Opinion ID: 3187215
Heading Depth: 1
Heading Rank: 10

Heading: intellectual disability claim

Text: A. District Court Finds that Ledford is Not Intellectually Disabled On March 19, 2008, the district court issued a 30-page order finding, by a preponderance of the evidence,13 that Ledford is not mentally retarded. The district court reviewed de novo whether Ledford was mentally retarded, based on the evidence presented at the evidentiary hearing. The district court recounted all of Ledford’s IQ test results as follows: (1) Dr. Herendeen’s 1992 Shipley Scale, on which Ledford scored an 85; (2) Dr. Perri’s 1992 WAIS-R, on which Ledford scored a 77; (3) the 1992 prison psychologist-administered Culture Fair, on which Ledford scored an 86; (4) Dr. Zimmerman’s 1998 Kaufman, on which Ledford scored a 66; (5) Dr. Zimmerman’s 1998 WAIS-III, on which Ledford scored a 69; and (6) Dr. King’s 2007 WAIS-III, on which Ledford scored a 79. The district court disregarded the Shipley Scale (85) and Culture Fair (86) based on the experts’ testimony regarding the unreliability of those tests. It disregarded Dr. Zimmerman’s tests of the 1998 Kaufman (66) and WAIS-III (69) on the grounds that “it [was] impossible to verify the accuracy or reliability of the scores” because (1) the written portion of the test administered was illegible, 13 Under Georgia law, a petitioner is required to prove his mental retardation “beyond a reasonable doubt.” See Ga. Code Ann. § 17-7-131(c)(3). The district court rejected Ledford’s argument that Georgia’s standard is unconstitutional. Nevertheless, the district court first considered whether Ledford proved his mental retardation by a preponderance of the evidence, and since he could not prove it by that preponderance standard, then he necessarily could not meet the reasonable doubt standard. Because the district court used the preponderance of the evidence standard, there is no issue raised in this appeal as to the reasonable doubt standard. 50 Case: 14-15650 Date Filed: 03/21/2016 Page: 51 of 103 (2) portions of the tests were missing pages, and (3) several of Ledford’s responses were not recorded, including mandatory “query” questions that are required for accurate IQ scoring. The district court found that Dr. Zimmerman’s crossexamination testimony suggested that he mis-scored several items. But for those scoring mistakes, Ledford’s IQ score would have been higher. The district court found that these scoring errors were significant considering that Ledford’s 69 on the WAIS-III was just below the level generally considered to indicate mental retardation. The district court pointed out Dr. Zimmerman’s acknowledgment that it was “extremely” difficult for him to read the responses that he did record. On the other hand, the district court found Dr. King’s testimony credible. The district court found that the IQ score obtained by Dr. King’s test (79) was within a few points of Dr. Perri’s 1992 test (77), and Dr. King explained his methodology in detail. The district court credited Dr. Perri’s score because (1) he was court-appointed with no discernable bias or interest in the case and (2) neither party presented evidence to suggest that Dr. Perri’s evaluation was not reliable or accurate. Accordingly, the district court credited only Ledford’s scores of 77 and 79. The district court was “not impressed” by Ledford’s evidence concerning the Flynn effect. The district court found that Dr. Zimmerman (Ledford’s expert) and Dr. King (the state’s expert) both agreed that the Flynn effect was not used in 51 Case: 14-15650 Date Filed: 03/21/2016 Page: 52 of 103 clinical practice to reduce IQ scores, and neither had seen the Flynn effect applied to IQ scores outside the context of capital litigation. The district court noted that, according to an article by Dr. Flynn and testimony by Dr. Tasse, the Flynn effect may not apply to the WAIS-III test, and, if it does, the suggested yearly gain is closer to 0.17 points than 0.3 points. The district court found that even if Ledford’s scores were subject to the full force of the Flynn effect, a four-point deduction would yield scores of 73 and 75, which are still above the level generally considered indicative of “significantly subaverage” intellectual functioning under Georgia law. Similarly, the district court found that Ledford’s measurement-error argument—that the standard error of measurement places him within the “range” of a mentally retarded person—failed. The district court recognized that the standard error of measurement is a “generally accepted scientific concept.” The district court, however, observed that the standard error of measurement means that an IQ score can overestimate or underestimate a person’s true level of intellectual functioning. It found “no basis for assuming that the standard error of measurement lowered [Ledford’s] score enough to meet Georgia’s mental retardation standard.” It explained that Ledford’s IQ “could just as likely be 80 as 68” and that Ledford’s “IQ score is more likely than not above 70.” 