Published on: 22 Jan 2016

Different children with the same diagnosis might have very different patterns of strength and weakness

The use of diagnostic labels

Poppy Ionides, Educational Psychologist and Consultant

The language and systems of identifying hard to spot children often cross over with the practice of seeking to classify children with labels such as dyslexia, AD(H)D, autistic spectrum disorder, dyscalculia and DCD/dyspraxia.

It is clear that across a population of children one sees a range of differences in learning and behaviour that arise at least in part from nature as well as nurture.  However, it’s not at all clear whether labels of specific learning difficulties and developmental disorders do these differences justice:

  • Labels are typically phrased in terms of disorder and difficulty, placing problems within individual children, whereas it is often the expectations and demands of the education system that turn a difference into a difficulty: “…if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
  • Diagnosis tends to involve assessment in numerous sub-skills.  For example, a dyslexia assessment might involve consideration of a child’s reading, spelling, phonological skills, auditory memory and verbal processing speed.  Children fall somewhere on a spectrum in each of the skills associated with any given label – decisions about assigning labels do not involve black-and-white hard-and-fast categories but multiple dimensions of grey. 
  • Different children with the same diagnosis might have very different patterns of strength and weakness.  As such, a diagnostic label alone does little to suggest appropriate intervention and support.
  • For many children, differences map onto a particular label without too much misfit.  However, many other children’s differences spread across numerous labels without a good fit for individual labels.  This is confused by the fact that different disorders have overlapping symptoms – if you imagine them as circles on a Venn diagram there would be many points of cross over between circles.  

Despite the inadequacies of diagnostic labels they provide a structure to support the identification of hard to spot children, and many times over I have seen great improvements in situations when children’s differences are given a name: joining dots to create a coherent named picture can make children’s differences feel ‘real’, giving those involved renewed ability to see the world from the child’s point of view, to respond sensitively. 

Even when labels serve a useful purpose it is important to remain mindful of their flaws, to look behind and around them to set each child in their environmental context and see their unique dance of strengths, weaknesses, motivations and aspirations.

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