Introduction
I was recently asked if I could offer any insights in response to the following situation:
A Christian pastor has a friend who has an eight-year-old daughter with Down syndrome and related intellectual impairments. The daughter’s impairments are on the more significant end of the spectrum, and her father is quite concerned about his daughter’s eternal destiny, along with other worries about whether his daughter is happy and whether she is able to have a good life.
In responding to this scenario, I want to begin, first, by addressing some comments of a “pastoral” nature to the father of the daughter with Down syndrome.[1] Next, I’ll zoom out a bit from this specific situation to briefly consider two key philosophical/theological questions that the scenario raises about the relationship between intellectual disability, human flourishing, and salvation.[2] Due to limitations of space, I will lay out in cursory fashion some initially plausible responses to these questions but will not be concerned to offer a systematic or comprehensive defense of any claims made with respect to them. Finally, I’ll close with a few words addressed to pastors and church leaders who may be reading this article.
Words of Encouragement to the Father of a Daughter with Down Syndrome
If I were sitting down with this pastor’s friend over a cup of coffee, here are a few general words of encouragement I would want to share with him.
Your daughter is “fearfully and wonderfully made” (Ps 139:14) and is both known and deeply loved by God. Her life is not an accident, and she was created for relationship with God and for his glory. I don’t know the extent of your daughter’s cognitive (or other) impairments, but I do know that people with cognitive limitations can enter into and enjoy a vibrant relationship with Jesus as their Lord and Savior. And they can be used by God as incredibly powerful ambassadors of his love, grace, and mercy.
Consider, for example, Sarah Hope Amick, who was born with Down syndrome, “a near fatal heart defect, and a slew of other genetic abnormalities.”[3] Sarah is the daughter of Shauna Amick, a speaker, author, and disability advocate who serves in several capacities at Joni and Friends, a Christian nonprofit ministry whose mission is to “glorify God as we communicate the Gospel and mobilize the global church to evangelize, disciple, and serve people living with disability.”[4] Shauna has shared publicly her story of receiving a prenatal diagnosis of Down syndrome and the challenges that went along with choosing life for her unborn baby girl.[5] Now a young woman, Sarah is a winsome ambassador of Christ’s love, especially through her “hug ministry,” which she uses to spread joy and encouragement to those around her.
Trevor Hendershot is a young man with Down syndrome who was hired as a team store greeter by the Los Angeles Angels in 2012, the Anaheim Ducks in 2013, and the Los Angeles Rams and USC Trojans in 2018. He uses his interactions with stadium visitors to glorify God and bear witness to the dignity of all human beings, including those with disabilities.
Or consider Bekah, a woman with Down syndrome who has a keen sense of her true spiritual identity. One time, when she was 22 and a student at the University of South Carolina, her father—Mark Maulding, a speaker at Christian youth retreats—brought her up on stage with him in front of a group of teenagers for an interview. As Maulding describes it in a blog post written some nine years later, “At one point in the interview, I asked her, ‘Is your identity in having Down syndrome?’ She answered, ‘No.’ ‘Where is your identity?’ ‘In Christ!’ she exclaimed with a smile.”
These are just three representative examples (among many more that could be given) of children with Down syndrome who have grown into young men and women who love Jesus and live flourishing lives. The point is simply this: In more ways than one, there absolutely is hope for your daughter—both for this life and for eternity.
To be sure, persons with Down syndrome are just that: persons with Down syndrome—which means that they have inherited a sin nature from our common ancestor, Adam, and are in need of redemption (Rom 5:12; Ps 51:5). And, as any parent of a teenager with Down syndrome will attest, that sin nature can make itself very well-known at times! Still, as with any other human being, people with Down syndrome have the God-given capacity for knowledge of and relationship with him. (After all, even little children are capable of believing in Jesus; see Matt 18:6.) Best of all, God desires to have a relationship with them (Matt 19:14). And he knows how to reach anyone, even those with significant intellectual or other limitations.
So, in the end, I would simply encourage you to continue sharing the gospel with your daughter, giving her opportunities to respond to it along with opportunities to grow in and exercise faith (e.g., by serving in the local church)—and then trust God’s Spirit to be able to reach your daughter in ways that only he can.
Two Key Questions
Of course, these all-too-brief pastoral comments leave unanswered many of the deeper philosophical and theological questions with which people like this father and others who find themselves in similar situations wrestle. In this next section, I want to identify and address briefly the two key questions that are embedded in the above scenario.
