Petetan, US Carnell Jr. A/K/A Carnell Petetan, Jr. ( 2021 )


Menu:
  •                IN THE COURT OF CRIMINAL APPEALS
    OF TEXAS
    NO. AP-77,038
    US CARNELL PETETAN, JR., Appellant
    v.
    THE STATE OF TEXAS
    ON REHEARING UPON COURT’S OWN MOTION
    FROM CAUSE NO. 2012-2331-C1 IN THE 19TH DISTRICT COURT
    McLENNAN COUNTY
    NEWELL, J. filed an opinion in which HERVEY, RICHARDSON,
    WALKER and MCCLURE, JJ., joined. KELLER, P.J., filed a dissenting
    opinion in which YEARY, KEEL and SLAUGHTER, JJ., joined.
    Appellant was convicted of the capital murder of his wife, Kimberly
    Petetan. The jury rejected, in a special issue, Appellant's claim that he
    is intellectually disabled and therefore categorically ineligible for the death
    Petetan Opinion On Rehearing — 2
    penalty.1 And the jury answered the statutory special issues in such a
    manner that Appellant was sentenced to death. Appeal to this court is
    automatic. We affirmed.2 Among the points of error we rejected were
    three relating to Appellant’s claim that he is intellectually disabled: that
    the jury’s answer to the intellectual disability special issue was against
    the great weight and preponderance of the evidence (claim 10); that he
    is ineligible for the death penalty due to intellectual disability (claim 11);
    and that he was entitled to a pre-trial determination of his intellectual
    disability (claim 27).
    At the time of our decision, Texas’s standard for evaluating claims
    of intellectual disability was being reviewed by the United States Supreme
    Court in the case of another Texas capital offender, Bobby James Moore.
    In 2015, we had held that Moore was not intellectually disabled and
    1
    The United States Supreme Court first used the term “mentally retarded” and its
    variants when it first recognized the Eight Amendment limitation on executing criminal
    defendants diagnosed with intellectual disability disorder. Atkins v. Virginia, 
    536 U.S. 304
    , 306
    (2002). The Court later announced that it would use the term “intellectual disability” to replace
    the term “mental retardation” because that was the terminology used in the Diagnostic and
    Statistical Manual of Mental Disorders. Hall v. Florida, 
    572 U.S. 701
    , 704 (2014). The fifth
    edition of the Diagnostic and Statistical Manual on Mental Disorders recognizes that this
    terminology is interchangeable with the more precise term for the disorder, “intellectual
    developmental disorder.” American Psychiatric Ass’n, Diagnostic and Statistical Manual of
    Mental Disorders at 33 (5th ed. 2013) (“DSM–5"). This opinion refers to the phrase
    “intellectual disability” and its variants even when referring to precedent using the phrase
    “mental retardation” and its variants for the sake of consistency.
    2
    Petetan v. State, ___ S.W.3d ___, 
    2017 WL 915530
     (Tex. Crim. App. Mar. 8, 2017).
    Petetan Opinion On Rehearing — 3
    consequently was eligible for the death penalty.3 The question before the
    Supreme Court was whether Texas’s legal standard for determining
    intellectual disability violated the Eighth Amendment’s prohibition against
    the execution of intellectually disabled people.4 Before we issued our
    mandate in the instant case, the Supreme Court decided that it did.5
    We granted rehearing in this case on our own motion to consider
    Appellant’s tenth, eleventh, and twenty-seventh claims in light of Moore.
    We substitute this opinion on rehearing for our resolution of those three
    issues, but leave the resolution of the other issues in the original opinion
    intact. Here, we again reject the claim that Appellant was entitled to a
    pre-trial determination of his intellectual disability.                  Concerning the
    sufficiency of the evidence regarding the jury’s rejection of his intellectual
    disability       claims,   we    apply    contemporary        clinical    standards—the
    framework set forth in the DSM–56—for assessing intellectual disability.
    We hold that, although legally sufficient, the evidence was factually
    3
    Ex parte Moore, 
    470 S.W.3d 481
    , 527–28 (Tex. Crim. App. 2015) (“Ex parte Moore
    I”).
    4
    Moore v. Texas, 
    137 S. Ct. 1039
    , 1044 (2017) (“Moore I”).
    5
    
    Id.
    6
    American Psychiatric Ass’n, Diagnostic and Statistical Manual of Mental Disorders (5th
    ed. 2013).
    Petetan Opinion On Rehearing — 4
    insufficient to support the jury’s rejection of the intellectual disability
    special issue. Appellant is therefore entitled to a new punishment hearing.
    Accordingly, we vacate Appellant’s death sentence and remand this cause
    for a new punishment hearing.
    Background
    The United State Supreme Court has held that executing a
    defendant diagnosed with intellectual developmental disorder violates the
    Eighth Amendment. When the State seeks the death penalty, a criminal
    defendant wanting to raise this issue must prove, by a preponderance of
    the evidence, that he is intellectually disabled.7 He must prove that he
    has subaverage intellectual functioning, and significant limitations in
    adaptive skills such as communication, self-care, and self-direction—both
    manifest before age eighteen.8
    Relevant to these criteria, the jury heard evidence at the
    7
    Franklin v. State, 
    579 S.W.3d 382
    , 386 (Tex. Crim. App. 2019) (the issue of intellectual
    disability is like an affirmative defense; the defendant has the burden to prove it by a
    preponderance of the evidence, whether the issue is raised at trial or on habeas).
    
    8 Hall, 572
     U.S. at 710 (“the medical community defines intellectual disability according
    to three criteria: significantly subaverage intellectual functioning, deficits in adaptive
    functioning (the inability to learn basic skills and adjust behavior to changing circumstances),
    and onset of these deficits during the developmental period”); Atkins, 
    536 U.S. at 318
     (“clinical
    definitions of [intellectual disability] require not only subaverage intellectual functioning, but
    also significant limitations in adaptive skills such as communication, self-care, and self-direction
    that became manifest before age 18”).
    Petetan Opinion On Rehearing — 5
    punishment phase of Appellant’s trial that all of Appellant’s IQ scores,
    adjusted for the standard error of measurement, fell in the “significantly
    subaverage intellectual functioning” category, and that several experts
    had diagnosed Appellant with intellectual disability.       First, the Texas
    Juvenile Justice Commission records showed that, in February of 1991,
    at age fifteen, Appellant was administered a child IQ test. The test yielded
    a full-scale IQ score of 61. It also yielded a verbal IQ score of 67 and a
    performance IQ score of 61.
    Second, in November 1991, psychiatrist Dr. Harold Scott examined
    Appellant as he entered a juvenile justice facility. As a result of the
    examination and previous test scores, Dr. Scott diagnosed Appellant as
    having “mild [intellectual disability] versus borderline intellectual
    functioning.” The phrase “versus borderline intellectual functioning” was
    a   hedge    on    the    intellectual   diagnosis    because     Appellant’s
    passive-aggressive nature and his stubbornness undermined the
    usefulness of the clinical interview as a measure of intellectual ability. Dr.
    Scott also diagnosed Appellant as having conduct disorder.
    Third, psychologist Dr. Ray Coxe administered intelligence and
    achievement tests to Appellant at age sixteen in April 1992. This testing
    was for the Jefferson County Juvenile Probation Office. The intelligence
    Petetan Opinion On Rehearing — 6
    tests for both children and adults were qualified for sixteen-year-olds, and
    Appellant took both tests. Appellant’s full-scale IQ score on the child test
    was 64 and on the adult test was 74. Dr. Coxe testified that the first
    test—where he had doubts about whether Appellant was putting forth his
    full effort—was the child test, which yielded the lower IQ score. Dr. Coxe
    felt that the second test, the adult test that yielded an IQ score of 74,
    was a reliable indicator of Appellant’s functioning. Nevertheless, Dr. Coxe
    testified that his “overall impression,” based on the results of testing and
    on observations during interviews, was that Appellant “was mildly
    [intellectually disabled].” He also diagnosed him with “undersocialized
    aggressive conduct disorder.”
    Fourth, an IQ test was given to Appellant when he entered the adult
    prison system. Travis Turner, the Vice Chairman of Classification in the
    Texas Department of Criminal Justice, testified that an offender is given
    an initial IQ test upon entry. If the offender scores below a certain cutoff,
    then a “secondary test”—involving adaptive behavior screening—is given
    to determine whether the offender should be assigned to the
    “developmentally disabled” program in the Hodge Unit. Appellant’s score
    on the IQ test was 69, so he was given the secondary test. There was no
    evidence of the results of that test. But Appellant was not assigned to
    Petetan Opinion On Rehearing — 7
    the program; he was assigned to the prison’s regular facilities.
    Fifth, in 2012, IQ testing was done as part of a Social Security
    disability   assessment.    Appellant,   by   then    age   thirty-six,   was
    administered the WAIS–III IQ test, which yielded a full-scale IQ score of
    55. The psychologist who conducted the test, Dr. Mark Correia, did not
    testify at trial, but his report was admitted into evidence. Dr. Correia
    diagnosed Appellant as having mild intellectual disability and antisocial
    personality disorder. The “mild [intellectual disability]” diagnosis was
    provisional “due to lack of supportive documentation from the
    developmental period.”
    Sixth, neuropsychologist Dr. Joan Mayfield conducted IQ tests and
    other testing at the request of the defense.         She administered the
    WAIS–IV IQ test and obtained a full scale IQ of 52. In light of all her
    testing, Dr. Mayfield concluded that Appellant “presents with global
    delays, global delays in intellectual ability and academic and attention and
    executive functioning and problem solving, memory, language, motor,
    and visual perception. There was global delays across all domains.”
    And seventh, psychologist Dr. Ellis Craig conducted an evaluation
    at the request of the defense to determine whether Appellant had
    adaptive deficits. He used the Adaptive Behavior Assessment System II
    Petetan Opinion On Rehearing — 8
    (ABAS–II), which uses people who know the subject (called “informants”)
    to assess the subject’s adaptive behavior in a number of areas. Dr. Craig
    conducted a “retrospective” screening, using reporting from family
    members. Dr. Craig concluded that the adaptive assessment scores fell
    within the range for moderate intellectual disability.
    As defense counsel pointed out to the jury in closing, the State did
    not put on an opposing expert to say that Appellant was not intellectually
    disabled. The jury considered all the evidence related to Appellant’s claim
    of intellectual disability and rejected it.          The jury also found against
    Appellant on the mitigation special issue.
    I.   The Evolution of the Legal Framework for Determining
    Intellectual Disability
    A.        Atkins
    In Atkins v. Virginia, the Supreme Court held that the Eighth
    Amendment bars the execution of intellectually disabled offenders.9 The
    Court stated that those intellectually disabled persons “who meet the
    law’s requirements for criminal responsibility should be tried and punished
    when they commit crimes.”10 But a death sentence is not a suitable
    9
    Atkins v. Virginia, 
    536 U.S. 304
     (2002).
    10
    
    Id. at 306
    .
    Petetan Opinion On Rehearing — 9
    punishment for an intellectually disabled criminal because the diminished
    capacity of the intellectually disabled criminal lessens his moral
    culpability.11
    The Court noted that clinical definitions of intellectual disability
    “require not only subaverage intellectual functioning, but also significant
    limitations in adaptive skills such as communication, self-care, and
    self-direction that became manifest before age 18.”12                But the Court
    recognized that “[n]ot all people who claim to be [intellectually disabled]
    will be so impaired as to fall within the range of [intellectually disabled]
    offenders about whom there is a national consensus” regarding
    diminished moral culpability.13 It otherwise left to the States the task of
    developing appropriate ways to enforce this constitutional restriction.14
    B.         Hall
    Later, in Hall v. Florida, the Court established rules, based on clinical
    standards, for interpreting IQ scores.15 Clinical definitions for intellectual
    11
    
    Id.
    12
    
    Id. at 318
    .
    13
    
    Id. at 317
    .
    14
    
    Id.
    15
    Hall v. Florida, 
    572 U.S. 701
     (2014).
    Petetan Opinion On Rehearing — 10
    disability, by their express terms, reject a strict IQ test score cutoff at 70
    and include the standard error of measurement (“SEM”).16          The SEM is
    “a statistical fact, a reflection of the inherent imprecision of the test
    itself.”17 For purposes of most IQ tests, this imprecision in the testing
    instrument means that an individual’s score is best understood as a range
    of scores on either side of the recorded score within which one may say
    an individual’s true IQ score lies.18
    Florida, however, had a law that, as interpreted, defined intellectual
    disability to require an IQ test score of 70 or less and failed to take into
    account the SEM.19           The Court held that Florida’s 70-point threshold
    disregarded established medical practice in two interrelated ways: (1) it
    took an IQ score as final and conclusive evidence of a defendant’s
    intellectual capacity, when experts would consider other evidence; and
    (2) it relied on a purportedly scientific measurement of a defendant’s
    abilities, his IQ score, while refusing to recognize that measurement’s
    16
    
    Id.
     at 712–13, 719.
    17
    
    Id. at 713
    .
    18
    
    Id.
    19
    
    Id.
     at 711–12.
    Petetan Opinion On Rehearing — 11
    inherent imprecision.20 The Court held that Florida’s strict IQ cutoff was
    unconstitutional because it created an unacceptable risk that persons with
    intellectual disability will be executed.21
    After Hall, a State cannot refuse to consider other evidence of
    intellectual disability when a defendant’s IQ score is close to, but above,
    70.22 Though Hall reiterated that the legal determination of intellectual
    disability is distinct from a medical diagnosis, it also emphasized that the
    legal determination is informed by the medical community’s diagnostic
    framework.23
    C.        Ex parte Moore I and Ex parte Moore II
    The following year, in Ex parte Moore I, we held that Moore’s IQ
    scores of 78 and 74 failed to establish by a preponderance of the
    evidence that he had significantly sub-average general intellectual
    functioning.24 Even though Moore had not established that criterion for
    20
    
    Id. at 712
    .
    21
    
    Id. at 704
    .
    22
    
    Id. at 723
     (“[W]hen 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.”).
    23
    
