Q&A: Does A Child Need a Diagnosis or Label?

Each week Michele Borba answers your parenting questions right here on her blog. If you have a parenting problem or question leave a comment on this post and you may have yours answered next week!

Do you believe in "sensory processing disorder?" My 6 year old is a happy and cooperative kid at home and at school but when he's at violin lessons, he becomes very hyper and uncooperative. I was told he needs occupational therapy because he's "sensory seeking." The OT tested him and agreed. Isn't he just acting up because he doesn't want to be there after a long day at school? This sensory disorder business sounds like a load of hooey to me.
--Judy Barnes


Well, well. I have to start by explaining my background so you know where I’m coming from. I’m a former special education teacher who has taught just about every spectrum disorder there is and had a private counseling center for a while. My doctorate is in educational psychology and counseling and I’ve worked with thousands of parents and their kids. I say all that because I think too often kids these days are “over-labeled” and “over diagnosed.” There are clearly times when children do need labels to help them get the treatment they need so they can survive and thrive. But don't just throw on the label for the label sake. So how do you know when a child does need the label?

I tell parents to use four factors when trying to figure out if a problem is “normal” or too far out and needs some kind of “diagnosis” or “label.” So think about these and your son.

Four Factors To Determine If Your Child Needs a Diagnosis or Label
  1. “The Family Factor”: Is your home life compromised and everyone is walking on eggshells because of this family member?
  2. “The Struggle Factor”: Is your child’s problem getting in the way of his happiness and ability to function in life?
  3. “The Gut Instinct Factor”: Do you feel deep down that something is not right with your child?
  4. “The Duration Factor”: The problem has persisted or even increased over a long period of time and every normal child rearing solution hasn’t worked. Despite your efforts, your child is suffering and it’s carrying over to different elements of his life.
If you say “Yes” to one or more of these four factors, then it’s time to take this seriously and do something about it.

So add up those factors Mom. None of those four factors are red flags. In fact, you yourself don’t think there’s anything wrong. (I swear the “Mom Gut Instinct Factor “ is the most telling.)

You have a HAPPY kid who is cooperative and from what you say is doing well in other areas of life. Yes? The only thing he isn't happy about is playing the violin--or at least having to play it after a long day of school.

My advice, stick to your instinct. Maybe change instruments? But forego the darn diagnosis. If the problem crops up in other areas and he struggles and changes his cooperative demeanor, then and only then do you worry.

There! Go hug your son. (Sounds like a great kid by the way.)

Click here to read more of Michele Borba's Q&As, or leave a comment below with your own questions and it may be answered next week.



Borba_BuildingMoral_136.jpgDr. Michele Borba is the author of Building Moral Intelligence: The Seven Essentail Virtues That Teach Kids to Do the Right Thing.

0 TrackBacks

Listed below are links to blogs that reference this entry: Q&A: Does A Child Need a Diagnosis or Label?.

TrackBack URL for this entry: http://micheleborba.ivillage.com/system/mt-tb.cgi/6488

16 Comments

Brenda said:

How do you handle your teen being teased about what others perceive as something being "wrong" with him. I need help with my 16-yr-old. He has problems being teased about his head size by the kids at school. His head is on the large size, but that's normal for our family. It's gotten to the point that he's no longer interested in going to school and his grades have started to slip. I try to reason with him that this is just high school, he should ignore it, and none of this will matter once he's out of school. He's hoping there will be a medical procedure that will reduce his head size and shifts between sad & angry re this problem. I don't want to say the wrong things and make matters worse. Any suggestions would be really appreciated. Thanks!

JS said:

I failed first and second grade, graduated high school with a 2.00 GPA,took six years to graduate college, and am now headed to a top 10 MBA school...The absolute only reason I am able to accomplish this is the LACK of being labeled as Dyslexic and ADHD as a child. It was not until age 19 that I was diagnosed and able to handle it. Many times a label becomes an excuse not just to the student, but parents and teachers as well. I worked twice as hard to try and be "normal" and learned courage, persistence, and perseverance. Trust me, you can always get a refresher on 3rd grade math, but never life's lessons that this taught me.

