Severe intellectual disability

How interesting it’s obviously not just an upside down thing as the books are turned over and the pictures laid down so it’s about changing it to her way of seeing/ thinking’ Or what’s comfortable for her Could it be a little control feature in a world that is out of her control
You don’t say how old she is or what professional help if any she gets If she does is it worth asking them Does she do it elsewhere or just in the home ?
I think looking at how brains work is fascinating

It might be stimming or compulsive behaviour related to her health condition.

I have no experience of this but do find it very interesting that your granddaughter gently and neatly turns everything upside down.

I thought you were going to say that she trashes the place!

She sounds lovely