    Id. at 721
    .
    24
    Ex Parte Moore I, 470 S.W.3d at 514.
    Petetan Opinion On Rehearing — 12
    intellectual disability, we went on to consider adaptive functioning.25 We
    held that Moore had not proven by a preponderance of the evidence that
    he had significant and related limitations in adaptive functioning.26 We
    noted some of Moore’s adaptive strengths, such as the fact that he
    survived on the streets, mowed lawns, and played pool for money.27 We
    further stated that the record showed that Moore’s academic difficulties
    were caused by a variety of factors—including trauma from the
    emotionally and physically abusive atmosphere in which he was raised
    and undiagnosed learning disorders—rather than by significantly
    sub-average general intellectual functioning.28 We concluded that Moore
    had not shown that his adaptive deficits were related to significantly sub-
    average general intellectual functioning.”29
    But we also relied upon our own case, Ex parte Briseno,30 to support
    this conclusion.31           We said that the Briseno factors weighed heavily
    25
    Id. at 520.
    26
    Id.
    27
    Id. at 522.
    28
    Id. at 488, 526.
    29
    Id. at 488, 526.
    30
    Ex parte Briseno, 
    135 S.W.3d 1
     (Tex. Crim. App. 2004).
    31
    Ex parte Moore I, 470 S.W.3d at 526–27.
    Petetan Opinion On Rehearing — 13
    against a finding that Moore’s adaptive deficits were related to
    significantly sub-average general intellectual functioning.32 We then
    rejected Moore’s claim of intellectual disability.33
    The Supreme Court granted certiorari. The Supreme Court held in
    part that our conclusion regarding Moore’s IQ scores was irreconcilable
    with Hall.34 The Court stated that our consideration of factors unique to
    Moore in disregarding the lower end of the SEM was contrary to clinical
    standards.35 According to clinicians, the presence of other sources of
    imprecision in administering the test to a particular individual cannot
    narrow the test-specific standard-error range.36 Because the lower end
    of Moore’s score range fell at or below 70, we had to move on to consider
    Moore’s adaptive functioning.37
    The Court also found fault with our adaptive-deficit conclusion.38
    First, the Court held that our reliance on Moore’s perceived adaptive
    32
    Id.
    33
    Id. at 527–28.
    34
    Moore I, 
    137 S. Ct. at 1049
    .
    35
    
    Id.
     at 1049–50.
    36
    
    Id. at 1049
    .
    37
    
    Id.
    38
    
    Id. at 1050
    .
    Petetan Opinion On Rehearing — 14
    strengths was erroneous.39 The proper inquiry, according to clinicians,
    should be on Moore’s deficits, like his lack of a basic understanding of
    time, seasons, the standards of measure, basic math, and his limited
    ability to read and write.40   The Court also chastised our reliance on
    Moore’s behavior in prison to support a finding of adaptive strengths.41
    According to the Court, this was inappropriate because clinicians caution
    against reliance on adaptive strengths developed in a controlled setting,
    like a prison.42
    Suspect, too, was our finding of record support that Moore’s
    academic difficulties were caused by a variety of factors rather than
    significantly sub-average general intellectual functioning.43 According to
    the Supreme Court, clinicians rely on such traumatic experiences as cause
    to explore the prospect of intellectual disability further, rather than to
    counter the case for a disability determination.44
    The Court also said that we departed from clinical practice by
    39
    
    Id.
    40
    
    Id.
    41
    
    Id.
    42
    
    Id.
    43
    
    Id. at 1051
    .
    44
    
    Id.
    Petetan Opinion On Rehearing — 15
    requiring Moore to show that his adaptive deficits were not related to “a
    personality disorder.”45 Again, according to clinicians, the existence of a
    personality disorder or mental-health issue is “‘not evidence that a person
    does not also have intellectual disability’”; many intellectually disabled
    people also have other mental or physical impairments.46
    Finally, the Court held that our attachment to the seven Briseno
    evidentiary factors “further impeded” our assessment of Moore’s adaptive
    functioning.47 The Court criticized the use of these factors both because
    they had no grounding in prevailing medical practice and because they
    invited “lay perceptions of intellectual disability” and “lay stereotypes” to
    guide assessment of intellectual disability.48 Emphasizing the Briseno
    factors over clinical factors, the Court said, creates an unacceptable risk
    that persons with intellectual disability will be executed.49 To sum up, the
    Court held that we, contrary to clinical practice: overemphasized Moore’s
    perceived adaptive strengths; stressed Moore’s improved behavior in
    45
    
    Id.
    46
    
    Id.
     (quoting Brief for American Psychological Association, APA, et al. as Amici Curiae
    19).
    47
    
    Id.
    48
    
    Id. at 1052
    .
    49
    
    Id. at 1051
    .
    Petetan Opinion On Rehearing — 16
    prison; concluded that Moore’s record of traumatic experiences detracted
    from a determination that his intellectual and adaptive deficits were
    related; required Moore to show that his adaptive deficits were not
    related to a personality disorder; and considered the Briseno factors. The
    Court vacated our judgment and remanded the case for further
    proceedings not inconsistent with the opinion.50
    On remand, we adopted the contemporary clinical standards set
    forth in the DSM–5 for assessing intellectual disability.51                   We applied
    those standards and once again determined that Moore was not
    intellectually disabled.52 Given that determination, we held that Moore
    was eligible for the death penalty.53
    The Supreme Court granted certiorari and summarily reversed.54
    The Supreme Court emphasized that, while Atkins and Hall left to the
    States the task of developing appropriate ways to enforce the restriction
    on executing intellectually disabled people, a court’s intellectual disability
    50
    
    Id. at 1053
    .
    51
    Ex parte Moore, 
    548 S.W.3d 552
    , 560 (Tex. Crim. App. 2018) (“Ex parte Moore II”).
    52
    
    Id. at 573
    .
    53
    
    Id.
    54
    Moore v. Texas, 
    139 S. Ct. 666
     (2019) (per curiam) (“Moore II”).
    Petetan Opinion On Rehearing — 17
    determination must be informed by the medical community’s diagnostic
    framework.55          According to the Court, we had again run afoul of the
    medical community’s diagnostic framework. This Court had: “relied less
    upon the adaptive deficits to which the trial court had referred than upon
    Moore’s apparent adaptive strengths”; “relied heavily upon adaptive
    improvements made in prison”; “concluded that Moore failed to show that
    the ‘cause of [his] deficient social behavior was related to any deficits in
    general mental abilities’ rather than ‘emotional problems’”; and “used
    many of [the Briseno] factors in reaching its conclusion.”56 The Court
    concluded that our opinion rested upon analysis too much of which too
    closely resembled what it had previously found improper.57 Given that,
    the Court held that Moore had shown he is a person with intellectual
    disability.58
    D.        The DSM–5, AAIDD-11, and “Relatedness”
    55
    Id. at 669.
    56
    Id. at 670–71.
    57
    Id. at 672.
    58
    Id. at 672. The Supreme Court reversed and remanded. And we reformed Moore’s
    sentence to life. Ex parte Moore, 
    587 S.W.3d 787
    , 788–89 (Tex. Crim. App. 2019) (“Having
    concluded that Applicant is a person with intellectual disability that is exempt from the death
    penalty, the Supreme Court has resolved Applicant’s claim in his favor. There is nothing left for
    us to do but to implement the Supreme Court’s holding. Accordingly, we reform Applicant’s
    sentence of death to a sentence of life imprisonment.”).
    Petetan Opinion On Rehearing — 18
    The Supreme Court’s evolving jurisprudence after Atkins leaves one
    small question open; must a defendant show that adaptive deficits are
    “related” to sub-average intellectual functioning? In Atkins, the United
    States Supreme Court mentioned two sources for determining intellectual
    disability, one from the American Psychiatric Association (APA) and the
    other from the American Association on Mental Retardation (now the
    AAIDD).59 Both pointed to the same three accepted diagnostic criteria
    (sub-average intellectual functioning, adaptive deficits, and onset prior to
    age eighteen), and both added the requirement that adaptive deficits
    must be related to sub-average intellectual functioning. But the AAIDD
    has since dropped that requirement, while the APA has not.60
    The APA and the AAIDD seem to approach their respective manuals
    from slightly different perspectives. The APA has designed the DSM-5
    primarily as an aid to clinicians; the drafters sought a common
    59
    Atkins, 526 U.S. at 308 n.3. At the time, the APA derived its definition and diagnostic
    criteria for intellectual disability from the fourth edition of the Diagnostic and Statistical Manual
    of Mental Disorders. The definition and diagnostic criteria has not changed from the fourth to
    the fifth edition. Compare DSM-4 at 42–43 with DSM-5 at 37–38. The American Association
    on Mental Retardation derived its definition and diagnostic criteria for intellectual disability from
    the ninth edition of its diagnostic manual, “Mental Retardation: Definition, Classification, and
    Systems of Supports 5.” After Atkins, The American Association on Mental Retardation changed
    its name to the American Association on Intellectual and Developmental Disabilities (AAIDD).
    AAIDD currently derives its definition and diagnostic criteria for intellectual disability from the
    eleventh edition of that diagnostic manual. The current edition of the AAIDD diagnostic manual
    omits the “relatedness” requirement.
    60
    See note 59.
    Petetan Opinion On Rehearing — 19
    terminology that would apply to a wide range of disciplines, including the
    law.61 The DSM recognizes that its diagnostic criteria are guidelines for
    use by clinicians, and acknowledges the need for caution when using
    them in forensic settings.              It specifically notes the risk of misuse
    attendant to relying upon the DSM-5's categories, criteria, and textual
    descriptions in a forensic setting.62 Nevertheless, this caution underlies
    that the manual has been drafted with the understanding that it will be
    used as a reference for courts and attorneys as well as clinicians.63
    In contrast, the AAIDD takes a more forward-looking view.
    According to the AAIDD-11, “the concept of intellectual disability (ID)
    belongs within the general construct of disability that has evolved over
    the last 3 decades to emphasize an ecological perspective that focuses on
    the interaction of the person with his or her environment and the
    recognition that the systemic application of individualized supports can
    61
    DSM-5 at xii (“Although this edition of DSM was designed first and foremost to be a
    useful guide in clinical practice, as an official nomenclature it must be applicable to a wide
    diversity of context.”).
    62
    DSM-5 at 25 (“When DSM-5 categories, criteria, and textual descriptions are employed
    for forensic purposes, there is a risk that diagnostic information will be misused or
    misunderstood.”).
    63
    Id. (“Although the DSM-5 diagnostic criteria and text are primarily designed to assist
    clinicians in conducting clinical assessment, case formulation, and treatment planning, DSM-5
    is also used as a reference for the courts and attorneys in assessing the forensic consequences
    of mental disorders.”).
    Petetan Opinion On Rehearing — 20
    enhance human functioning.”64                   Further, the AAIDD does not regard
    intellectual disability as a character trait.65 Instead, it sees intellectual
    disability as exemplifying the interaction between the person and his or
    her environment. The focus is on the role that individualized supports
    can play in enhancing human functioning and allowing for the pursuit and
    understanding of the principles inherent within the disability movement.66
    According to the AAIDD-11, “an important purpose of describing
    limitations is to develop a profile of needed supports.”67
    The approach taken in each manual highlights the inherent tension
    between the clinical perspective attendant to a diagnosis of intellectual
    development             disorder     and     the     legal      determination          of    moral
    blameworthiness.68 At its core, Atkins seems to rest its justification for
    a death-penalty exemption on the assumption that intellectual disability
    is a character trait that lessens moral culpability and so the retributive
    64
    AAIDD at xiii.
    65
    Id.
    66
    Id.
    67
    Id. at 1.
    68
    See, e.g., Kansas v. Crane, 
    534 U.S. 407
    , 413 (2002) (noting that “the science of
    psychiatry, which informs but does not control ultimate legal determinations, is an
    ever-advancing science, whose distinctions do not seek precisely to mirror those of the law”);
    Hall, 572 U.S. at 721 (“It is the Court's duty to interpret the Constitution, but it need not do so
    in isolation. The legal determination of intellectual disability is distinct from a medical diagnosis,
    but it is informed by the medical community's diagnostic framework.”).
    Petetan Opinion On Rehearing — 21
    value of the punishment. But the clinical criteria for diagnosing someone
    with intellectual development disorder seems to look forward to how the
    diagnosis can better assist the individual function in society without
    regard to any consideration of moral blameworthiness. And, as in the
    case with the AAIDD-11, there is an affirmative rejection of any
    character-based assessment.
    Nevertheless, the Supreme Court held that states are to focus on
    whether a capital murder defendant falls within that category of
    intellectual       developmental            disorder       that     limits      his    moral
    blameworthiness—the              original     justification       for    the     categorical
    exemption.69       To the extent that the clinical diagnosis of intellectual
    developmental disorder can be harmonized with a reviewing court’s legal
    inquiry under Atkins and its progeny, the approach taken by the DSM-5
    hews closer to the original justification set out by the Supreme Court than
    the AAIDD-11. And that is the approach we take.
    This is not to suggest that a court or jury should reject an expert’s
    testimony simply because the expert’s diagnosis was informed by the
    69
    Atkins, 
    536 U.S. at 306
     (“Those [intellectually disabled] persons who meet the law's
    requirements for criminal responsibility should be tried and punished when they commit crimes.
    Because of their disabilities in areas of reasoning, judgment, and control of their impulses,
    however, they do not act with the level of moral culpability that characterizes the most serious
    adult criminal conduct.”).
    Petetan Opinion On Rehearing — 22
    AAIDD-11. Such an approach would be antithetical to the caution urged
    by the drafters of the DSM-5 when considering the use of the manual in
    a forensic setting. As mentioned above, the criteria for diagnosing an
    individual with intellectual developmental disorder are largely the same
    in both diagnostic manuals. Nothing in this opinion should be construed
    as prohibiting consideration of or reliance upon the AAIDD-11. We only
    recognize that there must be a showing that adaptive deficits are related
    to subaverage intellectual functioning to satisfy the Atkins exception to
    the imposition of the death penalty.
    Neither do we suggest that this “relatedness” inquiry is unlimited.
    The Supreme Court did clarify in Moore I that relatedness cannot be a
    backdoor for reliance upon lay stereotypes or evidence of adaptive
    strengths to undermine an otherwise clinical diagnosis.70 Similarly, the
    Supreme Court faulted this Court for requiring proof that adaptive deficits
    are not related to “a personality disorder” because many intellectually
    disabled people have other mental or physical impairments.71 So while
    the relational requirement found in the DSM-5 is currently a necessary
    legal requirement under Atkins, it is not a vehicle to undermine an
    70
    Moore I, 137 at 1051.
    71
    