52 Case: 14-15650 Date Filed: 03/21/2016 Page: 53 of 103 In addition, the district court found that measurement error is more of a factor when only a single IQ test is given and that Ledford’s score of 79 on Dr. Perri’s test corroborated his score of 77 on Dr. King’s test, which “reduce[d] the likely impact of the standard error of measurement,” stating: [T]here is evidence that measurement error is more of a factor when only one IQ test is given. Specifically, Flynn notes that the possibility of measurement error is “much reduced” when more than one IQ test is given and the scores corroborate each other. (Tethering the Elephant at 186.) In this case, petitioner received a 77 on the WAIS- R administered by Dr. Perri in 1992 and a 79 on the WAIS-III administered by Dr. King in 2007. These two scores corroborate each other, and thus reduce the likely impact of the standard error of measurement. “[E]ven applying the Flynn effect” and “factoring in the possibility of measurement error,” the district court found that Ledford did not prove, by a preponderance of the evidence, that he suffered from “significantly subaverage intellectual functioning.” The district court found that Ledford also failed to prove, by a preponderance of the evidence, that his impairments in intellectual functioning “resulted in” or are “associated with” deficits in adaptive behavior. As to academics, the district court noted that “[n]one of the experts addressed the specific meaning of ‘functional academics.’” The district court reasoned that “if functional academics refers to basic literacy and numeracy skills sufficient to 53 Case: 14-15650 Date Filed: 03/21/2016 Page: 54 of 103 function in the world, the evidence does not support a diagnosis of mental retardation” because: (1) After administering the WRAT-4, Dr. King determined that Ledford “possessed adequate literacy skills with some specific difficulty in arithmetic, where he functions below what would ordinarily be expected”; (2) Dr. King testified that Ledford “knew: Einstein was associated with the Theory of Relativity; the President during the Civil War; the capital of Italy; what is the Koran; and the population of the world,” and in Dr. King’s opinion, these were not the responses of a mentally retarded person; (3) The standardized achievement test results in Ledford’s school records indicated that he “was reading and performing mathematics on a fourth grade level when he was in the fifth grade”; (4) While Ledford’s performance on those tests was “generally below average, it was not two standard deviations below the norm”; and (5) Ledford instead generally scored “between the 10th and the 20th percentiles, with the exception of math computation, in which he scored between the 1st and 10th percentiles, and capitalization and punctuation in which he scored between the 40th and 70th percentiles.” On the other hand, the district court observed that if “functional academics” refers to school performance, Ledford had “presented substantial evidence that he 54 Case: 14-15650 Date Filed: 03/21/2016 Page: 55 of 103 functioned significantly below the norm in this domain.” Several of his former teachers testified that he had difficulty doing school work, even when he tried. They uniformly testified that he was below grade level in almost every subject. His school records show that he failed first and third grades. He tried twice to complete the ninth grade, but dropped out both times because of failing grades. He had “particular difficulty with math and reading.” The district court said: “Based on the substantial evidence concerning petitioner’s problems functioning in school, the Court will assume that petitioner has demonstrated deficits in the area of functional academics.” The district court then found that Ledford did not suffer from deficits in the areas of work and self-direction. As to his work history, the district court found that Ledford’s former employers testified that he was a good employee who followed directions and performed well at assigned tasks. Employer Wilson said Ledford worked hard and was a good employee. Employer Cooper described Ledford as full of energy and ready to work and was glad to have Ledford as an employee. The district court observed that Ledford did not have a mature work history, which negated the importance of his performing only unskilled labor. It found that Ledford’s inability to keep a job was more a function of his drug and alcohol abuse, rather than some deficit in adaptive functioning. The court also determined that Ledford’s failure to save money and set life goals was a function 55 Case: 14-15650 Date Filed: 03/21/2016 Page: 56 of 103 of his young age in his late teens, and not of some significant deficit in the area of self-direction. The district court found that Ledford’s performance on two standardized measures of adaptive functioning did not reveal any significant deficit in adaptive behavior. Dr. King’s Adaptive Behavior Assessment System test placed Ledford in the low-average range of functioning, which corresponded with his IQ scores. Dr. King opined that Ledford did not have the requisite adaptive functioning deficits to be diagnosed as mentally retarded. While Dr. Zimmerman’s administration of the Vineland test on Ledford’s sister indicated significant deficits, Dr. Zimmerman conceded that her Vineland responses conflicted with record evidence establishing the contrary. B. In 2014, District Court Denies Ledford’s Motion to Reconsider On November 6, 2012, Ledford filed a motion to reconsider the district court’s March 2008 intellectual disability ruling. Ledford argued that, in the