When and how any particular Christian participates in the Christian sacrament of Eucharist, regardless of intellectual disability or cognitive capacity, depends on the way the administering Christian community understands the sacrament. Because there is a plurality of Christian accounts of Eucharist, there is a plurality of practices and traditions concerning the norms for participation in that case of a Christian who has an intellectual disability. Some Christian traditions maintain that a theological understanding of the sacrament is necessary to receive Eucharist and, therefore, do not administer the sacrament to intellectually disabled persons. Other Christian traditions maintain that spiritual devotion to the real presence of Jesus Christ is necessary to receive the Eucharist and, therefore, administer the sacrament to intellectually disabled persons under particular conditions—presuming the benefit of the sacrament can be received even if the Eucharist is not consumed. Still other Christian traditions understand the practice of Eucharist principally as a communal expression of community solidarity or unity and, therefore, administer the sacrament indiscriminately during the liturgy.
Both the theological and material history of how intellectually disabled persons have participated in the sacrament of Eucharist is available to researchers. Unfortunately, due to the limitations of printed text and challenges of translation, that theological and material history is generally unfamiliar to non-specialists. Nevertheless, advances in the digitization of rare texts has allowed for an unprecedented rediscovery of Ancient, Medieval, and Early Modern Christian practices and teaching on how persons who "lack the full use of reason" participate in the Christian sacraments. There is a well documented contemporary prejudice against premodern accounts of intellectual disability / mental illness, which supposes that premodern philosophers and theologians took those forms of impairment to be instances of demon possession. Although that contemporary prejudice has been wholly discredited by historians, the association has lingered in the popular imagination of western Christians—such that many contemporary Christian traditions and communities do not administer the sacrament of Eucharist to intellectually disabled and/or mentally ill persons.
Thomas Aquinas maintained that all cognitively impaired Christians have a right to the Eucharist and that the sacrament should not be withheld from such persons, except in the most extreme of circumstances (STh III.80.9). According to Aquinas, the extreme circumstance that warrants withholding the Eucharist from a cognitively impaired Christian is if the Christian is entirely incapable of expressing their desire to receive the Eucharist. The worry of Aquinas is that the Eucharist would be forced upon someone who does not want to participate in the sacrament.
The Code of Canon Law of the Roman Catholic Church (and those bodies in full communion with it) has official policy about how the sacraments should be administered in the case of adult Christians who lack the use of reason. The rationale is developed on the understanding that persons who lack the use of reason, like infants, need the assistance of others to participate in the sacraments of the Church. See Canons 96-99. Thus, ecclesial care for infants provides the principles for the ecclesial care of intellectually disabled persons. Regarding the administration of Eucharist to children and other persons who lack the use of reason, Canon 913 states
- "§1. The administration of the Most Holy Eucharist to children requires that they have sufficient knowledge and careful preparation so that they understand the mystery of Christ according to their capacity and are able to receive the body of Christ with faith and devotion."
- "§2. The Most Holy Eucharist, however, can be administered to children in danger of death if they can distinguish the body of Christ from ordinary food and receive communion reverently."
This policy is reflected in the positions published by many Roman Catholic dioceses in the United States. For example, in the section regarding preparation for First Communion:
- Children who are mentally retarded are to be admitted to the Eucharist when they express a desire for the sacrament and in some way manifest their reverence for it. In cases of profound retardation, the Eucharist may be shared without further requirements, as long as the child is able to consume the sacred elements.
Additionally, the United States Conference of Catholic Bishops stated in its Guidelines for the Celebration of the Sacraments with Persons with Disabilities (approved 1995):
- the criterion for reception of holy communion is the same for persons with developmental and mental disabilities as for all persons, namely, that the person be able to distinguish the Body of Christ from ordinary food, even if this recognition is evidenced through manner, gesture, or reverential silence rather than verbally. Pastors are encouraged to consult with parents, those who take the place of parents, diocesan personnel involved with disability issues, psychologists, religious educators, and other experts in making their judgment. If it is determined that a parishioner who is disabled is not ready to receive the sacrament, great care is to be taken in explaining the reasons for this decision. Cases of doubt should be resolved in favor of the right of the baptized person to receive the sacrament. The existence of a disability is not considered in and of itself as disqualifying a person from receiving the eucharist.
In an effort to better reach marginalized populations, such as those struggling with autism and other developmental disabilities, while at the same time providing for their religious education, organizations have emerged offering online alternatives to traditional Faith Formation in keeping with the USCCB's Guidelines.
Orthodox Christianity makes Communion available to all baptized and chrismated church members who wish to receive it, regardless of developmental or other disabilities. The theory is that the soul of the recipient understands what is being received even if the conscious mind is incapable of doing so, and that the grace imparted by Communion "for the healing of soul and body" is a benefit that most especially should not be denied in such cases. This is consistent with the practice of Infant Communion in Eastern Orthodoxy.
Orthodox Christians typically receive the Sacrament of Confession before receiving the Eucharist (see Eucharistic discipline). However, for those who are either mentally incapable of recognizing or recalling their sins, or who are mentally or physically incapable of communicating their sins to a priest, this requirement is dispensed with, just as it is for very young children.
The Church of Scotland says this regarding those with learning difficulties:
- "Notwithstanding the terms of Section 13 above [which obliges a Kirk Session to test the faith and understanding of a baptised person before authorising admission to the Lord's Table (ed.)] there is nothing in the law of the Church which would automatically disqualify a person with learning difficulties from admission to the Lord's Table and from having his or her name added to the Communion Roll of a congregation."
In most evangelical Christian churches, the only requirement for any individual to participate in Communion is that the person professes to have a personal relationship with God and to have accepted Jesus Christ as his or her Savior. Before Communion in these churches, the policy is usually verbally outlined and the decision is left up to the individual.
- Guidelines for the Celebration of the Sacraments with Persons with Disabilities from the United States Council of Catholic Bishops
- Welcome and Justice for Persons with Disabilities, also from USCCB
- Catholic Encyclopedia: Communion of Children
- Catholic Encyclopedia: Frequent Communion
- Code of Canon Law