    Id.
    Petetan Opinion On Rehearing — 23
    otherwise clinical diagnosis through consideration of lay stereotypes,
    adaptive strengths, and alternative disorders.
    Under the DSM–5, the following three criteria must be met for a
    person to be considered intellectually disabled: (A) deficits in intellectual
    functions; (B) deficits in adaptive functioning that are directly related to
    the intellectual impairments; and (C) the onset of these intellectual and
    adaptive deficits during childhood or adolescence.72                   We will address
    criterion one and criterion two in turn. We do not address criterion three
    because it is not in dispute. With that background in mind, and now with
    the benefit of both Moore decisions, we revisit our resolution of
    Appellant’s intellectual disability claims in this case.
    II.    The Constitution Does Not Require a Pre-trial Determination
    of Intellectual Disability
    On original submission, Appellant argued that the trial court erred
    in denying his motion for a pretrial determination of intellectual disability.
    At that time, the Legislature had not enacted legislation on this topic.
    This remains the case today.73                We concluded that “the issue of
    72
    DSM-5 at 33; see AAIDD–11. As Chief Justice Roberts noted in his dissent in Moore,
    “Keeping the relatedness requirement would be inconsistent with the AAIDD’s current guidance;
    dropping it would be out of step with the newest version of the DSM.” Moore, 
    137 S. Ct. at 1055
     (Roberts, C.J., dissenting).
    73
    See Tex. HB 1139, 86th Leg., R.S. (2019). The bill, filed by State Rep. Senfronia
    Thompson, D-Houston, would have provided, among other things, that in the face of evidence
    Petetan Opinion On Rehearing — 24
    [intellectual disability] may not be litigated pretrial.”74 We reasoned that:
    At any pretrial determination of [intellectual disability], the
    State would have to marshal “all of its evidence” of the
    defendant’s guilt of the offense and his role in the offense in
    order for the factfinder to be able to assess how that evidence
    might weigh into resolving the issue. That has to occur
    because the defendant’s conduct in connection with the
    offense is relevant to determining whether he is [intellectually
    disabled]. Moreover, nearly all of the State’s punishment
    evidence would be relevant as well. For example, extraneous
    offenses not explored at the guilt phase could shed as much
    light on a defendant’s mental abilities as the offense for which
    he is on trial. [Intellectual disability] “is a sentencing issue,”
    and litigating such an issue before a finding of guilt “puts the
    cart before the horse and results in an advisory opinion.”75
    On rehearing, Appellant argues that Moore undercuts our conclusion on
    from a credible source indicating that a capital defendant is a person with an intellectual
    disability and a timely request, “the judge shall hold a hearing to determine the issue not later
    than the 120th day before the date the trial is scheduled to begin.” As was reported in the
    Texas Tribune on May 26, 2019:
    As the bill moved through the Senate, however, it was largely gutted, instead
    only stating that a defendant who has an intellectual disability can’t receive the
    death penalty and such determinations must be made using current medical
    standards. That language would have codified existing U.S. Supreme Court
    rulings but offered no direction on how to follow them.
    Earlier this week, when the bill came back from the Senate amended, Thompson
    requested a conference committee in which members from both chambers could
    iron out the differences between the two versions. The committees had until
    midnight Sunday to file a report with a compromise version. The deadline passed
    without a report.
    Elizabeth Byrne and Jolie Mccullough, Despite bipartisan support, Texas bill tackling intellectual
    disability in death penalty cases fails, Texas Tribune, May 26, 2019,
    https://www.texastribune.org/2019/05/26/Texas-death-penalty-intellectual-disability-fails/.
    74
    Petetan, 
    2017 WL 915530
    , at *46.
    75
    Id., at *45.
    Petetan Opinion On Rehearing — 25
    original submission.76 We disagree.
    Atkins and its progeny did not hold that an intellectual-disability
    determination was something other than a sentencing issue, and they do
    not require a pretrial determination. Nor do the cases (in spite of the
    Court’s rejection of the Briseno factors)77 say details of the offense can’t
    be considered at all; rather, the cases just state that the focus should be
    on adaptive deficits and that adaptive strengths should not be
    overemphasized.78             And, given the relational requirement under the
    DSM–5, consideration of the details of the offense (and extraneous
    offenses) may be necessary when evaluating the strength and reliability
    of an expert’s opinion regarding intellectual disability. This is true even
    if the details do not provide an independent basis for determining the
    76
    Appellant’s Br. 52.
    77
    Briseno, 
    135 S.W.3d, at
    8–9 (“Putting aside any heinousness or gruesomeness
    surrounding the capital offense, did the commission of that offense require forethought,
    planning, and complex execution of purpose?”). See Brief for AAIDD et al. as Amici Curiae 14–
    15, and n.23 (“AAIDD has specifically disapproved of using the facts of the crime in the
    diagnostic process.” AAIDD, Manual 2010, supra note 3, at 102; American Association on
    Intellectual and Developmental Disabilities, User’s Guide: To Accompany the 11th Edition of
    Intellectual Disability: Definition, Classification, and Systems of Supports 20 (2012) (“Do not
    use past criminal behavior or verbal behavior to infer level of adaptive behavior. . . . The
    diagnosis of ID is not based on the person’s ‘street smarts,’ behavior in jail or prison, or
    ‘criminal adaptive functioning.’”)). But again, the jury is not diagnosing intellectual disability.
    It is determining whether Appellant fits in the class of “less morally culpable.” Ex parte Butler,
    
    416 S.W.3d 863
    , 870–71, 875 & n.51 (Tex. Crim. App. 2012) (per curiam) (“while clinicians
    might not use such behaviors in their diagnostic analysis, factfinders in the judicial system are
    not precluded from doing so”) (Cochran, J., concurring).
    78
    See, e.g., Moore I, 
    137 S. Ct. at 1059
    .
    Petetan Opinion On Rehearing — 26
    existence of an intellectual disability.79                   Therefore, under existing
    Supreme Court case law, and in light of the lack of state legislation, we
    re-affirm our holding that intellectual disability is a sentencing issue. And
    sentencing issues are generally not ripe for review before a finding of
    guilt.
    Indeed, Texas courts are not empowered to give advisory
    opinions—a prohibition that extends to cases that are not ripe for
    review.80 An issue is ripe when “the facts are sufficiently developed ‘so
    that an injury has occurred or is likely to occur, rather than being
    contingent or remote.’ . . . Thus, the ripeness analysis focuses on whether
    a case involves uncertain or contingent future events that may not occur
    as anticipated or may not occur at all.”81
    For example, in State ex rel. Watkins v. Creuzot, the defendant filed
    79
    DSM-5 at 38 (“To meet diagnostic criteria for intellectual disability, the deficits in
    adaptive functioning must be directly related to the intellectual impairments described in
    Criterion A.”).
    80
    Patterson v. Planned Parenthood of Hous. and Se. Tex., Inc., 
    971 S.W.2d 439
    , 443
    (Tex. 1998).
    81
    Patel v. Tex. Dep’t of Licensing and Regulation, 
    469 S.W.3d 69
    , 78 (Tex. 2015)
    (quoting Waco Indep. Sch. Dist. v. Gibson, 
    22 S.W.3d 849
    , 851–52 (Tex. 2000)); see In re
    Allen, 
    462 S.W.3d 47
    , 67 (Tex. Crim. App. 2015) (Newell, J., dissenting) (“‘At the time a lawsuit
    is filed, ripeness asks whether the facts have developed sufficiently so that an injury has
    occurred or is likely to occur, rather than being contingent or remote.’”) (quoting Patterson, 971
    S.W.2d at 442).
    Petetan Opinion On Rehearing — 27
    a motion to preclude the death penalty in his retrial.82 He argued that the
    lengthy delay in obtaining post-conviction relief had rendered certain
    mitigation evidence unavailable.83 After several evidentiary hearings, the
    trial judge granted the motion.84 The State filed a petition for a writ of
    mandamus and prohibition to require the trial judge to vacate this
    order.85        We concluded that the trial judge did not have the legal
    authority to preclude the State from seeking the death penalty and
    therefore conditionally granted mandamus relief.86
    In support of that conclusion, we stated that the adequacy of the
    defendant’s mitigation case was not yet ripe for review.87 We explained:
    We do not put the cart before the horse: “a defendant has no
    claim of wrongful conviction or wrongful sentencing before he
    has even gone to trial.” The adequacy and efficacy of [the
    defendant’s] mitigation case cannot be judged unless he has
    actually been convicted of capital murder and sentenced to
    death. Any pretrial determination of that mitigation case is
    necessarily hypothetical and unlikely to fairly reflect reality as
    82
    State ex rel. Watkins v. Creuzot, 
    352 S.W.3d 493
    , 494–95 (Tex. Crim. App. 2011).
    83
    
    Id. at 498
    .
    84
    
    Id.
    85
    
    Id. at 494
    .
    86
    
    Id. at 506
    .
    87
    
    Id. at 504
    .
    Petetan Opinion On Rehearing — 28
    it plays out in an actual trial.88
    That reasoning in Creuzot applies equally here. The injury Appellant
    complains about is imposing a death sentence on an intellectually
    disabled defendant in violation of the Eighth Amendment. But pretrial,
    that injury involves “uncertain or contingent future events that . . . may
    not occur at all.”89 Imposing a death sentence first requires a finding of
    guilt—something that, before trial, is “uncertain.” Holding a hearing on
    intellectual disability prior to a finding of guilt puts the cart before the
    horse and results in an advisory opinion.         More simply, a claim of
    intellectual disability is not yet ripe for review.
    Appellant argues that we should look at other states’ practices when
    determining this issue. Appellant asserts that, out of the states that have
    capital punishment, a majority of them either provide for or mandate a
    pretrial determination.90 While that may be true, Atkins and its progeny
    do not require it. Neither does Texas law.
    Appellant also argues that an intellectual-disability determination is
    a threshold question that must be determined apart from the merits of
    88
    
    Id. at 505
    .
    89
    Patel, 469 S.W.3d at 78.
    90
    Appellant’s Br. 58.
    Petetan Opinion On Rehearing — 29
    the case itself.91         In support of that argument, Appellant likens an
    intellectual-disability determination to determinations of a defendant’s
    incompetency or juvenile status—both of which are determined pretrial.92
    Regarding incompetency, he relies on Ex parte Hagans, in which we
    stated: “[W]here there is evidence to support a finding of incompetency
    to stand trial, a jury shall be impaneled, separate from the jury selected
    to determine guilt or innocence of the defendant, to determine the
    defendant’s competency to stand trial.”93 This requirement ensures that
    “an accused’s competency can be made ‘uncluttered by evidence of the
    offense itself.’”94
    Appellant, however, overlooks the right protected by that
    requirement: “The conviction of an accused while he is legally
    incompetent to assist in his own defense violates fundamental interests
    of due process.”95 It is the conviction itself that violates an incompetent
    defendant’s constitutional rights. This makes a pretrial incompetency
    91
    Id. at 60–61.
    92
    Id. at 63–67.
    93
    Ex parte Hagans, 
    558 S.W.2d 457
    , 461 (Tex. Crim. App. 1977).
    94
    
    Id.
    95
    
    Id.
     (emphasis added).
    Petetan Opinion On Rehearing — 30
    determination ripe for review. But with intellectual disability, it is not the
    conviction we are concerned with—it is the punishment.96 And we do not
    reach the issue of punishment without a conviction.                          Therefore, the
    rationale for requiring incompetency determinations pretrial is not
    applicable to intellectual-disability determinations.
    Finally, Appellant likens the categorical exemption from the death
    penalty for people with intellectual disability to the categorical exception
    from the death penalty for juveniles.                    According to Appellant, “the
    constitutional underpinnings of the categorical exemption for persons with
    intellectual disability are exactly the same as the categorical exemption
    for juveniles.”97          Therefore, in Appellant’s view, “the procedure for
    determining intellectual disability should be ‘no different from conducting
    a pretrial determination of whether the defendant was a juvenile at the
    time of the offense.’”98 Though we agree that the categorical exemption
    from the death penalty for juveniles developed from the categorical
    exemption for intellectually disabled individuals, we disagree that there
    96
    Cf. Atkins, 
    536 U.S. at 306
     (“Those [intellectually disabled] persons who meet the
    law’s requirements for criminal responsibility should be tried and punished when they commit
    crimes.”).
    97
    Appellant’s Br. 63.
    98
    
