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Estimates of the prevalence of psychiatric disorders in individuals with intellectual impairments range from 10% to 39% (Borthwick-Duffy 1994; Bouras and Drummond 1992). In children and adolescents with intellectual disabilities, emotional and behavioral problems are 3–7 times higher than in typically developing youth (Dykens 2000). Symptoms of psychiatric disorders are often attributed to the intellectual disability rather than recognized as comorbid psychiatric symptomatology. Additionally, some mental health conditions manifest differently in individuals with intellectual disabilities than they do in the general population (e.g., psychotic features may be more frequent symptoms of depression in individuals with intellectual impairments). These difficulties are exacerbated in individuals with severe forms of intellectual disability because of their limited communication skills and bland symptomatology known as psychosocial masking (Kerker et al. 2004).

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