The first question has to do with whether persons with intellectual disabilities can be said to be “happy” or to live “flourishing” human lives. Many will worry that these things are not possible for persons with intellectual disabilities, especially as the degree of intellectual impairment increases.
Next, there is the question of whether persons with intellectual disabilities—particularly those with severe or profound intellectual limitations—can be “saved.” To the extent that they are unable to understand intellectually the message of the gospel and/or profess their faith verbally, some will worry about their ability to enter into a saving relationship with God through faith in Jesus Christ.
Can Persons with Intellectual Disabilities Lead Flourishing Lives?
With regard to this first question, it’s worth noting, first of all, that there is a tendency to overestimate the “burden” of lives characterized by disability in general, and by intellectual disability in particular, and to underestimate the “quality of life” (QoL) experienced by people with disabilities.[6] Indeed, “a number of studies have shown that non-disabled members of the public and health professionals tend to estimate the QoL of disabled people as very low, whereas disabled people tend to rate their own QoL far more highly.”[7]
Second, there is a tendency to assume that persons with disabilities are suffering as a result of their disability, whereas this is very often not the case. In many instances—particularly those in which a disability is not accompanied by chronic pain or discomfort—a disabling condition simply becomes a part of a person’s normal way of living and is not experienced as a source of “suffering” per se.
Moreover, to the extent that people with disabilities do suffer, that suffering often has more to do with the world around them than with their actual impairments. All too often, for example, people with disabilities are excluded from participation in employment, civic life, friendships, or other meaningful relationships because of their impairments. In such cases, the emotional and psychological suffering that often results is better characterized as being caused by factors external to the individual (her surrounding environment, culture, etc.) than internal to her (e.g., physical or mental impairments located “in” her body).
Finally, we need to recognize that there are multiple dimensions to human flourishing—physical, mental, emotional, relational, spiritual, and (perhaps) others as well. Limitations in one dimension do not necessarily entail limitations in others. And one can have a truly flourishing life even with limitations in one or more of those dimensions.[8]
For these reasons and more, I submit that there is no good reason to assume, from the outset, that persons with disabilities, including those with intellectual disabilities, cannot live thriving, flourishing lives. Indeed, there is plenty of evidence—both empirical and anecdotal—that just the opposite is true: People with disabilities, intellectual or otherwise, can live lives that are just as “flourishing” as those of non-disabled people.
Can Persons with Severe or Profound Intellectual Disabilities be Saved?
Moving now to the second question, the worry for some is that if faith requires belief, and if belief presupposes being able to grasp certain cognitive propositions, then what about those whose intellectual limitations are such that they are unable to understand intellectually even the “basics” of the gospel? Are such individuals able to come to faith in Christ? Are they doomed to an eternity separated from God and his family? Is there hope for the eternal destiny of those who cannot grasp the propositional content of the Christian faith?
It must be emphasized here that these questions are not directly addressed or explicitly answered in Scripture. Accordingly, believers of good will have landed in different places on them.[9] There is a robust literature on this topic, to which I can only gesture here. The links interspersed throughout this article and in the references (see below) will take you to several introductory resources that I have found helpful in thinking about (some of) the thorny issues surrounding these questions; additionally, the accompanying resource list highlights a number of articles, books, and other resources that can assist you in going deeper in your exploration of these issues. While I do not necessarily agree with every individual theological statement made in the articles referenced here, I do think they generally capture an important insight—namely, that when it comes to salvation, there is a biblical case to be made that God holds people responsible for what they are able to perceive and comprehend of his revelation. Thus, for those who for their entire lives are never able to understand even the basics of the gospel, God’s grace in Christ is sufficient to cover their fallenness and need of redemption.
Essentially, the biblical case turns on drawing an analogy between persons (of any age) with severe or profound intellectual disabilities and two other groups of persons—babies who die either before birth or shortly thereafter, and children who die in infancy. On this argument, because individuals in each of these categories (1) are unable to perceive or reflect upon God’s general revelation of himself in nature,[10] (2) are incapable of grasping spiritual truths, (3) do not “commit conscious acts of sin,” and (4) do not understand “the concept of and the choice between right and wrong,” they therefore have an “excuse” before God that other human beings do not (cf. Rom 1:19–20).[11] The conclusion is then drawn that since salvation comes through faith, which requires some level of cognitive understanding,[12] those who lack the capacity for even a basic understanding of the gospel are reasonably assumed to be the subjects of the application of God’s saving grace motivated by his compassion and mercy.[13]
I also think it’s important that we resist an overly or hyper-cognitive conception of faith. Ultimately, it seems to me, biblical faith is largely about trust—trust in God, his character, his promises, and the fact that he will do what he has promised to do. To be sure, there is a cognitive component to faith, but true biblical faith—saving faith, if you will—goes beyond the merely cognitive or intellectual. After all, “even the demons believe . . . and shudder” (Jas 2:19). Arguably, there are also affective (how we feel), volitional (what we choose and will), and behavioral (how we act) aspects of faith as well. And there may be a communal aspect to faith, too. Here, the idea is not that one person or group can have saving faith for another, but rather that in the context of the body of Christ, people with intellectual disabilities can be enfolded into or within a community of faith in such a way that they are enabled to engage with the life of faith, even if they are limited in their cognitive abilities to understand or articulate things theologically.