    Id.
     (quoting In re Allen, 
    462 S.W.3d at 54
     (Meyers, J., concurring)).
    Petetan Opinion On Rehearing — 31
    is no difference in the procedures for juvenile offenders and adult
    offenders.
    For a juvenile to be tried as an adult for capital murder, the juvenile
    must first be transferred from the juvenile system to the district court.99
    For the juvenile system to have jurisdiction to transfer the case, the
    defendant must have been a juvenile (under the age of 17) when the
    offense was committed.100                Therefore, the defendant’s age must
    necessarily be determined at that time, making it ripe for review. And,
    unlike intellectual-disability determinations, the defendant’s age is usually
    readily ascertainable and not subject to reasonable dispute and does not
    depend on the facts of the offense or other evidence relating to
    punishment such as the defendant’s dangerousness and moral culpability.
    Thus, the rationale for requiring juvenile-status determinations prior to
    trial is not applicable to intellectual-disability determinations.
    Lastly, Appellant asserts that a pretrial determination “is plainly in
    the interest of judicial economy.”101              This may well be true.   But
    “[p]ublic-policy arguments quickly pile up on both sides of the debate on
    99
    Moon v. State, 
    451 S.W.3d 28
    , 37–38 (Tex. Crim. App. 2014).
    100
    See TEX. FAM. CODE § 51.04.
    101
    Appellant’s Br. 67.
    Petetan Opinion On Rehearing — 32
    when and by whom intellectual-disability determinations should be made;
    . . . [T]hey find utility only in the Legislature and should be directed
    there.”102 And our Legislature punted on that issue (again) when it last
    considered it.
    We therefore conclude that Atkins and its progeny do not require a
    pre-trial determination of intellectual disability as a matter of federal
    constitutional law.         Because the pre-trial determination was neither
    constitutionally nor statutorily required, the trial court did not err in
    refusing to hold a pre-trial hearing on the issue of intellectual disability.
    III. The Evidence Was Legally Sufficient To Support The Jury’s
    Adverse Finding on Intellectual Disability
    A.        Standard of Review
    Intellectual disability is a punishment-mitigation issue that is in the
    nature of an affirmative defense. The defendant shoulders the burden of
    proof to show intellectual disability by a preponderance of the evidence.103
    Affirmative defenses may be evaluated for legal and factual sufficiency.104
    In a legal-sufficiency review of an affirmative defense, reviewing
    102
    In re Allen, 
    462 S.W.3d at 53
    .
    103
    Neal v. State, 
    256 S.W.3d 264
    , 273 (Tex. Crim. App. 2008).
    104
    Matlock v. State, 
    392 S.W.3d 662
    , 669–70 (Tex. Crim. App. 2013).
    Petetan Opinion On Rehearing — 33
    courts should first assay the record for a scintilla of evidence favorable to
    the factfinder’s finding and disregard all evidence to the contrary unless
    a reasonable factfinder could not.105 The finding of the factfinder rejecting
    a defendant’s affirmative defense should be overturned for lack of legal
    sufficiency only if the appealing party establishes that the evidence
    conclusively proves his affirmative defense, and no reasonable factfinder
    was free to think otherwise.106
    We are, as was noted in the original majority opinion, evaluating the
    jury’s determination rather than independently considering whether
    Appellant is intellectually disabled.107 Unlike in the habeas context, we
    are not the ultimate factfinder on direct appeal.108                         The issue of
    intellectual disability was litigated at trial before a jury, and on direct
    appeal from that trial, we exercise appellate-style deference to the
    determination made by the jury.109 In the face of a record of historical
    105
    Butcher v. State, 
    454 S.W.3d 13
    , 20 (Tex. Crim. App. 2015) (citing Matlock, 392
    S.W.3d at 669–70).
    106
    Id. (citing Matlock, 392 S.W.3d at 670).
    107
    Petetan, 
    2017 WL 915530
    , at *6.
    108
    See Ex parte Owens, 
    515 S.W.3d 891
    , 895 (Tex. Crim. App. 2017) (on habeas
    review, although the trial court is the “original” factfinder, the Court is the “ultimate fact-
    finder”).
    109
    Neal, 
    256 S.W.3d at 273
    .
    Petetan Opinion On Rehearing — 34
    facts that supports conflicting inferences, a reviewing court must
    presume—even if it does not affirmatively appear in the record—that the
    trier of fact resolved any such conflicts in favor of the verdict, and must
    defer to that resolution.110
    B.        Analysis
    1.     Criterion A: Intellectual Deficits
    Criterion A—deficits in intellectual functioning—“refers to intellectual
    functions that involve reasoning, problem solving, planning, abstract
    thinking, judgment, learning from instruction and experience, and
    practical        understanding.            Critical    components        include     verbal
    comprehension, working memory, perceptual reasoning, quantitative
    reasoning, abstract thought, and cognitive efficacy.”111 These functions
    are typically measured through individually administered tests of
    intelligence.112 A score “approximately two standard deviations or more
    below the population mean, including a margin for measurement error
    (generally +5 points)” indicates intellectual disability.113 For tests with a
    110
    See Jackson v. Virginia, 
    443 U.S. 307
    , 326 (1979).
    111
    DSM–5 at 37.
    112
    
    Id.
     The tests must be psychometrically valid, comprehensive, culturally appropriate,
    and psychometrically sound. 
    Id.
    113
    Id.; AAIDD–11 at 35.
    Petetan Opinion On Rehearing — 35
    mean of 100 and standard deviation of 15, this would be a score of 65 to
    75 (70 ± 5).114 Practice effects and the “Flynn effect,”115 however, may
    affect test scores.116
    Here, Appellant produced the following IQ test scores:
    Psychologist                    Year      Score
    Texas Juvenile                  1991      61 (Full scale)
    Justice Commission                        67 (Verbal)
    61 (Performance)
    Dr. Ray Coxe                    1992      Child
    64 (Full scale)
    Adult
    74 (Full scale)
    Texas Department                1993      69 (Unclear)
    of Criminal Justice
    Dr. Mark Correia                2012      55 (Full scale)
    Dr. Joan Mayfield               2013      52   (Full scale)
    54   (Verbal)
    56   (Perceptual reasoning)
    71   (Working memory)
    52   (Processing speed)
    Dr. Coxe testified that the 1992 IQ test for adults that he
    administered to Appellant—resulting in a score of 74—had a standard
    114
    DSM–5 at 37.
    115
    The Flynn effect involves “overly high scores due to out-of-date test norms.” 
    Id.
    116
    
    Id.
    Petetan Opinion On Rehearing — 36
    error measurement of three points, which could yield an IQ score as high
    as 77 or as low as 71. This means that one of the five test scores placed
    Appellant outside the range of someone with intellectual deficits. This
    alone, however, is insufficient to reject Appellant’s intellectual-disability
    claim.117 Four scores placed Appellant within the range of intellectual
    disability.       And Moore requires courts to “continue the inquiry and
    consider other evidence of intellectual disability where an individual’s IQ
    score, adjusted for the test’s standard error, falls within the clinically
    established range for intellectual-functioning deficits.”118
    There was also some evidence that Appellant may have been
    malingering on some of the tests.119 But this alone is also insufficient to
    reject Appellant’s intellectual-disability claim.                   Under Moore, “the
    117
    Moore I, 
    137 S. Ct. at 1048
     (“In Hall v. Florida, we held that a State cannot refuse
    to entertain other evidence of intellectual disability when a defendant has an IQ score above
    70.”).
    118
    Moore I, 
    137 S. Ct. at 1050
    .
    119
    Dr. Coxe testified that he had to administer both the child IQ test and the adult IQ
    test to Appellant because Appellant’s attitude suggested that he was not putting forth his best
    efforts. Dr. Coxe further testified that, on some items and tests, Appellant “gave up very
    quickly without making too much of an effort” and had “a little bit of an attitude about the
    testing.” Dr. Correia testified that Appellant “had little interest in the exam, requesting
    repeatedly to be allowed to leave to smoke a cigarette, use the restroom and take cell phone
    calls.” Dr. Correia stated that Appellant seemed to “put forth an effort to cooperate minimally
    and superficially only.” Dr. Mayfield testified that she administered both the Test of Memory
    Malingering (“TOMM”) and the Rey 15 test to Appellant. The TOMM test placed Appellant in the
    category of “inadequate effort strongly suspected.” Appellant was also below the cutoff for
    adequate effort on the Rey test. Dr. Mayfield, however, discounted these scores based on other
    research. She concluded that Appellant exerted good efforts on all the tests.
    Petetan Opinion On Rehearing — 37
    presence of other sources of imprecision in administering the test to a
    particular individual . . . cannot narrow the test-specific standard-error
    range.”120 Therefore, we abandon our conclusion in the original opinion
    that the jury could have resolved Appellant’s intellectual disability claim
    against him based solely upon his failure to show sub-average
    intelligence. We next turn to the evidence regarding adaptive deficits.
    2.   Criterion B: Adaptive Deficits
    Criterion B—deficits in adaptive functioning—requires an evaluation
    of the individual’s ability to function across a variety of dimensions.121
    More specifically, it refers “to how well a person meets community
    standards of personal independence and social responsibility, in
    comparison to others of similar age and sociocultural background.”122
    This involves three domains of adaptive reasoning: conceptual, social,
    and practical.123
    Criterion B is satisfied when at least one of those domains “is
    sufficiently impaired that ongoing support is needed in order for the
    120
    Moore I, 
    137 S. Ct. at 1049
    .
    121
    Brumfield v. Cain, 
    135 S. Ct. 2269
    , 2279 (2015).
    122
    DSM–5 at 37.
    123
    