intervening four years, judicial opinions and medical authorities confirmed that both the Flynn effect and the standard error of measurement must be taken into account in determining whether an IQ test establishes significantly subaverage intellectual functioning. In a February 27, 2014 order, the district court denied Ledford’s motion to reconsider. After reviewing the cases cited by Ledford, the district court remained 56 Case: 14-15650 Date Filed: 03/21/2016 Page: 57 of 103 unconvinced that it must apply the Flynn Effect to reduce Ledford’s IQ scores. The district court noted that the Flynn effect was “gaining traction with some courts,” while other courts “continued to reject the practice.” “Given the prevailing uncertainty in the law,” the district court remained “hesitant to apply” the Flynn effect.14 Though the district court remained unconvinced that the Flynn effect must be used to reduce Ledford’s credible IQ scores, it nevertheless was “willing to investigate whether application of the Flynn Effect to [Ledford’s] IQ scores would have a material impact on the ultimate issue of whether [Ledford] is mentally retarded.” Accordingly, the district court afforded Ledford’s credible IQ scores (77 and 79) full four-point reductions, yielding scores of 73 and 75, and noted that those scores were “still above the score of 70 that is generally considered to demonstrate ‘significantly subaverage’ intellectual functioning under Georgia law.” The district court then considered whether the standard error of measurement would bring Ledford’s Flynn-adjusted scores into the range of significantly subaverage intellectual functioning. The court acknowledged that other states had set the benchmark for significantly subaverage intellectual 14 The district court acknowledged this Court’s opinion in Thomas v. Allen, 607 F.3d 749 (11th Cir. 2010), where we held that a district court’s application of the Flynn effect to reduce a petitioner’s IQ score did not amount to clear error. The district court correctly noted, however, that Thomas did “not mandate[] [the Flynn effect’s] application.” 57 Case: 14-15650 Date Filed: 03/21/2016 Page: 58 of 103 functioning at an IQ score of 75 to account for the standard error of measurement. However, the district court iterated that the standard error of measurement “merely provides a range within which [Ledford’s] IQ might be somewhat higher or lower than the score he achieved.” Thus, according to the court, “[Ledford’s] IQ is just as likely to be 78 or 80 rather than 68 or 70.” It cited expert testimony that the potential for measurement error was “much reduced” due to Ledford’s corroborating credible IQ scores of 77 and 79. The district court also revisited the adaptive functioning prong of its intellectual disability findings and again concluded that Ledford did not suffer from an adaptive deficit in the area of work. According to the court, while Ledford “was not a highly accomplished individual before his incarceration,” he nevertheless was a “good employee” who was “full of energy and ready to work.” Finally, the district court noted that the U.S. Supreme Court had granted certiorari in Hall v. Florida, 572 U.S. ___, 134 S. Ct. 1986 (2014), 15 a case involving Florida’s strict IQ cutoff law that potentially implicated the standard error of measurement issue. In contrast to Hall, the district court stressed that it had “not appl[ied] a bright-line IQ score cut-off of 70, but rather considered all of the evidence to determine that [Ledford] did not demonstrate ‘significantly subaverage’ intellectual functioning.” The district court found that the standard error 15 See infra Section XIV.H. 58 Case: 14-15650 Date Filed: 03/21/2016 Page: 59 of 103 of measurement “is less significant a factor” in Ledford’s case because of the corroborating results on two separate IQ tests. The court found that, in any event, Ledford “failed to meet his burden of proving that he has adaptive deficits in two or more of the relevant areas.” C. Standard of Review “A determination as to whether a person is [intellectually disabled] is a finding of fact.” Fults v. GDCP Warden, 764 F.3d 1311, 1319 (11th Cir. 2014); see also Conner v. GDCP Warden, 784 F.3d 752, 761 (11th Cir. 2015) (“The intellectual-disability determination is fact-intensive, requiring careful consideration of the petitioner’s intellectual functioning, adaptive skills, and age of onset, with the assistance of qualified experts.”). We review for clear error a district court’s finding that an individual is not intellectually disabled. Conner, 784 F.3d at 761. When reviewing for clear error, we must give due regard to the trial court’s opportunity to judge the witnesses’ credibility. Id. at 765. In that sense, the clearly erroneous standard is “very deferential.” Id. (quotation marks omitted). A finding is clearly erroneous when, although there is evidence to support it, the reviewing court on the entire evidence is left with the definite and firm conviction that a mistake has been committed. Id. “If the district court’s account of the evidence is plausible in light of the record viewed in its entirety, the court of appeals may not 59 Case: 14-15650 Date Filed: 03/21/2016 Page: 60 of 103 reverse it even though convinced that had it been sitting as the trier of fact, it would have weighed the evidence differently.” Anderson v. Bessemer City, 470 U.S. 564, 573-574, 105 S. Ct. 1504, 1511 (1985). On appeal, Ledford argues that the district court erred in finding that he was not intellectually disabled. 