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The Good and the Bad of Diagnoses

Kerri Milyko, Ph.D. BCBA

July 2010

Many parents are faced with the challenge of determining whether or not to have their child tested for some sort of disorder.  The diagnosis of many learning disorders and developmental disorders is on the upswing.  Regardless of whether this rise in diagnoses is due to the change in definition of the disorder or to other environmental, biological, or neurological factors, parents are faced with a decision: to test or not to test.

Behavior analysis, which is the branch of psychology adopted by this author, does not practice diagnosing individuals.  Rather, behavior analysts look to the behavior that the individual engages in and treats that behavior specifically as opposed to treating a diagnosis.  Therefore, whether or not the student has been diagnosed with ADHD, for example, is not as important as what the student is actually doing: academic behaviors, appropriate behaviors, inappropriate behaviors, and the like. 

Diagnoses are labels that allow us to quickly orient to a set of behaviors.  For example, the mom of a child with autism can quickly explain why her son enjoys to flap his hands in front of his face.  The nearby observers of the hand flapping then quickly understand the reply of, “he has autism”.   Therefore, the diagnosis provides a succinct word that comes with a host of assumptions regarding various behaviors, living conditions, and the like.

However, the “he has autism” reply does not help in treating the hand flapping.  It also does not help in eliminating the inappropriate behaviors and building the appropriate replacement behaviors and advancing the academic behaviors. 

The answer to “why” he engages in hand flapping is not “because he has autism.”  There are triggers in the environment that occasion the behavior and there are consequences that maintain that behavior.  It is the job of the behavior analyst to identify and these triggers and consequences.  Since every individual is different, even those individuals who share a common diagnosis, these triggers and consequences vary.  These consequences and triggers even vary amongst the same behaviors.  As a result, the diagnosis does not assist or is even required to treat the problem behavior.

Another problem with a diagnosis is that is functions as a label.  Many uneducated people will simply see the label and not the individual.  Furthermore, the label is often used as an excuse for the inappropriate behavior.  If treatment was successful and the individual does not exhibit those behaviors associated with the diagnosis, the label remains. 

Even though the diagnosis does not assist in the treatment of the symptom, it does provide an opportunity for funding treatment.  Treatment is often very expensive and lengthy.  Assistance in financing these services is essential since individuals across all socio-economic standing are affected.  However, it appears that the only diagnosis that receives any sort of decent funding for services is autism. 

Unfortunately, there is no clear choice on whether or not to have your child tested for a learning or developmental disorder.  However, before you make the choice, make sure to educate yourself on what the benefits and limitations are in doing so.  Make an informed decision.