    Id.
    Petetan Opinion On Rehearing — 38
    person to perform adequately in one or more life settings at school, at
    work, at home, or in the community.”124 Adaptive deficits are measured
    through clinical evaluations and testing, which must be culturally
    appropriate and psychometrically sound.125          The tests should use
    standardized measures “with knowledgeable informants (e.g., parent or
    other family member; teacher; counselor; care provider) and the
    individual to the extent possible.”126 Additional informational sources
    “include educational, developmental, medical, and mental heath
    evaluations.”127 All of this information “must be interpreted using clinical
    judgment.”128
    a.     Evidence Overview
    i.   Dr. Craig
    At the defense’s request, psychologist Dr. Ellis Craig evaluated
    Appellant to determine whether he had adaptive deficits. Dr. Craig used
    the ABAS-II.            He performed a retrospective assessment because
    124
    Id. at 38.
    125
    Id. at 37.
    126
    Id.
    127
    Id.
    128
    Id.
    Petetan Opinion On Rehearing — 39
    Appellant was incarcerated at the time129 and because no one had
    previously conducted a standardized adaptive behavior scale on
    Appellant.
    Dr. Craig stated that the ABAS-II was not normed for retrospective
    assessment, elaborating that “[r]etrospective assessments are a
    specialized subset that I don’t think any tests are normed to do.” On
    cross-examination,            the     prosecutor        went          through   the    ABAS–II
    questionnaire and pointed to items that could be inappropriate for a 14
    to 16 year old and for which Appellant was given the score of 1 (out of 0
    to 3).130 Dr. Craig was also asked what percentage of the population
    129
    More specifically, Dr. Craig stated: “In this context, where it really becomes important
    is that you really have to do a retrospective assessment of adaptive behavior for somebody who
    is incarcerated. You simply cannot do an adaptive behavior assessment in a jail or prison
    setting.”
    130
    These items included:
    •     Calls to find out if a repair or order is ready.
    •     Calls a repair person if, for instance, the air conditioner or heater
    is not working.
    •     Takes people on trips to nearby places; for example, takes a child
    or family member to a park.
    •     Asks a store clerk for product information before buying an item.
    •     Reads and follows instruction to assemble new purchases.
    •     Makes reminder notes or lists.
    •     Completes forms for business or services; for example, obtains a
    lease.
    Petetan Opinion On Rehearing — 40
    aged 30 to 39 (for which the particular ABAS–II was normed) had been
    incarcerated for 20 years of their life. Dr. Craig responded, “I would say
    zero,” and he acknowledged that he could only work with the data he was
    given from the “informants.”
    The ABAS–II requires “informants,” who are people that give
    information about the subject being assessed. Dr. Craig stated that an
    “informant” is “somebody who knows the individual well, has seen them
    in a variety of situations and for a fairly extended period of time. For that
    reason, it’s typically family members.” Dr. Craig also testified that it is
    important to find informants that don’t “have a vested interest in giving
    you incorrect information.”
    For Appellant’s assessment, Dr. Craig used Appellant, his mother,
    an older brother, an older sister, and an uncle as “informants.” The
    scores from highest to lowest were: brother, 53; uncle, 47; sister, 47;
    Appellant, 42; mother, 40. The norm for the population on the ABAS–II
    •     Reads important documents; for example, credit card applications
    or rental agreements.
    •     Balances a checkbook.
    •     Follows the maintenance schedule for home or car.
    •     Reserves tickets in advance for activities such as concerts or sports
    events.
    Petetan Opinion On Rehearing — 41
    is between 85 to 115, and the lowest possible score is 40.
    Dr. Craig did not rely on Appellant’s score “because there are some
    problems with self-reports.” For example, Dr. Craig stated that studies
    show that intellectually disabled people “will try to . . . ‘pass as normal,’
    and they will present themselves as more competent than they really are
    because they don’t want to be put into that class.”          Dr. Craig also
    discounted the mother’s assessment because she “was inconsistent in her
    responses.”
    All informants, except for the uncle, ranked Appellant’s social skills
    the highest, his conceptual skills second, and his practical skills the
    lowest. Dr. Craig noted that the pattern of the uncle’s responses was
    “very different” compared to the pattern of the other informants’
    responses. Dr. Craig “thought [the uncle] was a good informant and
    . . . had a very realistic picture of [Appellant],” but he opined that the
    pattern was different because the uncle “actually was not around
    [Appellant] that much” and had a different set of standards. Dr. Craig
    thought that the brother’s and sister’s “assessments were probably the
    most accurate and most reflective of what [Appellant’s] actual day-to-day
    functional skills really are.”
    Dr. Craig stated that Appellant’s “adaptive limitations far outweigh
    Petetan Opinion On Rehearing — 42
    his minimal skills.” Dr. Craig testified, “[A]ppellant does have skill areas.
    There is no question,” and stated, “What caused all this . . . is hard to
    say, but one likely explanation is that there were many missed
    opportunities to learn these skills.”131             Based on his ABAS-II and the
    scores he had “seen on intelligence,” Dr. Craig found Appellant “actually
    has—he would fall into the moderately [intellectually disabled] range.”
    ii.     Other Witnesses and Evidence
    Three school officials, Dorothy Stamps, Morris Lee, and Eddie
    Fowler, testified generally about Appellant’s behavior in school and his
    motivation.        Appellant’s mother, Ophelia Ortiz, also testified and
    described Appellant overall as “slow,” and said she had to give him more
    attention than her other children when he was growing up.                              Other
    witnesses included Appellant’s sister, Sabrina Mouton; Appellant’s aunt,
    Cathy Gauthier; Appellant’s cousin, Caston Gauthier; Appellant’s Cousin,
    Kimberly Jackson; and Appellant’s uncle, Thomas Kemper. Overall, they
    characterized Appellant as slower than others.
    Appellant’s education records from kindergarten through ninth grade
    were introduced into evidence at trial. Multiple letters from Appellant to
    131
    Regarding “missed opportunities,” Dr. Craig referenced the fact that Appellant spent
    the majority of his life incarcerated and, even when home, he did not receive adequate parental
    supervision.
    Petetan Opinion On Rehearing — 43
    Kimberly were also introduced at trial. Appellant testified at the guilt
    stage of trial. This testimony is set out in our original opinion. Appellant
    gave a somewhat incredible exculpatory account of the incidents that
    occurred on September 13 and 23, 2012. But his story was coherent,
    and he stuck with it consistently, even under attack by the prosecutor.
    b.   Conceptual Domain
    i.    Appellant’s Education Records–Conceptual Domain
    The trial record includes most of Appellant’s academic records for
    kindergarten through ninth grade.      For kindergarten through second
    grade, Appellant did not receive numerical grades. Instead, he received
    grades based on above average, average, below average, and level
    function. The record does not make clear what “level function” means.
    His grades, number of absences, and number of days present were as
    follows:
    K         1st       2nd
    Reading                     level
    below      below
    function
    Arithmetic                average     below      below
    Other Language Arts       average    average   average
    Social Studies            average    average   average
    Science                   average    average   average
    Petetan Opinion On Rehearing — 44
    Effort                     average       average   average
    Citizenship                average        below     below
    # of Absences                   7          18          10
    # of Days Present              136        154       165
    From third through fifth grade, Appellant received both numerical
    grades and letter grades of “S,” “N,” and “U.” Although the record does
    not make this clear, the designations “S,” “N,” and “U” appear to mean,
    respectively, “satisfactory,” “needs improvement,” and “unsatisfactory.”
    Appellant was “retained” in third grade, meaning he was required to
    repeat that grade. The following are Appellant’s grades, number of
    absences, and number of days present from both times he went through
    third grade, along with fourth and fifth grade:
    3rd      3rd      4th      5th
    Reading                54         63     72      75
    Language               45         43     64      76
    Spelling               40         53     62      76
    Handwriting            71         S      S       S
    Math                   37         63     74      75
    Social Studies         78         60     70      75
    Science                80         51     72      75
    Health                 79         N      S       S
    Petetan Opinion On Rehearing — 45
    Art                            79        S        S+          S
    Music / Band                   74       N          N          N
    P.E.                           85       N          N          S
    Personal Growth                U        U          N          N
    # of Absences                  29        7        30          8
    # of Days Present             146      168        145        167
    The records also include the scores from multiple standardized tests
    that he took between third and fifth grade. During his first time in third
    grade, Appellant took the Texas Assessment of Basic Skills (“TABS”) on
    math, reading, and writing. Overall, Appellant passed only five of the
    twenty-three objectives.132 Six months into the school year, he took the
    California Achievement Test (“CAT”) on reading, language, and math. He
    scored lower than 90% of the other students and tested at the level of a
    student four months into second grade.
    During his second time in third grade, Appellant took the Texas
    Educational Assessment of Minimum Skills (“TEAMS”) in math, reading,
    and writing. He passed the reading section but not the math and writing
    sections. Six months into the school year, he took the CAT. He scored
    lower than 81% of the other students and tested at the level of a student
    132
    The writing section had five objectives of which Appellant passed one and failed four.
    The reading section had eight objectives of which Appellant passed three and failed five. The
    math section had ten objectives of which Appellant passed one and failed nine.
    Petetan Opinion On Rehearing — 46
    seven months into second grade. Appellant was “socially promoted” to
    the fourth grade even though his grades were failing.
    Six months into fourth grade, Appellant took another CAT.          He
    scored lower than 91% of the other students and tested at the level of a
    student seven months into second grade. In fifth grade, Appellant took
    a TEAMS test, where he passed the reading section but not the math and
    writing sections. He also took a CAT. He scored lower than 92% of the
    other students and tested at the level of a student three months into third
    grade.
    In sixth grade, Appellant’s grades were as follows: 55 in Social
    Studies, 53 in “Read Imp,” 62 in Science, 52 in English, 53 in Math, and
    61 in P.E. He also took a CAT. He scored lower than 99% of the other
    students and tested at the level of a student one month into second
    grade. Appellant was retained in the sixth grade.
    At this point, the records become somewhat unclear. The records
    do not include any grades from the year he was supposed to repeat sixth
    grade or from seventh and eighth grade. The records, however, show
    that he attended ninth grade the year he would be in seventh grade (if he
    repeated sixth grade). The records indicate that he was retained in the
    ninth grade. The grades for both his years in ninth grade were numerical
    Petetan Opinion On Rehearing — 47
    grades split between two semesters. The grades were as follows:
    9th               9th
    English             50       50     41         50
    Math                50       50    62; 72      50
    Science             50       50     57         50
    Social Studies      55       50     61         50
    P.E.                50       60     72      56; 55
    Health              N/A      N/A    53         N/A
    During his second time in ninth grade, Appellant received a special
    education exemption from the Texas Assessment of Academic Skills
    (“TAAS test”). The records do not include TAAS test information from his
    first time in ninth grade. Appellant then dropped out of school.
    ii.   School Officials’ Testimony–Conceptual Domain
    Dorothy Stamps, Appellant’s first grade teacher, testified that
    Appellant was capable of doing the school work and, if he would have
    applied himself, he could have done the work. Morris Lee, an assistant
    principal at Appellant’s elementary school, also testified. He was asked:
    “[Appellant] chose not to apply himself, even as a young man. Is that
    right?” Lee responded, “Not in appropriate directions.”
    Eddie Fowler, a principal at Appellant’s middle school, testified that
    Appellant was placed into a special education program called “the self-
    Petetan Opinion On Rehearing — 48
    management program.”        Fowler said that this placement was “not
    necessarily because [Appellant] was so far behind, but because he was
    a discipline problem.” When asked “[s]o [Appellant] wasn’t in Special
    Education because of any mental defect or because he was [intellectually
    disabled], was he,” Fowler responded, “No.” Fowler agreed that, after
    reviewing Appellant’s school records, Appellant was “pretty average.”
    Fowler also agreed that, if Appellant applied himself, he could have been
    successful.
    iii.   Dr. Craig’s Testimony—Conceptual Domain
    Regarding Appellant’s strengths in the conceptual domain, Dr. Craig
    testified:
    When you just hear him talk, when he does talk—although he
    tends to be somewhat quiet—I mean, he speaks in complete
    sentences, and so he could, in that sense, quote, “pass for
    normal.” He can write pretty good. I mean, he can write his
    own address, including the zip code and so on. He had pretty
    good self-direction. He could go around in the community, go
    out alone, and he did often. In fact, he would tend to wander
    away from any kind of group going on, and he at least
    appears to listen when people are talking to him. You don’t
    know whether or not he’s really paying attention, but he does
    appear to listen.
    Regarding his limitations in the conceptual domain, Dr. Craig testified:
    Very limited conversational skills. It’s really hard to engage
    in a conversation with him. He just won’t follow the
    conversation. You can’t get a response to what you’re saying.
    Petetan Opinion On Rehearing — 49
    In terms of getting along in the world, it was routinely noted
    that he was unable to read menus. I mean, he would have to
    order things—if he went out to, you know, a fast food
    restaurant or something, he would have to order by the
    picture, just saying what he knew it was. He could not
    calculate the correct change. And you really couldn’t depend
    on him time-wise. He was irresponsible regarding time
    commitments.
    iv.   Appellant’s Testimony—Conceptual Domain
    Appellant testified about becoming a pen pal with Kimberly and
    stated that they wrote three or four letters a week to each other.
    Appellant testified that the letters were in his handwriting. Appellant
    stated that he had help from different people when writing the letters.
    When asked what he meant by that, Appellant responded: “Like spell and,
    you know, I write down what I want to say, and then they will put it into
    sentences and stuff for me.” Appellant also testified that he wrote letters
    to Kimberly’s daughter, A.W.
    Appellant agreed he had printed out the maps for the trip to Waco,
    where the crime took place, and paid for everything on the trip.
    Appellant was asked about documents found by law enforcement in his
    Suburban.    One of the documents, the “Cartel Boxing Promotions
    Business Plan Prepared By Petetan,” had a biography section, which was
    read aloud to the jury. It read:
    Petetan Opinion On Rehearing — 50
    Born in Port Arthur, Texas, Carnell Petetan, Jr. has his share
    of ups-and-downs. The tough street of his hometown groomed
    him into the dynamo he is today, and now, armed with a
    wealth of resources, skills and abilities, he is set to launch the
    long anticipated CARTEL BOXING PROMOTIONS.
    Co-Founder of Tripple Gold Records, along with brother and
    business partner, Herbert Mouton, Carnell Petetan has
    emerged with a vision so ambitious, success is eminent.
    The key feature and strength behind Cartel rests in the fact
    that for eighteen years of his life, he survived in Texas
    prisons; some of the deadliest in the nation. This is where he
    honed his leadership abilities and educated himself.
    Now this wise and intelligent young man is ready to take on
    the world. Surrounded by a support team of experts, his
    Cartel Boxing Promotions will quickly become an industry
    great in the years to come.
    You’ve seen the rest, now prepare for the best.
    Carnell enjoys reading, video games, and brainstorming. The
    author of over 800 songs, Carnell is also the respected and
    rising rap star, “Don Cartel”. Look for the documentary,
    “unshackled”, coming soon. With success looming over him,
    Carnell promises to stay grounded and Always put God First.
    Appellant denied he wrote it. He also denied writing a 40-page
    autobiography that was found in the Suburban.
    v.    Appellant’s     Mother’s     Testimony—Conceptual
    Domain
    Ophelia Ortiz, Appellant’s mother, testified that Appellant had a hard
    time reading and writing. When asked “[w]ould it surprise you to know
    Petetan Opinion On Rehearing — 51
    that he’s a self-admitted writer of over 800 musical songs,” Ophelia
    laughed and responded, “That’s funny. No, he’s not.” Ophelia agreed
    that it would be difficult for Appellant to write a simple letter to someone
    and stated, “Somebody would have to help him.”
    Ophelia said that although the family lived “right by the school”
    when Appellant was younger, Appellant would forget where to go and
    “would go another direction.”       Someone would have to walk him.
    Sometimes “I would say he was missing, because he was gone, like,
    sometimes three days and I didn’t see him, so the police put a missing
    person, and they would find him.” Appellant could not drive from Port
    Arthur to Houston. When asked “[w]ould he have trouble with, what, the
    signs or the roads or what,” Ophelia responded, “His remembering,
    mentally.”   Ophelia also stated that the only time when they sent
    Appellant to the store alone, “he went and put the money on the counter
    and walked out and forgot what I sent him in there to get.” Ophelia
    further testified that Appellant could not make change.
    vi.   Appellant’s Sister’s Testimony—Conceptual Domain
    Sabrina Mouton, Appellant’s sister, testified that Appellant did not
    walk until he was three years old and could not talk, in a manner they
    could understand, until he was four or five. Up until that time, “if my
    Petetan Opinion On Rehearing — 52
    mother asked him something, he wouldn’t answer, or if she tried to get
    him to talk, we didn’t understand what he was saying, so he just don’t
    say nothing.”     When asked about Appellant learning something new,
    Sabrina said: “He gets frustrated or just like he loses interest in it or he
    just—like his mind just go blank, like he looking off like he don’t care to
    hear it, you know, when he don’t understand something.”
    Sabrina said that Appellant wrote her letters from prison, but his
    letters were difficult to understand unless he had someone help him.
    When asked why she would think someone wrote a letter for him, she
    said that Appellant’s writing “looked like something a preschooler or
    kindergartner” would write; but if someone wrote the letter for him, then
    the letter would be in good handwriting. Sabrina said his writing had
    improved “a little bit.” The prosecutor asked Sabrina about one of his
    letters to Kimberly. “I’m going to show you what I’ve admitted into
    evidence as State’s Exhibit 126, and I’m going to do the Carnell Petetan
    letter grab bag. Go ahead and pick a letter, any letter.” Sabrina drew out
    of the bag a letter postmarked January 24, 2011. The letter read, in
    part:
    I Hope and Pray when this letter reaches you it finds you in
    the best of health as well as spirits in God’s Care and
    Protection as well as your love ones. Kim I want you to know
    Petetan Opinion On Rehearing — 53
    I was Glad to hear about your School progress and them
    welcoming you to Join they organization.
    Sabrina acknowledged that the letter was in Appellant’s handwriting. She
    further stated that “those letters look clearer than my letters, and Carnell
    writes up and down, up and down, and out of the margin and not clear at
    all.” When confronted with the fact that the letter to Kimberly that the
    prosecutor had Sabrina read did not conform to her “up and down”
    description, Sabrina stated, “His looks neater on hers than it does on
    ours.”
    vii.   Appellant’s Uncle’s Testimony—Conceptual Domain
    Thomas Kemper, Appellant’s uncle, testified that when Appellant
    was younger, he was placed in special education because “he couldn’t
    comprehend like any other kid.”
    viii. Appellant’s Letters—Conceptual Domain
    Appellant’s letters to his pen pal and then wife, Kimberly, were
    published to the jury and portions were read out loud by the prosecutor.
    Portions of some of the letters in the State’s exhibit are relevant to the
    conceptual domain. In one, Appellant stated: “Kim I Just wanna Show
    you Just in Houston Alone 20,000 CDS Pressed up for $10.00 a pop =
    $200,000. See im Not even haveing to leave houston to get rid of 20,000
    Petetan Opinion On Rehearing — 54
    records[.] . . . Say i Put 3 records out a year, and make 2000,000 x 3
    thats $600,000[.]” In another, he suggested the raffling of a watch,
    telling her that if she sold 100 tickets at $25.00, “that’s $2,500.” In
    another, Appellant stated: “I’ve wrote over 75 Albums Books and
    universal Records[.]” In another letter, Appellant included a response
    that he received from a recording company, Amerecord, stating “that of
    the numerous poems and songs sent to Amerecord over the past few
    months, a very select few have been chosen for a pre-production
    recording session.”
    ix.   Analysis—Conceptual Domain
    At trial, there was conflicting evidence regarding Appellant’s deficits
    in the conceptual domain. The jury could have inferred from Appellant’s
    academic record that he was impaired in the conceptual domain. Of
    Appellant’s 57 numerical grades included in the academic records, 39 of
    those grades were failing (or, below 70). Of the 20 grades Appellant
    received based on whether he was above average, average, or below
    average, he was “below average” for 6. Of the 19 grades he received
    based on satisfactory, needs improvement, and unsatisfactory, he
    received needs improvement for eight and unsatisfactory for two.
    Further, he performed poorly on standardized tests and was placed in
    Petetan Opinion On Rehearing — 55
    special education at some point.
    But there was also evidence that cut against a jury’s inference of
    deficits in the conceptual domain. Appellant received 18 passing (or, 70
    and above) numerical grades, 14 “averages,” 8 “satisfactories,” and 1
    “satisfactory plus.” The academic records also show that Appellant often
    had absences in the double digits. And three school officials testified that
    Appellant failed to appropriately apply himself in school. One of those
    officials also testified that Appellant was not in special education because
    of a low IQ but instead because of his behavior problems.
    Looking at the conceptual domain on a more discrete level, there
    was conflicting evidence on Appellant’s ability in math reasoning. There
    was evidence from which the jury could have inferred that Appellant was
    impaired in it. This evidence included his grades for “Arithmetic” in first
    through third grade and for “math” in both sixth and ninth grades, along
    with his scores on the CAT, TABS, and TEAMS tests. This evidence also
    included testimony from Sabrina that Appellant “never knew how to count
    [money]” and testimony from both Dr. Craig and Ophelia that Appellant
    could not calculate change. But on the other hand, Appellant received
    passing grades for math-related subjects in kindergarten, fourth, and fifth
    grades. Moreover, Appellant testified that he paid for the trip to Waco
    Petetan Opinion On Rehearing — 56
    and some of Appellant’s letters contained correct calculations.
    There was also conflicting evidence on Appellant’s writing ability.
    There was evidence from which the jury could have inferred that
    Appellant’s writing ability was impaired. This evidence included
    Appellant’s scores on the TABS, along with his grades for “Spelling” in
    third through fifth grade and his grades for “English” in both sixth and
    ninth grade. It also included Ophelia’s testimony that Appellant had a
    hard time writing and would need help, Sabrina’s testimony that
    Appellant’s letters were difficult to understand unless he had help, and
    Appellant’s testimony that he received help from other inmates when
    writing letters.
    Conversely, Appellant received passing grades in “handwriting” in
    third through fifth grade. Dr. Craig, who evaluated Appellant prior to
    trial, testified that Appellant can write pretty well. And the jury itself was
    able to read several letters from Appellant to Kimberly—letters that
    Appellant admitted were in his own handwriting.          Appellant had also
    written songs and poems well enough to be chosen for “a pre-production
    recording session.”
    Further, there was conflicting evidence on Appellant’s reading
    ability. Evidence from which the jury could have inferred that Appellant’s
    Petetan Opinion On Rehearing — 57
    reading ability was impaired included: Appellant’s grades in first, second,
    third, and sixth grade; his scores on the TABS, CAT, and TEAMS tests; Dr.
    Craig’s testimony that Appellant was unable to read menus; and Ophelia’s
    testimony that Appellant had a hard time reading. But on the other hand,
    Appellant received passing grades for “Reading” in both fourth and fifth
    grade and passed the reading section on both of his TEAMS tests.
    There was also conflicting evidence on Appellant’s language ability.
    There was evidence from which the jury could have inferred that
    Appellant’s language ability was impaired. This evidence included his
    grades in third grade and fourth grade; his scores on the CATs; and
    Sabrina’s testimony that Appellant was delayed in learning how to talk
    and that they were not able to understand what he was saying until he
    was about four or five years old. On the other hand, in kindergarten
    through second grade, he was “average” in “Other Language Arts” and he
    received a passing grade in “Language” in fifth grade. Further, Dr. Craig
    testified that Appellant speaks in complete sentences.        And during
    Appellant’s own testimony, the jury was able to hear for itself Appellant’s
    ability to speak.
    Lastly, there was conflicting evidence that Appellant’s memory was
    impaired. There was evidence from which the jury could have inferred
    Petetan Opinion On Rehearing — 58
    that Appellant’s memory was impaired. This evidence included Ophelia’s
    testimony that Appellant would often get lost, had trouble driving because
    of his memory, and forgot what he was supposed to buy when he got to
    the store. But during Appellant’s testimony at trial, the jury was able to
    gauge for itself Appellant’s ability to consistently remember various
    historical details on both direct examination and cross examination.
    For each piece of evidence supporting a finding that Appellant was
    impaired in the conceptual domain, there was evidence that cut against
    it.   Therefore, the issue came down to resolving those conflicts and
    inconsistencies based on credibility and weight determinations. That’s the
    jury’s duty, and we defer to the jury’s determinations.
    c.   Social Domain
    The   second    domain—social—“involves     awareness    of   others’
    thoughts,     feelings,    and   experiences;     empathy;   interpersonal
    communication skills; friendship abilities; and social judgment, among
    others.” This was Appellant’s strongest domain. The informants thought
    he had good social skills. He “could get along with people and he could
    kind of blend in.”
    i.      Dr. Craig’s testimony—Social Domain
    Dr. Craig’s conclusions were as follows:
    Petetan Opinion On Rehearing — 59
    A.   Areas of strength for him was that he has friends. He
    had good relations with his family. He was actually able
    to interpret others’ emotions. He could tell when
    somebody was upset, and he even showed some ability
    with leisure skills. He likes to listen to music.
    Q.   By “skills --”
    A.   Those are strengths for him.
    Q.   Strengths. Okay. And his limitations?
    A.   He doesn’t understand jokes. I mean, it’s too complex.
    Q.   How do you determine that? If you’re talking about a
    self-evaluation, for example, do you tell him a joke and
    see if he gets it or do you ask him? How do you
    determine that?
    A.   You know, I asked him, you know, “Do people tell you
    things that make you laugh,” and he said, “No.”
    Q.   And then other people that are just general informants,
    you can say, “Does he understand jokes?”
    A.   Yeah. I mean, “Can you joke around with him, and does
    he get the jokes?”
    Q.   Okay.
    A.   And they repeatedly noted that he was easily led by
    other people, that the basic social skills of being polite
    and offering to help people, he simply doesn’t do it. He
    doesn’t say thank you. He doesn’t give gifts. He doesn’t
    offer assistance to people. And this was a uniform
    finding too. He didn’t engage in games. The only games
    we ever heard that he played were with a cousin who
    played Hide and Seek with him, and this was when he
    was older, too. But he simply didn’t understand any kind
    Petetan Opinion On Rehearing — 60
    of simple kind of games that, you know, kids play. He
    showed no interest in most—what a lot of people use for
    leisure, which is TV. I mean, he has consistently over
    the years never shown the least bit of interest in TV.
    ii.   Analysis—Social Domain
    There was conflicting evidence regarding Appellant’s deficits in the
    social domain. The jury could have inferred from Appellant’s relationship
    with Kimberly that Appellant was not impaired in the social domain.
    While in prison, Appellant was not only able to become pen pals with
    Kimberly, a person Appellant did not know before she was encouraged by
    Appellant’s brother to contact him, but to develop their friendship into a
    serious romantic relationship resulting in marriage—a clear indication of
    his “friendship abilities.” Further, Appellant remained married to Kimberly
    from 2010 through the spring of 2012, when Appellant was released from
    prison. And although Kimberly considered divorcing Appellant shortly
    after he moved in with her, the two reconciled. After a falling out a few
    months later, the two again reconciled.       Thus, the jury could have
    reasonably concluded that Appellant possessed at least some meaningful
    “awareness of others’ thoughts, feelings, and experiences” because
    Appellant was able to successfully reconcile with his wife on more than
    one occasion.
    Petetan Opinion On Rehearing — 61
    By his own words, Appellant was also helpful to other prisoners,
    encouraging them to be polite. He related in his letters that he was a
    mentor to other inmates—“nice as can be” young males who did not
    belong behind bars. He told them how to act when they get out: “help
    little ole ladies across the street, and lend your neighbor a cup of sugar
    in advance.” His letters are replete with offers to help Kimberly and her
    daughter and appreciation for their own letters and love.
    Finally, the jury could credit Appellant’s own statements made in his
    letters to Kimberly, which, as is detailed later in this opinion, indicated a
    history of playing baseball, bowling, boxing, working out with weights,
    and watching sports on television. As a result, the jurors did not have to
    rely on lay stereotypes about the intellectually disabled to reject Dr.
    Craig’s testimony, or that of Appellant’s own family. They could reject his
    testimony as unreliable because it was based on interviews with vested
    witnesses and inconsistent with much of the record evidence.
    d.       Practical Domain
    The    third     domain—practical—“involves         learning   and     self-
    management      across    life   settings,   including   personal   care,    job
    responsibilities, money management, recreation, self-management of
    Petetan Opinion On Rehearing — 62
    behavior, and school and work task organization, among others.”133
    i.    Dr. Craig’s Testimony —Practical Domain
    Dr. Craig, based on his assessment, concluded that Appellant “had
    a lack of practical skills to get through the day.” He stated that all four
    of his “informants”—Appellant himself and Appellant’s mom, sister, and
    uncle—represented that “his practical skills, doing things on a day-to-day
    basis like taking care of himself, feeding, cooking something to eat, he
    had simply not developed those skills.”         Dr. Craig gave the following
    specifics on the practical domain:
    Q.       What about his skills and limitations on the practical
    portion of the test?
    A.       He was able to walk to familiar locations. Again, in his
    neighborhood he could get along just fine. I mean, he
    knew how to find places. He couldn’t necessarily tell you
    street names, but he knew where things were
    geographically. He could make simple meals for himself,
    and this was kind of like a little idiosyncratic thing about
    him. He never learned to use a fork. I mean, he would
    sometimes use a spoon, but every bit of food that you
    gave him, he would wrap up in bread. That’s how he ate.
    I mean, he made a sandwich out of everything. So in
    terms of the typical kinds of table skills, eating skills, he
    simply, either by choice or just lack of ability, he didn’t
    do. It’s fairly common for people, even with mild
    [intellectual disability], to have difficulties cutting their
    food into bite-size portions. Somebody may have to do
    133
    DSM–5 at 37.
    Petetan Opinion On Rehearing — 63
    that for them. I’m not sure if that was the case with
    him, because he didn’t use a knife. He just used a
    spoon. He was able to take medications. He was able to
    swallow them. He didn’t resist that. And he could dress
    himself. He didn’t necessarily dress himself well, but he
    could do the physical act.
    Q.    And his limitations?
    A.    Even though he could get around the community, he
    was unable to use a map. He relied on the ability
    to—either people tell him familiar locations or whatever,
    and he got lost fairly easily. He did not do
    housekeeping. He was described as a terrible
    housekeeper and never made his own bed, was unable
    to learn how to operate most common appliances, broke
    microwaves because he didn’t know how to use them,
    put the wrong things in them, had no conception about
    how to use a washer or a dryer. And even in the area of
    first aid, I mean, when asked what he would do if he cut
    his finger, he said he would sop it up. “Sop the blood
    up,” that was his response. So he didn’t—he just wasn’t
    worried that way where he would know to put a
    Band-Aid and some Bactine or something on it.
    Dr. Craig said that, for clinical purposes of a finding of significant
    limitations in adaptive functioning, the reason that the adaptive skills
    were not learned does not matter. Practical skills “don’t necessarily even
    go along with intelligence. I mean, in some ways the adaptive skills are
    very sensitive to what kind of training the person has received.” Practical
    skills can be limited “because their family was overprotective and did
    everything for them and weren’t good enough trainers or they weren’t
    Petetan Opinion On Rehearing — 64
    patient enough to allow them to learn how to do it on their own, and so
    they just never learned how to do it and they just came to expect their
    family to take care of it.” Speaking specifically about Appellant, Dr. Craig
    said:
    What caused all this, you know, is hard to say, but one likely
    explanation is that there were many missed opportunities to
    learn these skills. He has spent the majority of his life
    incarcerated, and he simply hasn’t had the opportunity to be
    around—I mean to learn those kind of skills on a consistent
    basis. And I think in his home environment, even when he
    was living there, the parental supervision was not such that he
    was expected to do it or, you know, the training was given to
    him, so he simply didn’t learn those skills. And being locked
    up most of his life, he has adjusted to prison routine, I guess.
    But in terms of adaptive skills, he is very limited.
    ii.   Appellant’s Mother’s Testimony —Practical Domain
    Appellant’s mother, Ophelia, testified that Appellant was a bed-
    wetter and she did not “know if he has stopped yet. All his life he been
    peeing on himself.” She testified that, as a child, Appellant could not tie
    his shoes, dress himself, take a bath, brush his teeth, or follow directions.
    He did not have any interests as a child; he did not play with toys, watch
    television, or play video games. He would “just sit there” or walk out and
    leave, and family members would not know where he went.
    When Appellant left prison, he could not keep his apartment clean,
    so his sister would come over and clean it.         Appellant did not wash
    Petetan Opinion On Rehearing — 65
    dishes, did not put food away, and left clothes strewn across the floor.
    He could not use a washing machine or a dryer. He still did not watch
    television, and he could not operate a cell phone. Appellant also could
    not be trusted with money because he could not make change. He could
    not drive.
    When cross-examined about Appellant’s alleged various “business
    plans,” Ophelia testified she did not pay them any mind because “I know
    he [doesn’t] know what he’s talking about.” Ophelia acknowledged that
    Appellant worked with his uncle cutting yards when he was on parole,
    that he had tried baseball but did not have the patience for it, and that
    she had bought him the Suburban.
    iii.   Appellant’s Sister’s Testimony —Practical Domain
    Appellant’s sister, Sabrina, testified that Appellant wet himself even
    when he was older. She also said that “Carnell never played sports or
    nothing with us. He would always just [wander] around.” Appellant had
    no special interests—“Not even television. We all would watch television.
    He wouldn’t watch it. Games, he didn’t want to play any games, nothing.”
    Appellant could not ride a bicycle; “He would try, but he couldn’t.”
    Sabrina testified that, when Appellant was released from prison,
    she helped set up and furnish an apartment for him. She tried to teach
    Petetan Opinion On Rehearing — 66
    him how to use a cell phone and microwave, but he could not figure
    either out. Sabrina said she would go over to the apartment twice a day
    to make sure Appellant had enough to eat and to clean up because
    Appellant would not clean up after himself. There would be “[f]ood laying
    around, candles lit for no reason.        Very tacky, nasty towels, his
    underwear and stuff.” Appellant did not know how to count money; he
    always asked his siblings “how much something is, how much this is.”
    Sabrina said that Appellant had unrealistic expectations about what he
    could do, “Like he would tell me he want to be rich or he’s going to do
    music or he’s going to have a business, and I’m, like, ‘Carnell, it takes
    money, and you’ve got to get a job’ or ‘Carnell, you left here with a
    school ID. You’ve got to get a driver’s license to do anything,’ you know.”
    Sabrina    agreed    that   Appellant   showed    some    interest   in
    extracurricular activities as he got older, and that he “likes his music. He
    does music . . . he records music.”      Sabrina also acknowledged that
    Appellant had been in prison since the early 1990s and had never lived
    on his own before he was released from prison. And she admitted that
    Appellant had tried to better himself in prison and that he was able to
    formulate business plans “[f]rom books that he got out of the library.”
    iv.   Appellant’s Uncle’s Testimony —Practical Domain
    Petetan Opinion On Rehearing — 67
    Thomas Kemper, Appellant’s uncle, testified that Appellant was
    “really slow” and “had problems making decisions on his own.” According
    to Thomas, “Little kids would make him do things that they didn’t want
    to do, that they wouldn’t do, and they would use Carnell, because he was
    real slow.” Thomas also said that Appellant would crawl up under a train
    even though other children would beg him not to. When he was twelve
    years old, Appellant had to be told not to open the door when someone
    knocked without first asking who it is. “He wouldn’t comb his hair . . . .
    [H]e wouldn’t take a bath, [and] he wouldn’t put on a belt.”
    When Appellant was released from prison, he wanted to be a
    businessman, but Thomas testified that Appellant “couldn’t understand
    how to go from [Point] A to Point Z.” Thomas said that Appellant had
    “great big dreams,” but
    [b]eing locked up all these years and knowing the first thing
    that you start a business and, you know, you say something
    simple to him like, “Carnell, first you need to get a DBA.”
    “What is a DBA?” You know, “Carnell, you need to open up
    your checking account.” “A checking account with what and
    how?” Everything that you say, you had to explain it to him,
    because he didn’t—and even if you explained it to him, he still
    did not understand.
    Thomas said that he never saw Appellant deal with money and that
    Kimberly handled the social security income Appellant received.
    Petetan Opinion On Rehearing — 68
    v.    The Gauthiers—Practical Domain
    Appellant came to live with the Gauthier family when he was
    thirteen or fourteen years old. Cathy Gauthier was Appellant’s aunt, and
    she had two children, Caston Gauthier and Kimberly Jackson. Cathy
    testified that Appellant was a little bit slower than her own kids, but she
    never had to discipline him. Appellant was just a little different, “real
    quiet all the time.”   Appellant “always had big dreams” of being a
    bondsman or a rapper. Cathy explained to Appellant that he could not be
    a bondsman because he had a felony conviction, but Appellant did not
    seem to understand that.
    Caston likewise described Appellant as being mentally slow. While
    visiting Appellant in prison, Caston knew he could not talk to him about
    anything dealing with his profession “because he probably wouldn’t have
    caught on to anything that I was talking about.”
    Kimberly Jackson was fourteen years old when Appellant came to
    live with them. She described Appellant as “a little different” and “not on
    the same level, mind-wise,” being “slower.” Appellant was her age, but
    she said that he could not do the same things she could. Her family had
    to “stay on” Appellant about his hygiene.
    vi.   Adrian Miller—Practical Domain
    Petetan Opinion On Rehearing — 69
    Miller testified that Appellant used his phone on the trip to Waco,
    but he wasn’t good at it.
    Q.     Carnell couldn’t use his phone?
    A.     Not to get it to just go to the phone and do the things
    that he probably would have wanted to do. The only
    thing, from my understanding, how he knew how to do
    was maybe text a little bit, use the little thing to record
    things or whatever, but once Kerrie deleted—turned the
    phone off, he didn’t know how to use it. So when we got
    to the Bryan police station and they put each one of us
    in the interrogation rooms, he had to send the phone to
    Kerrie because he couldn’t even turn it back on.
    vii.   Appellant’s Letters—Practical Domain
    Several letters in State’s Exhibit 126 are relevant to the practical
    domain. Regarding nutrition, he encouraged Kimberly to take Omega3
    fish oil as well as vitamins. He said they would eat healthy when he got
    out and told her he was only eating “fish and chicken.” He also talked
    about being on a salad diet. When he didn’t like what they were serving
    on his unit—pork meatballs which were “never fixed right”—he made tuna
    and rice.
    Some letters indicate interests. Appellant spoke of getting boxing
    gloves and weights for Christmas—“his first Christmas present.” Though
    he’d lost interest in baseball, “my love for boxing never died.” He asked
    Kimberly to “go online and look up Local Boxing Gold Gloves Tournaments
    Petetan Opinion On Rehearing — 70
    Local Reginal & National . . . down load all the info form me.” Several
    times he talked about his schedule, and it always included lifting weights.
    His letters indicated he watched TV. “Every Friday on ESPN2 they
    air Friday night fights.” He also referred to watching a documentary on
    the Tyson/Seldon fight and an NFL game.         He told Kimberly that he
    wanted them to go to Vegas to watch “a big fight” as their first vacation
    once he got out of prison. He also asked about boxing gyms in Waco.
    Appellant referenced a radio program he listened to called “Damage
    Control” and that “they play a lot of underground music it comes on at
    11:00 til 2:00.” He complained about his station “97.9 the Box” not
    playing Sweet James Jones—the solo album by Pimp C. He told Kimberly
    that he took part in a show in prison—one that included “like 16 Different
    Acts”—and that he had worked on his music for it for three months. He
    said there was “all kinds of talent inside this Place.”
    Appellant knew that his social security check was around $3,000;
    in a letter to Kimberly, Appellant told her the steps to take to get her own
    social security check for a “mental disability.” He told her to “go to the
    Social Security office in Waco, get a form and fill it out” under mental
    disability. He told her what to say to the case worker and doctor to
    become eligible. “You will get 1200” a month. In another letter, he
    Petetan Opinion On Rehearing — 71
    talked about how to make money grow, telling her it made more sense
    to invest a large sum of money rather than spend a good hunk on it on
    an expensive car, and how “you can’t loose with real estate.” He knew
    the approximate cost of a used Bentley, $175,000; and the approximate
    cost to rent a car, $25 or $28 a day.
    He also wrote about: imposing a sliding scale membership to a
    facility he wanted to start to keep kids off the streets—a fee of three
    dollars a month for low income kids and $25 for the others; giving
    Kimberly $250 to help her pay for her education; and how, after his
    parents divorced, his Dad gave his Mom $500 a month that he never saw.
    These letters contained numerous excerpts and references to books
    Appellant read—many of them self-help books. He told Kimberly that he
    reads “books in my cell and these books have become my best friends.”
    He shared quotes with Kim, one saying, “Anything that you’re not grateful
    for is Baggage—Anything you are thankful for is fuel.” He asked if she
    agreed with the quote and asked her to answer the question: “what
    Baggage do you need to get rid of and what steps will you take to rid
    yourself of this Baggage?”
    In one letter, he advised Kimberly to not let A.W. play outside
    unsupervised. Another expressed an intent to join the “Three Five Seven
    Petetan Opinion On Rehearing — 72
    Graveyard Crip set.” Still, others set out various grandiose (and not so
    grandiose) money making ideas. All the letters contained misspellings,
    and punctuation errors. Appellant comes across as sometimes sweet,
    sometimes controlling.
    viii. Analysis—Practical Domain
    At trial, there was conflicting evidence regarding Appellant’s deficits
    in the practical domain. The jury could have inferred from Appellant’s
    family member witnesses and Dr. Craig’s conclusions that he was
    impaired in the practical domain. Appellant received a score of 1 (out of
    3) on almost every home living task, including folding clean clothes,
    taking out the trash, clearing the table after a meal, making the bed,
    making minor repairs, putting things in their proper place, sweeping the
    floor, cleaning his room, cleaning the bathroom, mixing and cooking fairly
    complex foods, and dusting the furniture. And there is scant evidence
    that he did any of these day-to-day household chores.
    But Dr. Craig was not the fact-finder in this case. The jury could
    have doubted the efficacy of the ABAS-II given Dr. Craig’s circumscribed
    pool of “informants.” Dr. Craig testified that he assumes the informants
    give him the correct information. But the family members responding to
    the ABAS-II were aware of the implications of their responses. Although
    Petetan Opinion On Rehearing — 73
    Dr. Craig was not eager to admit it, all of the family members had an
    obvious vested interest in the outcome of their interviews with Dr. Craig:
    saving Appellant from a possible death penalty.134 “Indeed, individuals
    who have a close bond with the defendant/appellant have an identifiable,
    external incentive, to create the impression that the individual is impaired
    enough to meet the diagnostic criteria for [intellectual disability].”135
    Looking at the practical domain on a more discrete level, there was
    conflicting evidence on Appellant’s ability to use money. Appellant’s mom
    and sister testified that he could not be trusted with it because he could
    not make change, couldn’t count it, and couldn’t figure out how much
    things cost. His uncle testified that Appellant was not the spouse who
    dealt with money; Kimberly was. This was evidence from which the jury
    could have inferred that Appellant was impaired in a very basic and
    critical practical skill—the use of money.
    But jurors had Appellant’s own statements and the testimony of
    others indicating otherwise. Appellant repeatedly testified that he went
    134
    See Bridget M. Doane, Karen L. Salekin, Susceptibility of Current Adaptive Behavior
    Measures to Feigned Deficits, 33 LAW & HUM. BEHAV. 329, 331 (2009) (“Perhaps the most
    important caveat to keep in mind when using any measure of adaptive behavior is that the
    information obtained is limited by many factors including, but not limited to, the knowledge
    base of the rater, the extent of contact between the rater and the person of interest in one or
    more settings, and the candor of the rater.”).
    135
    Id.
    Petetan Opinion On Rehearing — 74
    to Waco to get a $300 deposit from his cousin to give to his wife. He
    acknowledged he paid for the gas, room, food, beer, and cigarettes. He
    was aware of the approximate cost or value of things: a social security
    check, a used luxury car, a rental car, and alimony. He demonstrated an
    awareness of the concept of the sliding scale.
    And Appellant’s representations in this regard were corroborated by
    others. Adrian Miller testified that when they were driving to Waco, he
    pumped the gas and Appellant paid $70 cash for it from his wallet. Miller
    also testified that, when it came to renting the room, Appellant gave a
    man money to rent it for him. He also gave a woman an appropriate
    amount for a ride. After the murder, Appellant gave Miller $60 to fill up
    the Suburban.
    Inmate Azikin Daniels testified that Appellant told him about owning
    “Cartel Records,” showed him how to file a DBA form, and explained to
    Daniels that an artist receives only a percentage of money from each
    record sale.     All of this testimony about Appellant’s use and
    understanding of money could have provided a basis for a rational jury
    to discount Appellant’s family members’ assertions that Appellant could
    not handle money.
    There also was conflicting evidence on whether another of
    Petetan Opinion On Rehearing — 75
    Appellant’s alleged deficits—the inability to use a modern cell phone (“a
    pervasive and insistent part of daily life”)—was real.136 Sabrina indicated
    that Appellant could not use a cell phone and that he could not learn to
    use one.       But the jury could have credited evidence showing that
    Appellant did in fact know how to use a cell phone. Appellant testified
    that he and Kimberly both had cell phones. He testified about several
    phone calls he made or received.                   He said that when he went to
    Kimberly’s apartment, “Kim opened the door. She backed up. She said,
    ‘Why you ain’t texted or called me.’”                 In his exculpatory account of
    September 23rd, Appellant testified that he had a cell phone and was
    going to use it to call “9-1-1” but stopped when Miller pointed the gun at
    him and took his phone away.                    Though the jury did not believe
    Appellant’s testimony, they were free to believe he had a cell phone.
    Kimberly’s adult daughter, Kristin Warmack, testified that her mom and
    Appellant had cell phones that were in Appellant’s name, and she was
    able to communicate with her mom until Appellant cut off service.
    Adrian Miller testified that Appellant used his cell phone in
    compromising situations before the Waco trip, which Miller theorized was
    136
    Riley v. California, 
    573 U.S. 373
    , 385 (2014) (modern cell phones “are now such a
    pervasive and insistent part of daily life that the proverbial visitor from Mars might conclude
    they were an important feature of human anatomy”).
    Petetan Opinion On Rehearing — 76
    an effort to create evidence. “He even passed by the neighborhood one
    day holding his cell phone out the window . . . He was driving down the
    street like he was taunting me. He was already plotting it.” “I think one
    day he even called Kimberly and he told me, ‘I’m going to give you this
    piece of dope. I want you to cuss this lady out.’ I cussed her out, but
    then he grabbed the phone, and he would do, like, ‘Oh, man, stop doing
    that. Man, this is my wife,’ this and that, but to try to make me—try to
    make it seem like I’m doing it. He was the one doing it.” At one point,
    Appellant dangled “a nickel piece of crack rock” to get Miller to repeat
    things while recording him.
    Similarly, there was conflicting evidence on whether Appellant’s
    family members lacked candor in attesting to Appellant having no interest
    in recreation. Ophelia and Sabrina both testified that Appellant had no
    special interests—he did not play games or watch TV. But the jury could
    credit Appellant’s own statements made in his letters to Kimberly, which
    indicated a history of playing baseball, bowling, boxing, and working out
    with weights. And the jury had before it letters indicating he watched
    sports on television. Appellant also expressed a past and current interest
    in music, specifically, rapping, and listening to the radio.
    Nothing in the record “rules out” Appellant having significant
    Petetan Opinion On Rehearing — 77
    limitations in the realm of practical skills. But Appellant’s evidence of
    adaptive deficits was subject to a credibility assessment. Under a legal
    sufficiency analysis, a rational jury could have rejected Appellant’s claims
    that he possessed adaptive deficits suggesting intellectual disability in
    light of all the evidence before it.
    e.    Conclusion — Legal Sufficiency
    Dr. Craig himself acknowledged many of the shortcomings in his
    testing: the ABAS–II is not normed for retrospective assessments; the
    pool of “informants” used to rate Appellant’s adaptive behavior was
    identified by the defense; every single person in that pool was related to
    Appellant; Dr. Craig conducted the interview only once per informant; and
    the interviews (except for Appellant’s) were conducted by telephone
    instead of in person. Appellant’s evidence of adaptive deficits was subject
    to a credibility assessment and was evidence that a jury could—in light
    of all the evidence before it—reasonably reject.
    The evidence is legally sufficient to support the jury’s adverse
    finding on the intellectual disability issue. As discussed above, the jury
    could simply reject the testimony that Appellant had adaptive
    deficits—one of the three elements of an intellectual-disability diagnostic
    definition.   “The finding of the factfinder rejecting a defendant’s
    Petetan Opinion On Rehearing — 78
    affirmative defense should be overturned for lack of legal sufficiency only
    if the appealing party establishes that the evidence conclusively proves
    his affirmative defense, and “no reasonable factfinder was free to think
    otherwise.”137 Given that Appellant had one IQ score that was over 70,
    and, as set out above, there were record-based reasons to discount the
    results of the ABAS–II, we cannot say that the evidence supporting the
    negative finding was legally insufficient.
    IV.   The Evidence Was Factually Insufficient To Support The
    Jury’s Adverse Finding On Intellectual Disability.
    A.       Standard of Review
    Holding that the evidence is legally sufficient is the starting point for
    a factual sufficiency review. While evidence may be legally sufficient to
    support a jury’s determination, it may nevertheless be factually
    insufficient to reject an affirmative defense. When examining whether an
    appellant established his factual-sufficiency claim, the appellate court
    views the entirety of the evidence in a neutral light, rather than the light
    most favorable to the verdict.138 But the appellate court may not usurp
    the function of the jury by substituting its judgment in place of the jury’s
    137
    Butcher, 454 S.W.3d at 20.
    138
    Matlock, 392 S.W.3d at 671; Neal, 
    256 S.W.3d at 275
    .
    Petetan Opinion On Rehearing — 79
    assessment of the weight and credibility of the witnesses’ testimony.139
    An appellate court may sustain a factual sufficiency challenge on appeal
    only if, after setting out the relevant evidence and explaining precisely
    how the contrary evidence greatly outweighs the evidence supporting the
    verdict, the court clearly states why the verdict is so much against the
    great         weight        of   the   evidence     as   to   be   manifestly   unjust,
    conscience-shocking, or clearly biased.140 If an appellate court conducting
    a factual-sufficiency review finds that the evidence supporting the
    affirmative defense so greatly outweighs the State’s contrary evidence
    that the verdict is manifestly unjust, then the appellate court may reverse
    the trial court’s judgment and remand the case for a new trial.141 The
    remedy in both civil and criminal cases for an appellate reversal based
    upon a factual-sufficiency claim that the jury’s verdict is against the great
    weight of the evidence is a new trial, not an acquittal.142
    As discussed above, the Supreme Court has set out certain
    constitutional minimums in any assessment of intellectual disability.
    139
    Matlock, 392 S.W.3d at 671.
    140
    Id.
    141
    Id. at 672.
    142
    Id.
    Petetan Opinion On Rehearing — 80
    First, the analysis must be informed by the current medical diagnostic
    framework for assessing intellectual disability.143                    Specifically, courts
    cannot focus upon one aspect of diagnostic criteria when clinicians would
    consider other aspects to reach an overall conclusion regarding
    intellectual ability.144         In both Hall and Moore I, the Supreme Court
    rejected the use of IQ scores to foreclose inquiry into adaptive deficits
    because it created too great a risk that someone with an intellectual
    disability would be executed.145
    Second, courts may not place undue emphasis upon adaptive
    strengths when rejecting an intellectual disability claim.146 In Moore I, the
    Supreme Court overturned this Court’s reliance upon lay evidence of
    adaptive strengths to overcome the clinical evidence of adaptive
    deficits.147      In Moore II, the Supreme Court summarily reversed this
    143
    See Hall, 572 U.S. at 721; Moore I, 
    137 S. Ct. at 1048
     (explaining that it clarified in
    Hall that a court’s intellectual-disability determination “must be informed by the medical
    community’s diagnostic framework” and stating that it relied on the most recent versions of the
    leading diagnostic manuals).
    144
    See Hall, 572 U.S. at 723 (Florida’s IQ test rule takes an IQ score as final and
    conclusive evidence of a defendant’s intellectual capacity when experts in the field would
    consider other evidence; therefore, defendants must be able to present additional evidence of
    intellectual disability, including testimony regarding adaptive deficits).
    145
    Id. at 704; Moore I, 
    137 S. Ct. at 1051
    .
    146
    See Moore I, 
    137 S. Ct. at 1050
    .
    147
    
