issues, and a childhood history to see what else might be going on. It’s NOT a single number.

I encourage you to consider getting evaluated but tell them you DONT want to know the final answer, only which skills and areas need strengthening. That was the most helpful part for us - I could go ok so we can’t do school this way but we can try cuz, and these are the jobs to look into that will do best on their strengths.

I had my iq evaluated and told to me as a kid and have chosen to never tell my kids theirs. It carries too much baggage whichever side you fall on the curve.

And the people I know with moderate low IQs hold down jobs, relationships and parent kids well. They’re not going to do the book-based jobs and they find me and my interests baffling but we are people who love each other and thrive.

You deserve to know and love your brain and thrive too.
posted by dorothyisunderwood at 2:01 AM on March 22 [11 favorites]

Fetal Alcohol Spectrum Disorder (FASD) is massively underdiagnosed in children - it is usually only diagnosed in adults once they end up in jail.

Individuals with FASD will experience some degree of challenges in their daily living, and need support with motor skills, physical health, learning, memory, attention, communication, emotional regulation, and social skills to reach their full potential.
posted by chariot pulled by cassowaries at 2:11 AM on March 22 [5 favorites]

Having also worked in education with a lot of kids and adults, I too have noticed an enormous variety in who "gets" what and how fast. It's extremely fine-grained. People who are overall brilliant will still struggle with some very specific kinds of things, and people who overall seem to just not get things will be extremely quick at getting a few very specific kinds of skills - often ones that many other people have trouble with. And there are no patterns or correlations I've ever been able to pick up on to predict what specific kinds of things people will take to or find impenetrable.

I see this in myself, too.

All of which is to say that IQ testing may or may not pick up on some of what you describe. I don't think it's anywhere near fine-grained enough, but I'm not an expert on IQ tests. I would be very surprised if it picked up on all of it.

(Speaking of variable and specific skills, for whatever it's worth, I find your writing is more fluid and lucid, and far more organized and considerate of the reader, than most people's. Producing that kind of writing takes a number of skills and types of thinking, some or all of which I've needed to spend a lot of time working on with most people who've come to me. These are mostly professionally successful adults you'd probably assume already know how to write like that.)
posted by trig at 3:12 AM on March 22 [17 favorites]

I'll add that most people I've worked with have had very little insight regarding the very specific skills they have trouble with; they've gone through school, college, and often grad school without identifying them or having them identified by others. (Mostly they're just able to compensate to a workable extent with other skills.) Some of them have been diagnosed with ADHD or dyslexia and believe everything stems from that, but based on what I've seen with other people (both with and without those diagnoses) I think it's much more complex than that, and sometimes unrelated. I've also seen a lot of people online (i.e. not people I've worked with personally) ascribing many of the kinds of difficulties you describe to autism. Which I'm prone to seeing as another overly-simplistic approach of ascribing everything to a single cause, but who knows.

I think we're still at very early stages of understanding intelligence in general. I think both that an assessment today might lead to a diagnosis for you, and that it's not unlikely that an assessment a few decades from now might lead to a different or additional one.

I'll also add that assessments in general are still quite variable. I once went through two separate assessments for ADHD: one concluded I had a severe case, and the other concluded I didn't have it at all. I was shocked at the time; I'd thought there was some kind of clear (and accurate) universal standard.
posted by trig at 3:31 AM on March 22 [7 favorites]

What are some next steps I could take to get more information on this?

Ask your primary care doctor for a referral to a psychologist or neurospychologist who specializes in learning disability assessment. Getting a diagnosis either way can be helpful for various reasons. If you do have a learning disability, diagnosiing it can be helpful, from seeking accommodations, to affirming for yourself that your struggles come from a condition that isn't your fault. And it's definitely possible to have a variety of learning disabilities that slipped through the cracks especially for the kind that don't impact your verbal skills. Good luck!
posted by ojocaliente at 5:56 AM on March 22 [6 favorites]

I would not worry about your general IQ. Anyone can have a large vocabulary, but amazingly few can string together sentences and paragraphs into a cogent essay. Your presentation and the ideas you are considering stand out from the general population.

That said, it is possible that you are slow in some regards. I have a niece who would be considered slow in many ways, but she’ll kick your ass at a game of chess. It will just take her a long while to make her moves.