16 Before examining Ledford’s arguments, we review federal and Georgia law relevant to Ledford’s intellectual disability claim. D. Atkins and Georgia’s Definition of Intellectual Disability In Atkins v. Virginia, the U.S. Supreme Court held that the execution of intellectually disabled individuals violates the Eighth Amendment of the United States Constitution. 536 U.S. 304, 321, 122 S. Ct. 2242, 2252 (2002). Although the U.S. Supreme Court in Atkins recognized a national consensus in the states against executing mentally retarded persons, it said that there was a notable lack of consensus on how to determine which offenders are mentally retarded: To the extent there is serious disagreement about the execution of mentally retarded offenders, it is in determining which offenders are in fact retarded. . . . Not all people who claim to be mentally retarded will be so impaired as to fall within the range of mentally retarded offenders about whom there is a national consensus. 16 In its order granting Ledford’s request for an evidentiary hearing, the district court concluded that the state habeas court’s findings regarding Ledford’s intellectual disability claim were based on an unreasonable determination of the facts and, therefore, satisfied the conditions of 28 U.S.C. § 2254(d). The State of Georgia does not contest that part of the district court’s order. Thus, we assume the district court was correct and, accordingly, we afford no deference to the state habeas court’s finding that Ledford is not intellectually disabled. See Panetti v. Quarterman, 551 U.S. 930, 953, 127 S. Ct. 2842, 2858 (2007). 60 Case: 14-15650 Date Filed: 03/21/2016 Page: 61 of 103 Id. at 317, 122 S. Ct. at 2250. The Supreme Court added that although the states’ “statutory definitions of mental retardation are not identical, [they] generally conform to the clinical definitions” established by the American Association on Mental Retardation, now known as the American Association on Intellectual and Developmental Disabilities (“AAIDD”) and the American Psychiatric Association (“APA”). Id. at 317 n.22, 122 S. Ct. at 2250 n.22. The Supreme Court concluded that various definitions of mental retardation all contain three basic requirements: (1) significantly subaverage general intellectual functioning; (2) limitations in adaptive functioning; and (3) onset before age 18. Id. at 308 n.3, 122 S. Ct. at 2245 n.3. As to the first requirement, the Supreme Court noted that “an IQ between 70 and 75 or lower . . . is typically considered the cutoff IQ score for the intellectual function prong of the mental retardation definition.” Id. at 309 n.5, 112 S. Ct. at 2245 n.5. As to the second requirement, the Supreme Court explained that limitations in adaptive functioning means “limitations in two or more of the following applicable adaptive-skill areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, health and safety, functional academics, leisure, and work.” Id. at 308 n.3, 122 S. Ct. at 2245 n.3. 61 Case: 14-15650 Date Filed: 03/21/2016 Page: 62 of 103 Other than these three basic requirements, Atkins “did not provide definitive procedural or substantive guides for determining when a person” is intellectually disabled. Bobby v. Bies, 556 U.S. 825, 831, 129 S. Ct. 2145, 2150 (2009). Although the Atkins Court alluded to two clinical definitions of intellectual disability, the Atkins Court left “to the States the task of developing appropriate ways to enforce the constitutional restriction upon its execution of sentences.” Atkins, 536 U.S. at 317, 122 S. Ct. at 2250 (quotation marks omitted). In particular, “[i]t left to the states the development of standards for courts to employ in making a determination of whether an offender is mentally retarded.” Thomas v. Allen, 607 F.3d 749, 752 (11th Cir. 2010). Accordingly, federal courts must look to Georgia law to determine whether a Georgia inmate is intellectually disabled. See Holladay v. Allen, 555 F.3d 1346, 1353 (11th Cir. 2009). Georgia’s definition of intellectual disability “essentially tracks the . . . definitions mentioned in Atkins.” Hill v. Humphrey, 662 F.3d 1335, 1341 (11th Cir. 2011) (en banc). Under Georgia law, a defendant must establish three things beyond a reasonable doubt to prove that he or she is intellectually disabled: (1) “significantly subaverage general intellectual functioning,” (2) “resulting in or associated with impairments in adaptive behavior,” (3) “which manifested during the developmental period.” Ga. Code Ann. § 17-7-131(a)(3), (c)(3). The third prong of the test means that the disability originates before the age of 18. In re 62 Case: 14-15650 Date Filed: 03/21/2016 Page: 63 of 103 Hill, 715 F.3d 284, 286 n.2 (11th Cir. 2013). The district court here concluded that Ledford had not proven his intellectual disability by a preponderance of the evidence and, therefore, necessarily he had not proven it beyond a reasonable doubt.17 Georgia’s test for intellectual disability does not use a strict IQ-cutoff. In re Hill, 777 F.3d 1214, 1224 (11th Cir. 2015); see also Ga. Code Ann. § 17-7- 131(a)(3). And while in Georgia an IQ score of approximately 70 