    Id.
     at 1051–52.
    Petetan Opinion On Rehearing — 81
    Court’s reliance upon evidence of adaptive strengths when that evidence
    was used to undermine the credibility of a clinician’s diagnosis.148
    Most importantly, the Supreme Court has been willing to overturn
    this Court’s rejection of intellectual disability even when that rejection
    was based upon the rational resolution of factual conflicts by a factfinder.
    In Moore II, the Supreme Court went beyond making a legal ruling and
    corrected this Court’s “factual findings.”149 It did so over a dissent that
    criticized the Court for usurping this Court’s role as factfinder on a writ of
    habeas corpus.150
    In this case, viewing the evidence in a neutral light, the rational
    resolution of evidentiary conflicts surrounding the adaptive deficits
    testimony fails to fully account for the great weight and preponderance
    of diagnostic evidence establishing subaverage intelligence. Though the
    jury could rationally reject evidence showing adaptive deficits in isolation,
    failing to consider that evidence in conjunction with the evidence of
    148
    Moore II, 139 S. Ct. at 670.
    149
    See id. at 670–73 (contrasting conclusions of “the trial court” with the view of
    “the court of appeals”).
    150
    Id. at 673 n.1 (Roberts, J., dissenting).
    Petetan Opinion On Rehearing — 82
    subaverage intelligence runs afoul of Hall.151 Under a proper diagnostic
    framework, intellectual disability is determined by considering all three
    diagnostic criteria together rather than each one in isolation.152 Allowing
    the rejection of one diagnostic criterium when clinicians would consider
    criteria together creates an unconstitutional risk that an individual with
    an intellectual disability will be executed.
    Second, emphasizing Appellant’s adaptive strengths to undermine
    reliance upon an expert diagnosis repeats the problem identified by the
    Supreme Court in Moore I and Moore II. Though clinicians may rely upon
    evidence of adaptive strengths when making an intellectual disability
    diagnosis,153      allowing       the    jury    to    reject     such     a   diagnosis       by
    overemphasizing that evidence places the focus upon adaptive strengths
    