In my own life, people seem to believe I’m intelligent but the last few years have rammed home for me just how unfit I am for learning languages. What other people learn in two months takes me a year. I get flustered almost immediately when I try to speak. If I didn’t have a very good reason to learn a language right now I would’ve dropped this grind a long time ago.

Just to put the issue to bed I would follow the advice above and talk to a neuropsychologist.

————

On the topic of enjoying “childish” things, there is little sadder to me than someone who truly enjoys an activity and then later develops scorn for it. Life is about finding new things to enjoy, not rejecting old ones. For most people there is little enough pleasure in life to make throwing any of it away anything less than a tragedy.
posted by Tell Me No Lies at 6:55 AM on March 22 [2 favorites]

IQ is NOT Intelligence and Neither Are Other Test Scores There are many resources that show the problems with IQ tests, but this is a decent place to start.
posted by Ookseer at 8:02 AM on March 22 [2 favorites]

Definitely sounds like ADHD/ASD/AuDHD etc. My husband is exactly the same (apart from the romantic relationship part).
posted by low_horrible_immoral at 8:09 AM on March 22 [1 favorite]

This sounds like you might benefit from a neuropsychological exam. These are usually thought of as tools used to help parents and school systems evaluate children, but they can also be helpful for adults.

In my experience, some neuropsychological practitioners think of the exams primarily as a way to get special services. "The parent wants me to document the fact that there is a deficit." On the other hand, there are practitioners who can provide a very thoughtful, insightful, actionable profile of strengths and deficits.

They aren't cheap, and insurance often won't cover them. But I think this is the sort of thing you're looking for. Here's some info on neuropsychological testing for adults.

Good luck to you.
posted by Winnie the Proust at 8:37 AM on March 22 [5 favorites]

Feeling gullible/naive/childish with poor executive functioning and struggling to hold down jobs is a pretty common experience for autistic people, even ones with average or above-average IQ scores and strong skills elsewhere.

This isn't the only thing it could be, but if someone said they were autistic and then described the same experiences as you, I'd be completely unsurprised.
posted by BungaDunga at 8:42 AM on March 22 [6 favorites]

affirming for yourself that your struggles come from a condition that isn't your fault

One way or another, whatever testing shows or fails to, something being harder for you than other people is not your fault. Or any reflection of worth or moral value.

I know it can be easier to believe this when there's an official result saying it, but know that it's true even if an official result fails to say it.
posted by trig at 8:42 AM on March 22 [17 favorites]

Although this doesn’t seem like the right fit for you, I have heard of several instances where adults were diagnosed with Williams Syndrome quite late in life (30s-50s), despite having lived in nominally caring family environments (ie no enormous neglect). This is considered actually quite a severe intellectual disability but folks with strengths in key areas and without a few key indicators can be missed for decades.
posted by samthemander at 8:49 AM on March 22 [1 favorite]

The other reason autism comes to mind is: you have highly educated parents? That's... well, that's not proof of anything. But certain manifestations of autism are really compatible with excelling academically. Others, obviously, aren't. And autism is known to be heritable, it runs in families.
posted by BungaDunga at 8:50 AM on March 22

It is possible to discover it in adulthood, yes. Most of us were entirely at the mercy of our school districts, good or bad, for childhood identification and assessment.

Neurologist first, then you can go to a psychiatrist for assessment for spectrum disorders. Either might refer you on to a Speech and Language pathologist for learning disability assessment. Someone above suggested a neuropsychologist, that's probably not a terrible idea if you can find one, but in a lot of states only a psychiatrist MD or NP can do the formal testing.

I know you've been through testing before, but there's a lot of sexism in the field so I recommend you find someone who's making a point of inclusivity.
posted by Lyn Never at 9:24 AM on March 22

Yes!

Once you're an adult, it is easy for neurospicy and similar conditions to continue to be undiagnosed because: 1) many adults have learned coping strategies for managing and masking conditions that they may be unaware of, just to get through the day, and 2) doctors don't normally see things unless they are part of a normal annual checkup, or the patient brings it up.
posted by zippy at 2:26 PM on March 22

If you're interested in checking out the autism angle, it is SO commonly undiagnosed or misdiagnosed (as anxiety, depression, borderline, bipolar) that 80% of adult women in the U.S. who fit the criteria do not know they are autistic. That's a tragedy, in my opinion, because having an operator's manual for how you work is crucial in crafting a life that works for you.

Do you see yourself in any of these links?

