On Labelling Kids

I’ve sometimes heard it said that there’s too many diagnostic labels for kids these days – Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder, Oppositional Defiant Disorder, Dyslexia, Dyspraxia, Dyscalculia and so forth. The argument is that there’s now a label for everything.

My own view of diagnostic labels is a fairly pragmatic one. If they describe something accurately and serve a useful purpose, then they’re all well and good. If not, then don’t use them.

Oppositional Defiant Disorder, sometimes jokingly referred to as “Naughty Child Syndrome” is a label that tends to raise a few eyebrows. A lot of child psychiatrists are reluctant to use it unless it’s diagnosed as co-morbid with something that has a more neurological flavour, such as ADHD or ASD.

With high-functioning autism, sometimes the decision about whether to diagnose can come down to what the child will get for it. There’s no psychiatric treatment as such for autism, but a diagnosis can sometimes unlock educational support. If the child is struggling to cope with school, and support is on offer, then there’s a case to make the diagnosis. If they’re coping okay, or if no extra support will be available, or if the kid doesn’t want the support, then often we simply don’t bother to diagnose. Why label them if there’s nothing in return?

Back in my own childhood, I actually acquired a label of my own – dyspraxia aka Developmental Coordination Disorder aka Clumsy Child Syndrome. My motor coordination wasn’t developing as quickly as it should, which meant that I struggled with handwriting, and if I kicked a ball it would go in every direction except where it was meant to go.

This was causing me problems in school. I’d get frustrated at trying to write stuff, so lose interest and start staring out of the window in a daydream. I managed to sail all the way through primary school without it being noticed. Went I went up to high school, to their credit they picked up on it in the first term. I was sent to the special educational needs teacher, and then to a paediatrician who made the diagnosis. Hence I got my label.

Then again, before I had that label, I was given other labels instead.

Thick.

Lazy.

Bone idle.

I think I preferred the dyspraxia label. At least it was a label I wasn’t made to stand on a chair and repeat in front of the entire classroom.

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2 responses to “On Labelling Kids

  1. In the words of therapy guru Irvin Yalom: “Avoid Diagnosis (Except for Insurance Companies)” – and, I would add, use caution even then that you’re diagnosing accurately and using the most stigmatized diagnoses only with absolute necessity (e.g., borderline)! – Natalie (practicewisdom.blogspot.com)

  2. In the UK it’s a bit different in that insurance companies don’t come into it, thanks to our NHS system.

    Diagnoses can be useful if they point the way towards treatment and/or support. Sometimes they can be useful to provide the child with an explanation – I remember a recently-diagnosed kid with aspergers telling me, “Now I realise it’s not my fault.” but there’s definitely pitfalls as well.

    I definitely agree with you re: borderline personality disorder. Especially since with children and adolescents their personality is still developing. Somebody might fight the diagnostic criteria for BPD when they’re 15, but not when they’re 20. So why risk stigmatising them with that label?

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