or below generally shows significantly subaverage intellectual functioning, the Georgia Supreme Court has recognized that, “[a]t best, an IQ score is only accurate within a range of several points, and for a variety of reasons, a particular score may be less accurate.” Stripling v. State, 401 S.E.2d 500, 504 (Ga. 1991); see also Head v. Stripling, 590 S.E.2d 122, 124 n.1 (Ga. 2003). With this background, we address Ledford’s arguments on appeal. E. Credibility of Dr. Zimmerman On appeal, Ledford argues that he established the existence of his significantly subaverage general intellectual functioning through four IQ tests with scores of 66, 69, 77, and 79. Ledford contends that the district court clearly erred by discrediting Dr. Zimmerman’s IQ scores of 66 and 69. Although Dr. Zimmerman admitted that his test data was difficult to read, Ledford argues that 17 Given how the district court ruled, this case does not involve an issue concerning Georgia’s “beyond a reasonable doubt” standard. 63 Case: 14-15650 Date Filed: 03/21/2016 Page: 64 of 103 Dr. Zimmerman “never testified that he may have mis-scored any questions and he was consistent in his testimony that he had full confidence in the scores.” Giving “due regard” to the district court’s assessment of the expert witnesses, we conclude that the district court did not clearly err in crediting Dr. King’s expert testimony over Dr. Zimmerman’s. Conner, 784 F.3d at 765. On cross-examination, Dr. Zimmerman admitted that his IQ tests were missing pages and that Ledford’s responses were not clearly recorded, making the test extremely difficult to read. Dr. Zimmerman admitted that these issues would make it “very difficult” to accurately score the test. Dr. Tasse corroborated Dr. Zimmerman’s adverse admissions by testifying that an examiner may make scoring mistakes if the examinee’s responses are not clearly recorded. On the other hand, Dr. King explained his methodology in detail and only admitted to minor scoring errors that, cumulatively, would have only decreased Ledford’s IQ by one point. Dr. King’s IQ results were substantively corroborated by Dr. Perri—a court-appointed expert witness with no discernable bias. The district court did not clearly err in concluding that Dr. Zimmerman’s IQ scores of 66 and 69 were suspect, while Dr. King and Dr. Perri’s IQ scores of 77 and 79 were credible. See id. at 766 (“[W]here . . . there are two permissible views of the evidence, the factfinder’s choice between them cannot be clearly erroneous.”) 64 Case: 14-15650 Date Filed: 03/21/2016 Page: 65 of 103 F. Flynn Effect Ledford next argues that even if the district court did not err in discrediting Dr. Zimmerman’s scores, it clearly erred in failing to apply the Flynn effect to Ledford’s credible IQ scores. Ledford contends that the Flynn effect has become a “widely accepted” phenomenon in medical literature and judicial decisions. As such, Ledford asserts that his true IQ scores were 73 and 75 if Dr. Perri and Dr. King’s scores of 77 and 79 are each reduced by four points to account for the Flynn effect. He argues that his Flynn-adjusted scores of 73 and 75 would bring his IQ within the standard error of measurement for establishing significantly subaverage general intellectual functioning. The U.S. Supreme Court has never discussed the Flynn effect, nor has any Georgia state court. Several federal circuit courts have discussed the Flynn effect, including our Court. We review what other circuits have done and then our decisions about the Flynn effect. The Fifth Circuit does not recognize the Flynn effect’s scientific validity. See Brumfield v. Cain, 808 F.3d 1041, 1060 n.27 (5th Cir. 2015) (“The State correctly points out that the Fifth Circuit has not recognized the Flynn effect.”); Maldonado v. Thaler, 625 F.3d 229, 238 (5th Cir. 2010) (“As the district and state habeas courts recognized, . . . neither this court nor the [Texas Court of Criminal Appeals] has recognized the Flynn effect as scientifically valid.”); Gray v. Epps, 65 Case: 14-15650 Date Filed: 03/21/2016 Page: 66 of 103 616 F.3d 436, 447 n.9 (5th Cir. 2010) (“[T]he Flynn Effect has not been accepted in this Circuit as scientifically valid.”) (quotation marks omitted); In re Mathis, 483 F.3d 395, 398 n.1 (5th Cir. 2007) (concluding that the Flynn effect has not been accepted as scientifically valid). The Seventh Circuit has held that lower courts have “no obligation to accept and apply the Flynn Effect in the face of conflicting expert testimony about its acceptability and reliability.” Pruitt v. Neal, 788 F.3d 248, 267 & n.2 (7th Cir. 2015) (quotation marks omitted) (noting that “[f]our highly qualified experts with extensive experience with the intellectually disabled” offered conflicting testimony about the Flynn effect). One expert in Pruitt testified that “the application of the Flynn effect was contentious in the professional community,” and “that he ha[d] never adjusted an IQ score in the clinical setting to account for the effect.” Id. at 267 n.2. The Seventh Circuit emphasized that “nothing in Atkins suggests that IQ test scores must be adjusted to account for the Flynn Effect in order to be considered reliable evidence of intellectual functioning.” Id. (quoting McManus v. Neal, 779 F.3d 634, 653 (7th Cir. 2015)). Similarly, other circuits have looked on the Flynn