​Utility of Diagnostic Labels

In the past twenty years, there has been a startling increase in the number of children identified with communication and learning disorders with no established cause. These disorders have, unfortunately, been commonly labeled as:

• Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD)
• Autistic Spectrum (ASD), Autism, Asperger’s Disorder 
• Pervasive Developmental Disorder (PDD), Multi-Systems Disorder (MSD)
• Non-Verbal Learning Disorder
• Dyslexia & Specific Learning Disabilities (SLD)
• Sensory Processing Deficits
• Central Auditory Processing Disorder (CAPD)
• Sensory Integration Disorder (SID)

All of these disorders involve limitations or deficits in many of the same areas of developmental functioning, such as:

• Speech and/ or language
• Motor planning (sequencing of actions or behaviors)
• Social interactions and social relatedness
• Cognition & perceptual functioning (visual, auditory and kinesthetic)

Diagnostic labels are simply a way of classifying sets of behaviors or symptoms into discrete groups to facilitate communication among professionals.  When a child is exhibiting difficulties in development, psychiatrists, therapists and educators will try to attach labels to describe these difficulties.  There are many labels for children with communication and learning disorders. Many parents seek comfort in finding a specific label for their child, hoping that it will help them understand exactly what is wrong, and perhaps serve as a springboard for intervention planning. 

These labels, while intended to simplify evaluation and treatment of these disorders, have instead led to confusion and ineffective identification, evaluation and treatment strategies. They often limit our interpretations or the information we seek.  Diagnostic labels have a tendency to become viewed as a real entity rather than the construct they are.  For example, a child diagnosed with dyslexia often is referred to as dyslexic when in actuality the difficulties the child is experiencing are consistent with the set of symptoms categorized as dyslexia.  There exists also an issue of circularity where the diagnostic label becomes the cause of the behavior.  For example, a child diagnosed with autism flaps his hands because he is autistic or a child is hyperactive because they have ADHD.  In this situation, the very behaviors that are used to meet criteria of a given disorder are attributed as a result of the disorder.

Labeling approaches may confound how we evaluate and treat individuals with specific diagnoses because they influence us to only notice information or behavior that is consistent with the specific diagnostic label.  There exists an assumption of homogeneity with diagnostic label which suggests that all individuals with the same diagnostic label exhibit the same behaviors and impairments or that an individual who is given a particular diagnosis will exhibit all of the symptoms that comprise a particular diagnosis. 

Each child, no matter what label or diagnosis given by symptoms, displays unique patterns of strengths and challenges and must be treated as an individual rather than as a "child with a diagnosis."  One child may have difficulties because he is over-reactive to touch and sound; another may be under-reactive.  Another child may have more of a problem with comprehending sound, another with visual perception, and another with planning responses.  Ultimately, an intervention and treatment plan must be designed to treat the child's underlying difficulties, not just the symptoms observed.
The only true benefit of a diagnostic label is access to services.  Some programs, such as early intervention, schools or clinics may require a diagnostic label before providing ancillary services.  Health insurance companies may also require a diagnostic code before they will fund services.  Other government services, such as social security, require diagnostic labels before they will provide supplementary income to the individual.
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The Unicorn Children’s Foundation encourages a broader "functional descriptive" approach with broader eclectic intervention and treatment options to accommodate for each individual child's needs rather than the child accommodating to a unitary treatment approach offered.  To better help you understand this functional approach to dealing with these disorders, it is important that you understand how to look at your child from a "descriptive" rather than from a "symptoms" perspective.