How do people with low IQs (≤80) perceive things in everyday life?

Many years ago, one of my husband’s patients asked us to employ her niece. I didn’t realise at the time, but she has serious learning difficulties.

I don’t know (or care) what her IQ is (and as everyone has already pointed out, IQ tests are flawed), but given that they measure logic, spacial recognition and memory, I’m sure that if she were to do one, she’d score extremely low.

She was taken by her family to numerous doctors when she failed to develop normally. She doesn’t have any specific pathology, but can’t understand or learn things easily. She struggled to learn to read when she was in her twenties. She told me that she used to be too afraid to answer the phone, make a phone call, or catch a bus.

The worst part of life for her seems to be her lack of self-confidence and fear of anything new. Her sense of logic is about the same as a that of a 4 year-old. She’s very emotional about things which wouldn’t worry most of us. She depends on her Catholic faith to make sense of the world.

She’s now worked for us for over 20 years and is hard-working, and reliable. She’s most comfortable when she has a routine; answering the phone, looking after the house and family when I am not home, cooking and cleaning. She couldn’t do much of this when she first came, but with time (and patience) she has increased her skills. She has also grown in confidence, as being the employee in the doctor’s house gives her a certain status in this small, rural town.

She knows that she forgets things and gets confused, and blames it on her “poor little head.” However, not having any sense of logic, she seems to have no perception of how illogical she is. For example, one day, we ran out of cardboard boxes which we were using for packing china, so I asked her to get some similar ones from the local supermarket. Some time later, she returned dragging an enormous fridge box. It was far bigger than her (she’s not very tall), and even bigger than me (and I’m quite tall). It was hilarious, and I asked her how we could put the china in the box, whether we should toss it in like a basket ball. She didn’t seem to understand, and was quite upset at having to return the box. As funny as it seemed to me (and I’m careful not to laugh at her), I had to realise that she really hadn’t been able to work it out.

She tends to react like a child in many ways. If she pours liquid from a tall thin receptacle to shorter wider one, she thinks the quantity has changed. She thinks that I can see what she can see; when I saw that the iron temperature was too high, I warned her about it. While looking at me, she turned the dial down with her thumb, and said “no, it’s already low, look!”

If she breaks a plate (which I think is a normal thing to happen, and I have never blamed her for it), she tends to hide the evidence and lie about it. If something happens to disturb her routine she cannot adjust.

It’s easy to make her laugh with very simple jokes. This is useful when she’s getting upset about something unimportant (like breaking a plate).

And yet she is an incredibly loyal, hard-working, reliable lady. She’s clearly and obviously happy, and tells me that she is. She is capable of looking after herself, catching a bus, keeping her house clean and tidy (though her nearby family keep a close eye on her).

I cannot say that she’s typical of people with low intelligence, but I have learned from her something about how the world seems from her perspective.

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