Quantitative assessment of sexual knowledge and consent capacity in people with mild to moderate intellectual disability

While it is well known that people with an intellectual disability experience the same needs for intimacy as those without an intellectual disability, a number of developmental, structural, environmental, and attitudinal barriers circumvent the expression of sexuality in people with an intellectual disability - particularly in institutional and residential health care settings. People with an intellectual disability generally have lower levels of sexual knowledge than those without an intellectual disability, and sexual exploration and expression is frequently viewed with concern by mental health care practitioners and caregivers, who may regard people with an intellectual disability as being 'nonsexual' or 'hypersexual'. However, the rights of people with an intellectual disability to sexual expression have been established in policy and legislation. Service providers are required at times to make determinations regarding the ability of people with an intellectual disability to consent to sexual intercourse in a number of health care settings. There is a dearth of published literature on psychometric instruments to assess sexual knowledge and consent capacity. This article briefly reviews the more commonly used sexual knowledge and consent assessments for people with mild to moderate intellectual disability and advances recommendations in this regard.