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Assessing psychological and behavioral disorders in children is an area rife with danger. While a proper diagnosis might get a child the services they need or help teachers understand them better, a bad prognosis can also have many drawbacks.

The problem of over diagnosis

Millions of kids are currently being diagnosed with conditions they don’t actually have, and many are put on dangerous drug regimens as a result. Even when they aren’t put on medication, being pinned with a particular label has the potential to diminish their quality of life and lead to further problems. It’s crucial that parents, teachers, and professionals know more about the diagnostic process and what it all means, so that they can make more intelligent decisions regarding a child’s care and treatment.

How children are diagnosed

Children are diagnosed based on behavioral checklists listed in a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. If a child seems to exhibit a particular behavior, a box is checked. If a certain number of associated symptom boxes are checked for a particular malady, then the child is diagnosed with that disorder.

It’s a process that leaves a lot of room for error. These assessments are made from subjective observation, which is one of the least reliable forms of evidence. Primary doctors are often the ones on the front lines diagnosing children and prescribing medications, but most have little to no training in mental health issues. Even when a diagnosis is made by a mental health professional, it is an error-prone process that can go astray in many ways.

How common is misdiagnosis?

It’s hard to say for sure, because the diagnostic process is based entirely on subjective evidence which can be neither proven nor disproven. But research suggests that anywhere from 25% to 75% of diagnoses for mental and behavioral disorders in children are wrong, with the rate varYlng on the type of disorder. Whatever the actual number, it’s clear that many doctors are mislabeling children and treating them with strong drugs without having any idea what ails them. (Jabr, 2012)

The danger in a false diagnosis

Aside from the risks associated with unnecessary medication, which will be discussed in a separate chapter, there are many potential dangers in being falsely labeled with a disorder. Belief is a powerful force in human psychology that will determine the course of a person’s life. People are easily led to believe that they should or shouldn’t be disturbed by something, and so the therapist has a lot of power to actually create disturbances where none should exist. Your kid may not be crazy now but they can easily be made that way if it’s suggested that they are. There are even documented cases where people have literally believed themselves into death, so they can certainly believe themselves into mental illness.

Beliefs and expectations also sway the actions of others in ways both subtle and profound. For example, one study took a group of kids and determined which ones were the most and least advanced based on IQ and knowledge in different subjects. They then inversed this reality, misleading teachers into believing that the dullest kids were actually the brightest, and vice versa. This subtle bias ended up affecting the way they taught and what they expected from their students, creating a self-fulfilling prophecy. By the end of the year, the deceit had become reality: The “dull” kids were leading the class while the brightest kids had fallen behind. (add ref)

This effect can be even more profound for children labeled with a mental or behavioral disorder. Once they get diagnosed with a particular condition, parents and teachers adjust their expectations accordingly, which has enormous potential to turn the label into a self-fulfilling prophecy. In the worst of cases it acts like a dead weight chained to a child, holding them back and preventing them from reaching their fullest potential.

Diagnostic labels can also become a part of a child’s identity. Just take a look at what happened in 2012 when psychiatrists stripped Aspergers Syndrome from their list of recognized conditions in the DSM-5, instead choosing to lump it into the category for unspecified Autism Spectrum Disorder. Nothing real or tangible had changed in the world. The condition was always nothing more than a mental construct – a label created with the stroke of a pen and wiped away just as easily. Yet “Aspies” as they had come to know themselves by were up in arms about the decision. As Ferris Jabr writes, “Now the diagnosis will disappear, and Aspies may find an important part of their identity stripped away.” (Jabr, 2012, p. 32)

Many people can probably identify (pardon the pun) with the plight of Aspies. But this example also serves as proof of the power labels have to alter one’s identity in the first place. Labels can define a child and spell out who they are, and as soon as you slap a diagnosis on a youngster, it starts altering the way that child sees themselves. Consider how people who see themselves as victims can be drawn to this label even as it holds them back in life. It provides an excuse for why nothing is their fault and immerses them in a blame game with the world. Yet this also makes them mentally powerless to take control of their own life. If you’re a helpless victim who has been gravely wounded by what others have done to you, then by consequence you’re placing the power squarely in the hands of your oppressors. It is they whose actions dictate your wellbeing. Adopting this victim mentality is an unmitigated disaster, yet millions of Americans willingly do it, and such a mentality is widely preached on virtually every television show.

Likewise, a false diagnosis is an open invitation for a child to believe self-limiting ideas about themselves. All mental health diagnoses are, at their root, just a way of labeling and categorizing people. And just like when we label and stereotype others over things like race or religion, the simple act of identifying a child under a particular label can limit their range of mobility. Each mental ailment is suggestive of a narrowed range of behavior: Can’t do this, can’t do that, have to act this way and not like that. Those “Aspies” who had come to define themselves by their disorder are precluded from acting more normally even if they are quite capable of it, because the condition defines their behavior.

The point we’re trying to make is that a diagnosis is not a benign little thin5. It has the potential to define your child and define their life. It can make them (or others) believe in limitations that aren’t there. So parents and anyone else who deals with kids should approach this issue with a healthy degree of skepticism. The next few sections will highlight some of the things that commonly go wrong in the diagnostic process.

Notice: If you reached this page looking for resources on diagnosing a particular problem or condition, please see the following:

-ADHD diagnosis in kids -Bipolar diagnosis in kids

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