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Profound mental retardation or profound mental handicap (UK) is a designation for those people with the severest reductions in intellectual functioning, those with an IQ of less than 20. Since the diagnosis is not based only on IQ scores, but must also take into consideration the person's adaptive functioning, the diagnosis is not made rigidly. It encompasses intellectual scores, adaptive functioning scores from an adaptive behavior rating scale based on descriptions of known abilities provided by someone familiar with the person, and also the observations of the assessment examiner who is able to find out directly from the person what he or she can understand, communicate, and the like.