    151 Hall, 572
     U.S. at 727 (“In the context of a formal assessment, the existence of
    concurrent deficits in intellectual and adaptive functioning has long been the defining
    characteristic of intellectual disability.”) (internal quotation omitted).
    152
    See 
    id. at 723
     (“It is not sound to view a single factor as dispositive of a conjunctive
    and interrelated assessment.”); Atkins, 
    536 U.S. at 318
     (“[C]linical definitions of [intellectual
    disability] require not only subaverage intellectual functioning, but also significant limitations
    in adaptive skills such as communication, self-care, and self-direction that became manifest
    before age 18.”).
    153
    Moore I, 
    137 S. Ct. at
    1050 n.8 (“The dissent suggests that disagreement exists
    about the precise role of adaptive strengths in the adaptive-functioning inquiry. But even if
    clinicians would consider adaptive strengths alongside adaptive weaknesses within the same
    adaptive-skill domain, neither Texas nor the dissent identifies any clinical authority permitting
    the arbitrary offsetting of deficits against unconnected strengths in which the CCA engaged.”).
    Petetan Opinion On Rehearing — 83
    rather than adaptive deficits.154 Further, it encourages the jury to rely
    upon lay stereotypes regarding intellectual disabilities to reject a clinical
    diagnosis.155
    Expert after expert diagnosed Appellant with mild intellectual
    disability:       Dr. Harold Scott (“mild [intellectually disability] versus
    borderline intellectual functioning”); Dr. Coxe (“mildly [intellectually
    disabled]”; Dr. Correia (“mild intellectual disability”); Dr. Mayfield,
    (“global delays across all domains”); Dr. Craig (adaptive assessment
    scores fell within the range for moderate intellectual disability).
    Appellant consistently scored within the range for intellectual
    disability on intelligence testing administered across decades.                        Mild
    intellectual disability is typically used to describe people with an IQ level
    of 50–55 to approximately 70.156 Evidence of six full-scale IQ scores
    since 1991 were admitted. All but one on its face put Appellant within the
    clinically-accepted range of intellectual disability:
    61        on the Wechsler Intelligence Scale for Children - Revised
    154
    See Moore I, 
    137 S. Ct. at 1050
     (deeming this Court’s reliance on Moore’s perceived
    adaptative strengths as an overemphasis because the medical community focuses the
    adaptive-functioning inquiry on adaptive deficits).
    155
    See 
    id. at 1052
     (explaining that “the medical profession has endeavored to counter
    lay stereotypes of the intellectually disabled”).
    156
    Atkins, 
    536 U.S. at
    309 n.3 (citing DSM–4 at 42–43).
    Petetan Opinion On Rehearing — 84
    (WISC-R), administered in 1991 (age 15);
    64          on the WISC-R, administered in 1992 (age 16);
    74          on the Wechsler Adult Intelligence Scale-Revised
    (WAIS-R), administered in 1992 (age 16);
    69          on an unknown intelligence instrument, administered in
    1993 (age 17);
    55          on the WAIS-III, administered in 2012 (age 36); and
    52          on the WAIS-IV, administered before trial (age 37).
    In our original opinion we discounted all but the score of 74, and
    noted that, even when the three-point margin of error was considered,
    “the score at the low end of the margin-of-error range would be 71—still
    above the general ceiling for [intellectual disability], albeit barely.”157 We
    concluded, “[t]his was some evidence that appellant’s general intellectual
    functioning fell above the range for [intellectual disability].”158 Of course,
    “[i]t is not sound to view a single factor as dispositive of a conjunctive
    and   interrelated        assessment.”159         According   to   the   DSM-5,   a
    comprehensive evaluation includes an assessment of intellectual capacity
    and adaptive functioning; identification of genetic and nongenetic
    157
    Petetan, 
    2017 WL 915530
    , at *24.
    158
    
