Using diagnostic descriptors can be problematic. First and foremost, human beings are complex wholes who rarely are defined completely or even well by a collection of symptoms. In addition, these diagnostic descriptors do not define mental health or emotional wellness, which of course are more than just the absence of pathology. There are practical benefits to the use of these descriptors, however, such as their utility in treatment planning, implications for prognosis, and need in gaining insurance reimbursement and in acquiring school accommodations (now and/or in the future). They also provide a rudimentary language for communicating with schools and other professionals. Most importantly, however, a thoughtful diagnosis can provide a partial explanation for behavior(s), connect one with a community of individuals with similar experiences, serve as a call to action, and provide hope for the future.

In summary, a diagnosis should be seen as an important part of an overall assessment, an assessment that also should account for the more complicated and individual aspects of each person. As part of each assessment, while a diagnostic descriptor may be used, your son or daughter and their strengths and challenges will also be presented in a contextual and multi-dimensional manner that is appreciative of their individuality. This is especially important as symptoms can mean different things for different individuals; there are certainly many pathways to an individual’s overt behavior(s).

Typically, there are five commonly used criteria for understanding and deciding whether or not to diagnosis and intervene with a given child’s behavior(s). First, mental health clinicians typically engage in a type of “pattern analysis” in order to determine if behaviors (including thoughts and feelings) are similar to those from a given diagnostic category. The advantage here is in treatment planning (e.g., how have other people in similar situations found help?). Second, a commonly used criterion is to assess whether or not the behavior is dangerous in any way (e.g., could the individual be hurt, now or in the future, as a result of these behaviors?). Third, clinicians use the criteria of emotional distress (e.g., anxiety, sadness/depression, irritability). That is, if the individual is experiencing elevated amounts of emotional distress, it may be prudent to take steps to reduce it. Fourth, clinicians use the criteria of time (e.g., are the individual’s behaviors a temporary reaction to troubling events or are they built in to their everyday life?). This criterion is especially important for children (in whom developmental factors can lead to rapid changes) and for adolescents (in whom peer pressure, family issues and problems in growing up can also play a complicating role). Finally, clinicians understand an individual’s behavior using the criterion of impairment. This impairment might be physical (e.g., sleep deprivation, malnutrition), social (e.g., are they alienating themselves from peers?) or avoidant related (e.g., are they avoiding or not dealing with a problem they have and is it interfering with participation and success in life?).

Our staff is available to follow up with you on these criteria and how they may be used to understand you or your child’s individual circumstances.