As one piece of evidence suggesting that biblical faith cannot be reduced to the merely cognitive or intellectual, consider the account in the first chapter of Luke’s Gospel, when pregnant Mary goes to visit Elizabeth, who is pregnant with John the Baptist (Luke 1:39-56). Earlier in the chapter, the angel Gabriel had foretold that John the Baptist would be “filled with the Holy Spirit even before he [was] born” (v. 15). Now, in verse 41, we are told that upon Mary’s arrival, John the Baptist “leaped” in Elizabeth’s womb. Just a few verses later, Elizabeth tells Mary that “as soon as the sound of your greeting reached my ears, the baby in my womb leaped for joy” (Luke 1:44). Apparently, John recognized that he was in the presence of his Savior. Note that this verse specifically states that John leaped “for joy”—a response that is, at the very least, suggestive of a response of faith. And yet, John was at that point a tiny preborn human being with as-yet undeveloped cognitive abilities. We must be careful, of course, not to overinterpret this passage—it does not, by itself, directly answer the questions we are considering in this article. But if an unborn child, whose cognitive abilities are unsophisticated at best, can (in this instance, at least) be “filled with the Holy Spirit” and can (in some sense) respond in faith to the presence of the Savior, then it seems safe to conclude that there are important aspects of biblical faith that go beyond the (merely) cognitive or intellectual.
Which leads to a final point: It’s important that we not underestimate the ability of God’s Spirit to communicate with the spirits of human beings, including those with intellectual disabilities. “The Lord works in mysterious ways,” as the saying goes, and there may be ways in which his Spirit works that we will never know about until we reach eternity. If God’s Spirit can engage with an unborn child in the ways we see pictured in Luke 1, why think that he can’t also engage with our loved ones who have severe or profound intellectual disabilities?
A Word to Pastors and Church Leaders
Before concluding, I would be remiss if I did not address a few comments to pastors and church leaders who may be reading this article.
Pastors and church leaders play a crucial role in enhancing and promoting the flourishing of persons with disabilities, including those with intellectual disabilities. Churches can—and should—actively seek not only to include persons with disabilities in the communal life of the church (e.g., by making sure facilities are accessible so that mobility-impaired individuals can attend church services) but also to move beyond that to fostering their belonging as full-fledged members of the community. Consider these evaluative questions with respect to your specific church context:
- Are persons with disabilities given opportunities to serve—and even lead—in the church setting, in accordance with their giftings and callings?
- Are persons with disabilities of any type (including intellectual) routinely sequestered away from the rest of the church family in “special” classes or programs, or are they integrated into the daily life of the church to the greatest extent possible?
- Are people with disabilities honored as valuable members of the body of Christ, or are they treated as second-class citizens of the kingdom—as problems to be “fixed” (through healing, for example) rather than as gifts to be received with gratefulness?
As a pastor or church leader, you play a vital role in setting the tone in your church in this regard. Parachurch ministries like Joni and Friends and Key Ministry, among others, can help you as you seek to fulfill the Luke 14 mandate to “compel” the “poor, the crippled, the blind and the lame” to enjoy the feast of fellowship, so that the Father’s house “will be full” (Luke 14:21–23).
Conclusion
As we’ve seen already in this Intersections series on disability, persons with disabilities have gifts to offer the church (Jessica Garske, “Disposition of the Heart”), can grow in discipleship (Eric Targe, “Holey, Wholly, Holy Discipleship“), and can both serve and lead in the church (Rick L. Vollema, “Disabled Isn’t Unabled: What Living as a Disabled Pastor Has Taught Me about the Church”).
While the details might look different for those with intellectual disabilities than those without, these facts remain true for them as well. For example, a woman who attended the adult special needs brunch group at a church I previously attended had both physical and intellectual disabilities. But that did not stop her from being concerned about the eternal state of her fellow students in the day school for persons with intellectual disabilities that she attended. She used every opportunity she could get to share Jesus with her friends at that school. No doubt there will be crowns waiting for her in heaven.