effect with disfavor. See, e.g., Hooks v. Workman, 689 F.3d 1148, 1170 (10th Cir. 2012) (“Atkins does not mandate an adjustment for the Flynn Effect. Moreover, there is no scientific consensus on its validity.”); Richardson v. Branker, 668 F.3d 128, 152 (4th Cir. 66 Case: 14-15650 Date Filed: 03/21/2016 Page: 67 of 103 2012) (noting that Atkins does not require that the Flynn effect be accounted for in determining intellectual disability). On the other hand, two circuits have indicated that the fact-finding court must allow a party to present Flynn effect evidence for consideration by the court. In Black v. Bell, the Sixth Circuit held that, under Tennessee law, a Tennessee state court must allow a party to present Flynn effect evidence and then at least consider that evidence, and not summarily reject such evidence, in assessing a defendant’s functional IQ. 664 F.3d 81, 96 (6th Cir. 2011). Similarly, in Walker v. True, the Fourth Circuit, applying Virginia law, faulted a district court for summarily refusing to consider at all the Flynn effect evidence when the intellectual disability claim was never adjudicated on the merits by a state court and was brought in the first instance in district court for de novo review. 399 F.3d 315, 319, 322-23 (4th Cir. 2005); see also Richardson, 668 F.3d at 152 n.26 (discussing the “unusual procedural posture” of the Atkins claim in Walker and how the petitioner in Walker had exhausted his state remedies before Atkins was decided). Notably, the Fourth Circuit later concluded that “neither Atkins nor Virginia law appear[ed] to require expressly that the Flynn effect . . . be accounted for in determining mental retardation status.” Richardson, 668 F.3d at 152 (quoting Green v. Johnson, 315 F.3d 290, 300 n.2 (4th Cir. 2008)). 67 Case: 14-15650 Date Filed: 03/21/2016 Page: 68 of 103 More importantly, our Court addressed the Flynn effect in Thomas v. Allen. We observed that the Flynn effect is recognized in some courts, but not in others. Thomas, 607 F.3d at 757-58. We pointed out that there is “no uniform consensus regarding the application of the Flynn effect in determining a capital offender’s intellectual functioning.” Id. at 758. The above survey of cases confirms that assessment. However, Thomas was an easier case because at the hearing, “all the experts acknowledged that the Flynn effect is a statistically-proven phenomenon, although no medical association recognizes its validity.” Id. at 757. The parties in Thomas also agreed that “the Flynn effect is an empirically proven statistical fact; however, they disagree[d] on the extent to which an individual test subject’s IQ score should be adjusted to take into consideration this phenomenon.” Id. at 753. Accordingly, this Court held in Thomas that, based on the expert testimony in the record, the district court did not clearly err by applying the Flynn effect to lower a § 2254 petitioner’s IQ score. Id. at 757-58. We stressed: “The district court considered the Flynn effect just as it considered the other evidence in the record presented by the parties regarding [the petitioner’s] intellectual functioning.” Id. at 758. That court’s application of the Flynn effect simply amounted to an exercise of discretionary fact-finding based on the expert testimony in that particular record. See id. Based on the factual record and medical 68 Case: 14-15650 Date Filed: 03/21/2016 Page: 69 of 103 testimony in that case, the Thomas Court could not say that the district court had clearly erred in deciding to apply the Flynn effect. To be clear, nothing in Thomas requires a district court, when presented with conflicting expert testimony, to accept and apply the Flynn effect. All of our postThomas decisions mentioning the Flynn effect cite Thomas for the proposition that mental health evaluators may consider the Flynn effect, or that expert Flynn effect testimony is subject to a credibility determination by the district court. See Conner, 784 F.3d at 763 n.11 (“[T]he Flynn effect can be applied by a test evaluator in arriving at an individual’s final test score.”) (emphasis added); Burgess v. Comm’r, 723 F.3d 1308, 1321-22 (11th Cir. 2013) (holding that a § 2254 petitioner was entitled to an evidentiary hearing because an expert affidavit discussing the Flynn effect and standard error of measurement may entitle the petitioner to habeas relief “[i]f the district court were to find [the expert’s] testimony to be credible”); see also Hill, 662 F.3d at 1373 n.15 (citing Thomas and stating that “this circuit has recognized that the statistical phenomenon known as the Flynn Effect . . . can be applied by a test administrator to an individual’s raw IQ test score”) (emphasis added) (Barkett, J., dissenting). In sum, our Circuit, like a few others, leaves it to the fact-finder court to hear and consider the Flynn effect evidence and to make its own fact-findings about the credibility and weight of the expert evidence regarding the Flynn effect. That is 69 Case: 14-15650 Date Filed: 03/21/2016 Page: 70 of 103 exactly what the district court did here. Given the evidence in the record, the district court was not required to adjust for the Flynn effect or to accept IQ scores that had been adjusted for the Flynn effect. G. New Evidence as to the Flynn Effect Regardless of the legal community’s treatment of the Flynn effect in the past, Ledford also argues that the medical community now has reached a general consensus endorsing the practice of reducing IQ scores pursuant to the Flynn effect. To support his argument, Ledford cites the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder, published in 2013 by the APA (hereinafter “DSM-V”), 18 and an article by psychologist Kevin McGrew titled Norm Obsolescence: The Flynn Effect, which appears in a 2015 compilation published by the AAIDD (hereinafter “Norm Obsolescence”). 