RE: BRENDA - I would encourage your son to have a sense of humor about it and make him realize any child that is making fun of him does so due to their own insecurities...it simply makes them feel better to put others down. The more he reacts the more they know it hurts him and will continue. Do you really want his only hope to to be a medical procedure that will make his head smaller...probably not. What you teach him now is what he will teach his children as well. And it will continue past high school so teach him to deal with it, not 'wait it out'. It will continue in different forms (car you drive, house you own, etc)in work, life, social relationships, etc. Just my two sense and good luck.

Anonymous said:

I sometimes think that we are too quick to diagnose our children with having something. Did this mom ever think that perhaps her six-year-old son just doesn't enjoy learning to play the violin? Learning an instrument is a very structured and disciplined environment. Maybe his uncooperativeness is his way of saying that he is not ready to do this activity.

Misty said:

In regards to the above post:
I believe that the mom did ask if maybe this was because he just didn't want to be there after a long day of school..and even called the prognosis a "load of hooey" so she wasn't 'labeling' her child. She was in fact disagreeing with the specialists and in this case she was correct to question their diagnosis.

Melanie said:

I have a four year old little Girl. Her behavior with me is off the wall. Me and her father divorced a year ago. Before we divorced she stayed home with him durring the day and me and night, as we worked different shifts. She behaves very good for him and very bad for me. She spits, bites, sticks her tongue out at others, very nasty attitude at times. Demands that she gets her way. Ive been dating the same man for over a year and a half. She will mind him when he gets on her for not listening to me. But she won't mind me. She has so much energy and at times acts like a two year old instead of a four year old. My Best friends little girl who is five is on clonidine for blood pressure control which calms her down. She took her to a neurologist for her behavior. Which was just like my childs now. What do I do? I spank, put her in time out, take things away from her. Her half brother was diagnosed with A.D.H.D...Help!

misty said:

Melanie,
First, spanking a child only teaches them to hit back.
Did she behave this way with you before the divorce? I'd suggest speaking to a child psychologist first and see if they recommend any behavioural medicines for her but it could also be that she simply needs more time with you. Especially if you're still working at night. Also, and please don't take this the wrong way, but have you ever considered parenting classes for yourself that could teach you different ways to deal with your child?
Just don't be too hasty to put her on meds to 'calm' her down. She may be acting out her frustrations with you to get more attention from you.
Good luck!!

michelle said:

ever since my daughter has been able to walk she has done nothing but be a total handful, her temper tantrums are gettin worse as she gets older,it prevents me spending time with my son and i think in time its going to affect my relationship with him, its gettin to the point where i dont her near me and thats bad in my eyes im her mum and should love her no matter what, i have ne help besides my nanna, i dont know what to do im struggling to cope with her and im dreading when she gets older, how am i going to keep this under conrol when shes going to be taller than me if im struggling now??????

Ilene Dillon said:

I am so happy to see the issue of putting "labels" on our children being addressed. As a family therapist with 36 years of experience who is helping people develop Conscious Families, I applaud your response.

My son had a similar issue when he was six. Having sailed through Yamaha keyboard lessons at age 5, now he would not open the top to his keyboard, fidgeted during class, and refused to cooperate with anything the teacher asked. We had the advantage of knowing his behavior from the previous year, so I concluded there must be something about the new class that didn't agree with him.

Accordingly, I asked whether we might move him to another teacher. The administrator informed me that his second year teacher was a recovering alcoholic they were giving a "second chance." While I totally supported what they were doing with her, it was clear to me that something about her energy was not agreeing with my son. Sure enough, as soon as we moved him, he settled down and enjoyed his lessons!

Especially since your son doesn't have difficulties in other places, I urge you to consider that the problem may be outside of him! Please don't be quick to put the onus on your child--it may be that there is something (or someone) in his environment that jangles or disagrees with him!

Anonymous said:

One reason I am cautious of how many labels we apply to our children (and ourselves) is the self-efficacy effect.