Embrace Autism: quizzes and blog
Autistic anxiety vs. neurotypical anxiety
Samantha Craft's Autistic Traits Checklist
Tania Marshall's Moving Toward a Female Profile of Autism
Why are high-masking adults overlooked?

Note: Most high-masking autistic people are also ADHD ("AuDHD"). We tend to have high levels of anxiety, depression and complex attachment trauma because it is so difficult fitting into a world that isn't made for us. If you see a professional for a differential evaluation, make sure they are neurodiversity-affirming and know something about how these neurotypes look in adults!
posted by lloquat at 3:41 PM on March 22 [4 favorites]

There are a surprising number of people who only discover they have Mosaic Down Syndrome as adults, since the presentation is not the stereotype of DS at all. I mean sure it could be ARND (the pregnancy related alcohol syndrome with which you are most likely to have made it to adulthood without being diagnosed) or autism too but literally everyone is just guessing here. This is absolutely something you can talk to your Primary Care physician about to start screenings. I don't know but I would imagine screening is the easiest to start with, because unlike autism it's not a subjective diagnostic process.
posted by DarlingBri at 7:49 AM on March 23

I think that the poor executive function, difficulty concentrating, overwhelm and communication difficulties that present in autism can definitely seem and feel and maybe look like intellectual disability or learning disability and NOT be. It’s really difficult to meet what would be your full potential when you haven’t been able to fully take on board all the information, process it or reform it into your own ideas about it that other people understand when those first things I mentioned aren’t working right.

My son has autism and had an iq test when he was 5 or 6… one therapist thought he was a complete stunted write off and he had a report written about him that made him sound like… i don’t Know… not full of potential. I ran the report by a different professional I trusted and she explained it: look at it like a computer, he has the hardware (normal cognitive ability), but because of the other developmental stuff, the software is glitching… or something like that. Anyway, i wasn’t sure for a long time how he would get on and he’s a lot slower than my other child but it’s clear he’s cognitively able but there are just other barriers.

My point is that our perceptions of intelligence and disabilities can be really messed up.

Also learning difficulties and learning disabilities are two different things.

I worked part time once in a home for moderate learning disabilities and I was really surprised how disabled or different a moderately learning disabled person was from me. You may be surprised as well. I would have thought before they just had a hard time learning games or grocery shopping, no, it’s far more than that.

A person with mild learning disability might not be able to learn how to use a phone no matter how many times you show them or what kind of ways you teach it. A person with a learning difficulty would probably eventually be able to learn it with the right support.

Autism can overlap with learning difficulties (and intellectual disability)

Another task like going to the grocery store with a 5 item list might be or not be manageable to either person but for different reasons.

I almost think they need a new name for autism in women because it’s just so different than it is in boys that I think it makes women really confused. I’m not sure if anyone agrees with me about that… but that part you said about feeling like a little girl or girlish is something so many autistic women describe.
posted by flink at 7:54 AM on March 23

I want to point out as well- your understanding of yourself as girlish or having tastes more suiting a younger girl, that idea shows conceptual awareness which is a component of intelligence in the tests- you understand a concept, you’re taking it, processing it and applying it to yourself. It’s abstract/conceptual awareness. I am not your doctor or psychiatrist but I’m not sure you could do that with an actual technical mild impairment, even if you aren’t as smart as you wish. I Know I wish I was smarter!
posted by flink at 8:02 AM on March 23

Looking at your previous asks, I see that at various times you've been convinced you're objectively ugly, that you're a failure, that you're lazy, that you have no personality, that you're immature... and now you think you must have an intellectual disability of some kind. Look, I don't know you, but I really doubt you're anywhere near as awful as you seem to think. Your self-esteem is just in the crapper, you poor thing.

I suspect that when you were growing up you were fed a lot of toxic BS about how worthless you were, and maybe you internalized it to the point that you don't even question it now. You talk about your family "outgrowing" you, and... that's not really how family is supposed to work. You say you had a stable upbringing, but was it merely stable in the sense that you were fed and housed, or did you also feel cared for? Or maybe you were bullied terribly at school, or by a sibling. Somebody somewhere convinced you that you act wrong and look wrong and think wrong and you're just wrong, wrong, wrong. But they were wrong.

That voice in your head, the one that says you deserve to suffer like this? It's a fucking liar.
posted by Ursula Hitler at 10:53 PM on March 23 [1 favorite]