19 On appeal, Ledford acknowledges, as he must, that the DSM-V and McGrew’s article were published well after the district court’s 2008 intellectual disability order.20 Because this evidence was not before the district court, we 18 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013). 19 Kevin S. McGrew, Norm Obsolescence: The Flynn Effect, in American Association of Intellectual and Developmental Disabilities, The Death Penalty and Intellectual Disability (Edward A. Polloway ed., 2015). 20 Although the district court adjudicated Ledford’s motion to reconsider in 2014, after the DSM-V was published, it does not appear that the parties ever submitted any portion of the DSM-V as evidence for the district court to consider. The district court’s 2014 reconsideration order pre-dated the publication of McGrew’s article. 70 Case: 14-15650 Date Filed: 03/21/2016 Page: 71 of 103 cannot consider it. See Selman v. Cobb Cty. Sch. Dist., 449 F.3d 1320, 1332 (11th Cir. 2006) (“In deciding issues on appeal we consider only evidence that was part of the record before the district court.”). Ledford asks this Court to remand his intellectual disability claim to the district court for an additional evidentiary hearing in light of this new evidence. We should not, and do not, remand for two independently adequate reasons. First, district courts do not need to revisit rulings every time the APA publishes a revised DSM or the AAIDD publishes a new article. Hall tells us that “[t]he legal determination of intellectual disability is distinct from a medical diagnosis,” though that legal determination “is informed by the medical community’s diagnostic framework.” Hall, 572 U.S. at ___, 134 S. Ct. at 2000. While medical literature informs a court’s legal analysis, it does not control it. See id. (concluding that the views of medical experts inform, but “do not dictate,” a court’s decision). Second, these new items do not show a general consensus in the medical community about the Flynn effect. Ledford overstates and misconstrues the DSM- V’s discussion of the Flynn effect. Far from mandating numerically specific Flynn-effect reductions to all IQ scores, the DSM-V does little more than acknowledge the possibility that the Flynn effect is a “factor” that “may” impact an individual’s IQ score. In its only reference to the Flynn effect, the DSM-V provides: “Factors that may affect [intelligence] test scores include practice effects 71 Case: 14-15650 Date Filed: 03/21/2016 Page: 72 of 103 and the ‘Flynn effect’ (i.e., overly high scores due to out-of-date test norms).” DSM-V at 37 (emphasis added). While the DSM-V states that the Flynn effect “may” affect intelligence scores, it does not provide any guidance as to how a clinician should actually apply the Flynn effect, let alone mandate any 0.3 pointper-year reduction for IQ scores obtained from tests with outdated norms. See id. In similar fashion, Ledford misconstrues McGrew’s article. Based on his survey of various academic studies conducted between 2007 and 2012, McGrew asserts that “there is . . . a consensus that individually obtained IQ test scores derived from tests with outdated norms must be adjusted to account for the Flynn effect, particularly in Atkins cases.” Norm Obsolescence at 160. But McGrew qualifies this assertion by stating that “[t]he use of the Flynn effect correction in clinical settings is less of an issue.” Of course, it is less of an issue because, as Dr. King testified in this case, the Flynn effect is not used in clinical settings, and ipso facto, there is no medical consensus at all. McGrew even undercuts the imperative quality of his original assertion by later stating that “best practices require recognition of a potential Flynn effect when older editions of an intelligence test . . . are used.” Norm Obsolescence at 160 (emphasis added). McGrew states that the Flynn effect should be considered in Atkins cases because courts are often required to focus on “specific ‘bright-line’ cutoff scores.” 72 Case: 14-15650 Date Filed: 03/21/2016 Page: 73 of 103 Id. at 161. Georgia, however, has no bright-line cutoff score for a finding of significantly subaverage intellectual functioning. See In re Hill, 777 F.3d at 1224. Even though McGrew endorses reducing IQ scores pursuant to the Flynn effect, he still concedes that “a minority of scholars have offered a different approach to the issue of correcting IQ test scores due to the Flynn effect.” Norm Obsolescence at 161. For example, McGrew cites one scholar who “advocates that experts should simply inform the fact finder of what the research shows and the trier-of-fact should evaluate and decide if and how to apply it when interpreting individual scores.” Id. By acknowledging the competing views of scholars, albeit what he calls a minority, McGrew’s own article directly