Quiet Mom said:

Is it Selective Mutism? That's what we are thinking about my 8 year old daughter, but having joined a message board on Selective Mutism, I am having my doubts. I don't want to label her with anything because I know how label stick or can be used for excuses, which I'm not sure if I am doing now. The problem is my daughter will not speak to anyone other than my mother, her cousins, and myself. No one else in the family. It has caused great strain in the family, but I don't bother with the adults that find her to be rude or disrespectful. She is not deliberatley ignoring them, I can see something happen in her when others come around. It's almost like a switch has gone off and once they leave the room, it's back on. She's okay at school, and with peers, which is why I second guess the Selective Mutism. Is this a normal behavior? She says she just can't make herself talk around them (mainly adults), and has gone without privileges in our attempts to get her to speak. I have since stopped with any punishments, because I don't feel it's right to punish a child for something they can't control. The guidance counselor at school agrees that this is not a punishable behavior, and she will hopefully outgrow it. Anyone experience such behavior?

jane said:

I personally think that child acting up at violin lessons needs disciplined. yes it is probably he would rather be playing that playing the violin or any other instrument. but his behavior says to me if he isnt allowed to act this way at home then he thinks he can get away with it at this teachers lessons. its time for the parents to show authority and discipline this child. he should be told if he continues to act up at these lessons he will be grounded or something. but today too many diagnose them with something to drug them instead of making them behave.

old school mom said:

Holy Crap! What is wrong with you people...labeling? There was a time when that was BAD. It seems everytime we take 2 steps forward, someone claiming to know more than the rest, makes us take 4 steps backward! No labeling, no judging....TALK with your kids get to know them and then figure out what the dam problem is. How the heck is someone online who doesn't even know you or your child going to give you sound advise. People really, parenting has been going on alot longer than some of these so called experts have been alive! It is a new concept I am sure of it, but it does work- rather than spending time with your 'girlfriends', watching sex in the city, going out on the lunch date to catch up with an old friend or advance in your company, making sure your love life is in order according to some magazine you picked up while getting you hair done- TALK TO YOUR KIDS! Get know them as people and respect them just the same....trust me you all be better off.
People get off your arses, stop self absorbing. You had a child take care of them...oh other than feeding, walking and giving them a place to live. Brother...I really feel sorry for the next gen. they have one heck of a mess to clean up from you people.

beedee1126 said:

Hi Quiet Mom.

I used to feel the same way with my 15 child. She would only talk to me, her dad, her friends,her girl cousin, my mom and that's it. She started to talk to my dad, her paternal grandparents, her aunt and uncle, teachers, etc. The only thing that I could say is that she would only talk to people who she was comfortable with. Trust your child's instincts.

mary lou said:

20+ yrs ago (at age 2/3), I was having real problems with my son's temper tantrums and disciplene issues over respecting as offlimits his sisters room. Nothing worked. I took him in to be evaluated. I was told to wrap him in a large towel to protect himself and others from his violence. I was also told he was possibly AD but as he was extremely bright, it should not matter. My gut instinct told me there was something more but we never could get to the root of it. At the age of 24 after a psychotic break, he was hospitalized and diagnosed as bipolar manic. One month later, he committed suicide. After reading some books on bipolar disorder and finding Danielle Steele's book about her son, I realized he had been bipolar since very early childhood. Too true that labels can often hinder more than help, but I sure wish with all my heart, he'd been labeled and gotten treatment. As you said, gut feelings can oftentimes be the most reliable. Hard to say whether if he had gotten treatment early on, if it would have saved him or even if he would have been the brilliant shining star he was for 24 years.

Linda said:

I am a 55 year old granmother and we have been plaged with child malesters in our family,from fothers to sons.I myself have been malisted by a family member and so have other sablings in the family.But now I am wored about my 9 year old granson he is tuching other children younger then him the first was a girlfriends child a boy about 6 and the perents did't do any thing about it and now 4mo. latter he is cought with a 5 year old girl his step sister,in a saspichus way.It was a may be mybe not thing,and neath of the kids said any thing so now my granson can no longer come to that home.I cry for him,Were do they go for help?Or do they need help,Or is it part of a boy growing up?????? Help

Leave a comment


Type the characters you see in the picture above.

Michele Borba

About Me

Author of books like No More Misbehavin' and Don't Give Me That Attitude!, parenting expert, educational psychologist, Today show contributor and mom Michele Borba is here to help you.

RSS

Favorite Posts

Archives

Favorite Links