At Learning Insights we have been assessing individuals, adults and children, for many years.
Here are some thoughts on labels and diagnoses, enlightened by the title of this section ‘nature smudges the boundaries’. What does this really mean? In reality, when children today are diagnosed as a result of some aspect of their behaviour or development, they will rarely end up with a single label or diagnosis. They will, very likely, command two or even three diagnoses. Why is this? The reality is many diagnoses share features in common. A good example of this is difficulties with attention. A child can be diagnosed with having an attention deficit disorder, a specific learning difficulty and depending upon what other behaviours there are showing. This may include a diagnosis of autistic spectrum disorder (ASD) or developmental coordination disability.
Autistic spectrum disorder is not a single disorder, it is, in fact, several spectrums. A child with fragile X, fetal alcohol syndrome, extreme prematurity, or any number of genetic mutations, can show features of autistic spectrum and therefore command this diagnosis amongst others. Autistic features can also co-occur with development coordination disability, specific learning difficulties, oppositional defiant disorder and attention deficit hyperactivity disorder (ADHD) and speech and language difficulties. Therefore, it would be better referred to as autistic spectrum conditions. There is now data to suggest autism is highly correlated with ADHD and that these conditions share a genetic basis.
In reality the impairment a child has, drives the diagnostic decision, so it will depend upon the priority one gives to the impairment as to which label is applied first.
So, for these reasons, we believe it is preferable to describe the child's behaviours, the triggers to these behaviours, and then what can help to support the child and provide the best conditions for their learning and development. This averts the need for a list of labels, which for many parents and teachers, leaves them feeling quite unable to know where to start to support the child and in reality, the approach is adopted are often ‘containing’ activities, all involved feeling completely overwhelmed by the intimidating list of disabilities this child appears to have.
Here is one final thought, which as educational and occupational psychologists, we find quite disquieting. Prof Christopher Gillberg, at the 3rd symposium on paediatric psychology, identified that Intellectual Development Disorder (in other words a Specific or General Learning Disability) as a diagnosis has gone down by 15%, while at the same time, the diagnosis of autistic spectrum disorder has gone up by 15%. His view is that we are now happier to ‘label’ the child with autistic spectrum and not recognise them as having an intellectual development disability, which in fact he argues most of these labels would actually identify.
If you are confused or concerned about these labels, then go to the Contact Us page or call us or send us an email.