contravenes Ledford’s assertion that the medical community has reached a consensus regarding the application of the Flynn effect. Indeed, experts in Ledford’s own case testified that the Flynn effect is not scientifically sound and not used in clinical practice. Included in a compilation of articles published by the AAIDD, McGrew’s article is merely another expert opinion in the ongoing debate regarding the application of the Flynn effect in capital punishment cases. While future factfinders grappling with the Flynn effect will have to decide what expert medical testimony to credit, McGrew’s article is a far cry from evincing a definitive and universal proclamation that the medical community has reached a consensus regarding this highly controversial topic. And even if McGrew’s article more fully 73 Case: 14-15650 Date Filed: 03/21/2016 Page: 74 of 103 supported Ledford’s position, we conclude that an article written by one psychologist does not dictate the views of the medical community at large and certainly does not control the courts with respect to the Flynn effect. H. Hall and Brumfield Do Not Concern the Flynn Effect Ledford also claims that Hall and Brumfield v. Cain, 576 U.S. ___, 135 S. Ct. 2269 (2015), require courts to apply Flynn effect adjustments to IQ scores due to the medical community’s alleged general acceptance of the Flynn effect. Ledford misreads those opinions. In Hall, the Supreme Court held that Florida’s strict IQ score cutoff of 70 was unconstitutional. Hall, 572 U.S. at ___, 134 S. Ct. at 1990. Florida’s death penalty statute had defined “significantly subaverage general intellectual functioning” as “performance that is two or more standard deviations from the mean score on a standardized intelligence test.” Fla. Stat. § 921.137. The Florida Supreme Court had interpreted this statute to mean that a defendant must show an IQ test score of 70 or below before he could present any additional evidence of his intellectual disability or adaptive functioning. See Hall v. State, 109 So. 3d 704, 707 (Fla. 2012); Cherry v. State, 959 So. 2d 702, 712-13 (Fla. 2007). The U.S. Supreme Court emphasized that Florida’s “strict IQ test score cutoff of 70 is the issue,” and that in Florida, “[i]f, from test scores, a prisoner is deemed to have an IQ above 70, all further exploration of intellectual disability is 74 Case: 14-15650 Date Filed: 03/21/2016 Page: 75 of 103 foreclosed.” Id. at ___, ___, 134 S. Ct at 1990, 1994. That combination is what the Hall case was about. The Florida Supreme Court’s strict 70 IQ score cutoff did not take into account the standard measurement error of an IQ test. Because “an IQ test score represents a range rather than a fixed number,” the U.S. Supreme Court observed that “when a defendant’s IQ test score falls within the test’s acknowledged and inherent margin of error, the defendant must be able to present additional evidence of intellectual disability, including testimony regarding adaptive deficits.” Hall, 572 U.S. at ___, 134 S. Ct. at 2001 (emphasis added). Thus, in Hall, the Supreme Court concluded that because of a plus or minus 5-point standard of error, “an individual with an IQ test score ‘between 70 and 75 or lower’ . . . may show intellectual disability by presenting additional evidence regarding difficulties in adaptive functioning.” Id. at ___, 134 S. Ct. at 2000 (quoting Atkins, 536 U.S. at 309 n.5, 122 S. Ct. at 2245 n.5) (emphasis added). Notably, Hall did not mention the Flynn effect. Rather, the Supreme Court in Hall relied upon the uncontroverted opinions of medical experts to recognize the “established medical practice” of acknowledging the existence of a standard error of measurement inherent in every IQ test. Hall, 572 U.S. at ___, 134 S. Ct. at 1995. There is no “established medical practice” of reducing IQ scores pursuant to 75 Case: 14-15650 Date Filed: 03/21/2016 Page: 76 of 103 the Flynn effect. The Flynn effect remains disputed by medical experts, which renders the rationale of Hall wholly inapposite. Nor is Ledford helped by Brumfield. In that case, the Louisiana state court found that the petitioner’s IQ score of 75 conclusively demonstrated that he could not possess subaverage intelligence and that the petitioner’s evidence was insufficient to raise a question as to his adaptive impairments; therefore, the court rejected the petitioner’s request for an Atkins evidentiary hearing. Brumfield, 576 U.S. at ___, 135 S. Ct. at 2276-82. The Supreme Court noted that because of the standard error of measurement, an IQ score had a margin of error. Id. at ___, 135 S. Ct. at 2278. The Brumfield Court, quoting Atkins, observed that “an IQ between 70 and 75 or lower . . . is typically considered the cutoff IQ score for the intellectual function prong of the mental retardation definition.” Id. (quoting Atkins, 536 U.S. at 309 n.5, 122 S. Ct. at 2245 n.5). “Accounting for [the] margin of error,” the petitioner’s reported IQ score of 75 “was squarely in the range of potential intellectual disability,” and the petitioner should have been allowed to present evidence of his adaptive impairments. Id. Here, the district court allowed Ledford to present evidence of his adaptive functioning. And like Hall, the Brumfield Court made no mention of the Flynn effect. 76 Case: 14-15650 Date Filed: 03/21/2016 Page: 77 of 103