Does a diagnostic assessment make my child vulnerable?
Most parents will at some point will face the ‘diagnosis dilemma’; that is, the decision to investigate whether a child’s academic, developmental or clinical results vary significantly from their peers. For many parents this decision may involve a great deal of fear and uncertainty as they consider the potential impact of a diagnostic label for their child in the school environment, amongst peers or siblings, and whether the impact will follow through to a child’s higher education or work life.
Broader ethical debates can feed these fears, such as a lack of consensus regarding what constitutes a disorder, the limitations of our current diagnostic tools, and the belief that mental health diagnoses pathologise human diversity. However for children, teens and families facing significant challenges, the more urgent issue is how to find their pathway to appropriate support for a set of specific needs.
What’s involved in an assessment?
An assessment usually involves a comprehensive investigation of academic, emotional and behavioural domains via a multi-step process that may involve clinical interviews, interviews with significant adults, behavioural observations, and rating scales. It also seeks to answer a specific referral question or set of questions based on a child’s particular challenges, answers and evidence for which are then outlined in a formal report or explained in a feedback session.
What is the value of an assessment?
For most children and families who present for evaluation, there will already be a sense that something in their lives is far more difficult than they expected it to be, and they are usually wondering why. While going through an assessment process with your child may never be the highlight of your year, there are some potentially life-changing outcomes. A diagnostic assessment may offer you the following opportunities:
- Understand your child’s individual needs. When a child is understood and accepted in their formative relationships, they have the best chance of understanding and accepting themselves.
- Identify lagging skills. Whether this be the inability to manage big feelings, an excessive fear of social situations or phonological dyslexia, an evaluation will give you information about the specific area in which your child is struggling.
- Plan and prepare. With specific information, parents are better able to plan for successful outings, holidays and events.
- Change your child’s developmental trajectory. When assessment and intervention is timely, the future of your child may literally be changed. For example, when ADHD is managed well from an early age, the progression of ADHD to oppositional behaviour and then conduct problems in adulthood may be prevented.
- Draw on the evidence-base. Struggling parents can be vulnerable to adopting pseudoscience, e.g. A child with learning difficulties may feel emotionally deprived if a parent leans heavily on harsh consequences or tough love.
- Set realistic expectations. A child with an executive function deficit for example, will not have the ability to manage his time, or organise his thoughts and will need support and frequent reminders.
- Avoid damaging discipline. When lagging skills play out, parents and teachers with realistic expectations are able to avoid the unethical situation that arises when children are punished for their diagnoses, e.g. When a child with dyslexia seeks verbal confirmation of instructions from a classmate or teacher and is disciplined for calling out.
- Model self-advocacy. When a child is part of a collaborative process they learn that challenges can be spoken about and problems addressed. A good assessment should send a clear message to a child that their struggles are not their fault, and that with information and planning, goals can be achieved.
Managing potential vulnerabilities after a diagnoses has been made
Unfortunately not every person our children come across will respect their individual needs. It can be worth planning ahead with your child who their ‘helpers’ are, so that they are not left with knowledge that feels secretive, or a belief that they are defective in some way. We can also help to reduce the potential for self-stigma by framing diversity as an important aspect of the world we live in.
Parents also have a particular role to play to reduce vulnerability that requires both strength and subtlety. Parents are powerful advocates for the needs of their child in the community, however they must also be mindful to step out of the way of natural development. Sometimes overzealous parents can unintentionally add to the vulnerability of their child by helping too much. This may create a situation where the longer-term burden a child faces is increased by a parent who is over-functioning, essentially denying the child the opportunity to learn to live effectively and resiliently.
If you need support to figure out what your child’s individual needs are and how to support them, the staff at The Centre for Effective Living are able to help.
Sarah Hindle (M Psych (Clinical), B Psych Sci (Hons), Grad Dip Psych) brings her warmth, wisdom and rapport to the individuals and families she sees; the knowledge that a strong and collaborative therapeutic relationship is foundational to the successful outcome of any intervention. Sarah has experience working with adolescents, adults and families facing a range of mental health difficulties including depression, anxiety, attachment and parenting issues, eating disorders and the management of stressful life events and adjusting to change. As a former classical musician, Sarah also has a particular interest in the treatment of musical performance-related anxiety, a topic on which she has delivered individual therapy and psycho-educational seminars. Sarah also has a particular interest in working with children/adolescents and families facing challenges related to learning difficulties and attention-deficit hyperactivity disorder (ADHD).