    Id.
    159
    
    Id. at 723
    .
    Petetan Opinion On Rehearing — 85
    etiologies; evaluation for associated medical conditions (e.g., cerebral
    palsy, seizure disorder); and evaluation for co-occurring mental,
    emotional, and behavioral disorders.160 As the Supreme Court observed
    in Hall, IQ scores are an approximation of conceptual functioning but
    may be insufficient to assess reasoning in real-life situations and mastery
    of practical tasks.161           This is why clinical judgement is needed in
    interpreting the results of IQ tests.162 And, unlike many Atkins cases,
    where the IQ scores start out high and get lower once the incentive to
    score low arises, Appellant’s scores started out low and stayed there.
    We have said that jurors are free to reject expert testimony if the
    testimony fails to comport with the jurors’ concepts of sound logic.163 In
    choosing to disregard expert testimony, the jury is constrained only by
    the requirement that any action taken must be pursued in a nonarbitrary
    manner.164 We said this in a case addressing sanity. And, like insanity,
    160
    DSM-5 at 39.
    
    161 Hall 572
     U.S. at 722 (quoting the DSM-5 at 37).
    162
    DSM-5 at 37.
    163
    Graham v. State, 
    566 S.W.2d 941
    , 951 (Tex. Crim. App. 1978).
    164
    
    Id.
     at 950–51 (recognizing that a defendant is not entitled to a judgment of acquittal
    simply because he offers expert testimony on the issue of insanity and the government
    attempts to rebut it without any expert witnesses; “While a jury may not arbitrarily disregard
    expert testimony, it also may not give conclusive effect to the opinion of an expert merely
    because that opinion is not challenged by some other expert”) (internal quotation marks
    omitted).
    Petetan Opinion On Rehearing — 86
    intellectually disability is expressed in terms of a mental diagnosis, but
    the issue is not strictly a medical one. What we have said about insanity
    is true here too:
    The issue is not strictly medical, and expert witnesses,
    although capable of giving testimony that may aid the jury in
    its determination of the ultimate issue, are not capable of
    dictating determination of that issue. Only the jury can join
    the non-medical components that must also be considered in
    deciding the ultimate issue. That ultimate issue of criminal
    responsibility is beyond the province of expert witnesses.
    Were it otherwise, the issue would be tried in hospitals rather
    than the courts.165
    The ultimate issue in this case is not criminal responsibility—it is
    whether Appellant has an intellectual disability that diminishes his
    personal moral culpability.          But that issue, like the insanity issue, is
    ultimately for the factfinder, not the expert.166               So, the “legal
    determination of intellectual disability is distinct from a medical diagnosis,
    but it is informed by the medical community’s diagnostic framework.”167
    In this case, the medical community was of one mind. We cannot
    hold the evidence supporting the adverse finding factually sufficient
    165
    Graham, 
    566 S.W.2d at 949
    .
    166
    See 
    id. at 952
    .
    
    167 Hall, 572
     U.S. at 721.
    Petetan Opinion On Rehearing — 87
    because there was no competing medical evidence.168 Had there been,
    we might be assured that the jury’s rejection of the evidence of
    intellectual disability did not run afoul of Supreme Court precedent. After
    Moore I and Moore II, a factfinder cannot substitute its opinion for that
    of all of the examining doctors. We therefore conclude that the jury’s
    rejection of Appellant’s intellectual disability claim was clearly wrong and
    manifestly unjust.          Having determined the evidence was factually
    insufficient, Appellant is entitled to a new punishment hearing.169
    Conclusion
    Appellant was not and is not constitutionally entitled to a pre-trial
    168
    Petetan, 
    2017 WL 915530
    , at *26 (“No psychological expert testified
    definitively—during appellant’s capital murder trial—that appellant was not [intellectually
    disabled].”).
    169
    See Matlock, 392 S.W.3d at 672 (explaining that reversal based upon factual-
    sufficiency claim is a new trial, not an acquittal); Brownlow v. State, No. AP-77,068, 
    2020 WL 718026
    , at *23 (Tex. Crim. App. Feb. 12, 2020) (not designated for publication) (remedy for
    a meritorious factual-sufficiency claim is a new punishment hearing, not reformation of the
    sentence). After Moore II, this Court has granted relief on several Applicants’ intellectual
    disability claims. See the following unpublished opinions: Ex parte Williams, WR-71,296-03,
    
    2020 WL 7234532
    , at *1 (Tex. Crim. App. Dec. 9, 2020); Ex parte Gutierrez, WR-70,152-03,
    
    2020 WL 6930823
    , at *1 (Tex. Crim. App. Nov. 25, 2020) Ex parte Guevara, WR-63,926-03,
    
    2020 WL 5649445
    , at *3 (Tex. Crim. App. Sept. 23, 2020); Ex parte Lizcano, No. WR-68,348-
    03, 
    2020 WL 5540165
    , at *1 (Tex. Crim. App. Sept. 16, 2020); Ex parte Escobedo,
    WR-56,818-03, 
    2020 WL 3469044
    , at *1 (Tex. Crim. App. June 24, 2020); Ex parte Henderson,
    
    2020 Tex. Crim. App. Unpub. LEXIS 171
    , at *2 (Tex. Crim. App. Apr. 15, 2020). Other
    Applicants’ cases have been remanded to the habeas court for considerations on the merits.
    Again, see the following unpublished opinions: Ex parte Lewis, WR-86,572-01, 
    2020 WL 5540550
    , at *1 (Tex. Crim. App. Sept. 16, 2020); Ex parte Butler, WR-41,121-03, 
    2019 WL 4464270
    , at *2 (Tex. Crim. App. Sept. 18, 2019). Though these cases are not authority, our
    factual-sufficiency determination, as well as our decision to remand for a new punishment
    hearing, in the present case are consistent with these cases.
    Petetan Opinion On Rehearing — 88
    determination of his intellectual disability. The evidence in this case is
    legally sufficient for the jury to reject Appellant’s intellectual disability
    claim. As such, and based on the record before us, Appellant has not
    been shown to be categorically ineligible for the imposition of the death
    penalty. However, the jury’s rejection of Appellant’s affirmative defense
    of intellectual disability was against the great weight and preponderance
    of the evidence. Accordingly, we vacate Appellant’s death sentence and
    remand this cause for a new punishment hearing.
    Filed: May 12, 2021
    Publish