Persons with intellectual disabilities are capable of relationship, including friendship, and they often have a special way of bringing unexpected joy into our lives. When my wife and I got married, we invited our friends from our church’s adult special needs group—most of whom had some level of intellectual disability—to attend. As I escorted my mom down the aisle to lead the wedding party at the beginning of the ceremony, they spontaneously burst into applause. But they didn’t stop there. As each additional member of the wedding party walked down the aisle to the front of the church auditorium, our friends continued to cheer and applaud. Their joy became infectious, and soon the entire audience had joined in the celebration. These friends of ours didn’t know that you’re not “supposed” to applaud until the end of a wedding ceremony. All they knew was that their friends were getting married, and they were happy for us. We had numerous people tell us afterward that this had been one of the most joyous weddings they had ever attended.
If people with intellectual disabilities can be friends with other human beings, why think they cannot be friends of God as well, despite their seemingly “limited” (from our perspective) cognitive abilities?[14] James 2:5 tells us that God has “chosen those who are poor in the eyes of the world to be rich in faith and to inherit the kingdom he promised those who love him.” Persons with intellectual disabilities may be “poor” in the eyes of the world, but they can be “rich” in what matters most—faith.
References
[1] Down syndrome is “a set of cognitive and physical symptoms that result from having an extra chromosome 21 or an extra piece of that chromosome. It is the most common chromosomal cause of mild to moderate intellectual disabilities.” See “Down Syndrome,” NIH, accessed July 13, 2025, https://www.nichd.nih.gov/health/topics/factsheets/downsyndrome.
[2] Intellectual disability refers to differences in both “intellectual functioning or intelligence, which include the ability to learn, reason, problem solve, and other skills” and “adaptive behavior, which includes everyday social and life skills” that start prior to age eighteen (“About Intellectual and Developmental Disabilities [IDDs],” NIH, November 9, 2021, https://www.nichd.nih.gov/health/topics/idds/conditioninfo) and is typically classified into four categories of severity: “mild,” “moderate,” “severe” and “profound.” (See “Intellectual Disability,” Cleveland Clinic, May 5, 2023, https://my.clevelandclinic.org/health/diseases/25015-intellectual-disability-id for definitions and details).
[3] Shauna Amick, “About,” LinkedIn, accessed July 13, 2025, https://www.linkedin.com/in/shauna-amick-m-ed-b288211a6/.
[4] See “About,” Joni and Friends, accessed July 13, 2025, https://joniandfriends.org/about/.
[5] See Shauna Amick, My Baby Has a Disability: Life-Giving Questions and Answers (Joni and Friends, 2019), https://joniandfriends.org/product/my-baby-has-a-disability-life-giving-questions-and-answers/#.
[6] See the essays in David Wasserman, Jerome Bickenbach, and Robert Wachbroit, eds., Quality of Life and Human Difference: Genetic Testing, Health Care, and Disability (Cambridge University Press, 2005) for discussion of this and related issues.
[7] Neil Messer, Flourishing: Health, Disease, and Bioethics in Theological Perspective (Eerdmans, 2013), 70.
[8] For an extended discussion of the concept of flourishing, particularly as it relates to the contexts of health care and bioethics, along with extensive interaction with the disability literature, see Messer, Flourishing.
[9] See Lewis B. Smedes, “Can God Reach the Mentally Disabled?” Christianity Today, March 5, 2001, https://www.christianitytoday.com/2001/03/can-god-reach-mentally-disabled/ for a survey of some representative positions.
[10] John Knight, “Will My Son Go to Heaven? Infancy, Disability, and Sovereign Grace,” Desiring God, April 19, 2022, https://www.desiringgod.org/articles/will-my-son-go-to-heaven.
[11] Jared Mulvihill, “Cognitive Disability and Eternal Destiny: Open Letter to Uncertain Loved Ones,” April 4, 2020, Desiring God, https://www.desiringgod.org/articles/cognitive-disability-and-eternal-destiny.
[12] Mulvihill, “Cognitive Disability and Eternal Destiny.”
[13] “Can Infants and Mentally Disabled Individuals Go to Heaven?” Insight for Living, March 30, 2020, https://insight.org/resources/article-library/individual/can-infants-and-mentally-disabled-individuals-go-to-heaven.
[14] See Hans S. Reinders, Receiving the Gift of Friendship: Profound Disability, Theological Anthropology, and Ethics (Eerdmans, 2008) for extensive discussion of this idea.