When Is Getting a Firm Diagnosis Important? | MGH Clay Center for Young Healthy Minds

When Is Getting a Firm Diagnosis Important?

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Posted in: Grade School

Topics: Learning + Attention Issues

Stephen’s parents were worried.  Stephen was an active 7-year-old who was having trouble learning to read, and staying seated in class.  Now that he was in second grade, he was having trouble completing homework.  Even though his homework was only supposed to take 15 minutes a night, he just couldn’t get started on it; he had even more difficulty getting it done.  Stephen’s teacher mentioned that it might be a good idea to have Stephen see a psychologist or psychiatrist who could “diagnosis” his problems.  This idea was tough for Stephen’s parents to hear.  They didn’t like the idea of labeling kids, and felt that Stephen was just being a kid.  Stephen’s dad had had difficulty learning to read and as he said, “I turned out fine!”  However, as Stephen progressed from second to grade, his problems got worse.  He hadn’t caught up with his peers’ reading skills, and his teacher was talking about retention.  His parents were scared, and wondered whether they should finally take the advice of consulting a professional who could determine whether Stephen had a problem that needed to be identified.

As Stephen’s case illustrates, it’s not uncommon for a child to be identified by a teacher as needing an evaluation.  Sometimes the evaluation is completed through the school, where the school identifies a “need for services” that they then provide.  In this case, having a firm diagnosis isn’t necessary to get the needed support.  However, there are times when an accurate and specific diagnosis is important, which is what was necessary for Stephen, who was eventually diagnosed with dyslexia and ADHD.  Without these “labels,” Stephen might not have received the specialized reading support and medication that he needed to be a successful student.

Parents understandably have personal reactions to identifying their child by a “label.”  When parents share these concerns with me, I remind them of two points.  First, a label should never define anyone.  It’s just one way of describing a child’s learning, behavioral or emotional functioning at that point in time.  Second, a label is only as good as the treatment that follows it.  In other words, the most important reason we use labels is because they help direct treatment.

So, when is getting a firm diagnosis important?  The reasons fall into a few categories:

  1.  When you want to make sure your child gets the best possible overall treatment.  Schools can, and do, provide accommodations and special education services for students whose test results have shown a need, but many times schools won’t provide services unless there is a diagnosis.  Outside of the school environment, if medication is the best course of treatment for your child, most doctors will not prescribe medication without a diagnosis.
  2. When you want to make sure your child receives accommodations on tests such as the SAT or ACT.  In this case, a report with a firm diagnosis, such as a reading disorder or math disorder, increases the chances that your child will get extended time.  Sometimes extended time is granted just on the basis of documentation of current and previous IEP support, but other times that’s not enough.  In fact, the College Board is increasingly not granting extended time on tests without a specific, documented diagnosis.
  3. When you want to be an active, informed participant in your child’s treatment.  Without a firm diagnosis, you may not have a clear idea of how to help him or her.
  4. When the school seems to be on the fence about providing services for your child.  Although no diagnosis is a guarantee that your child will receive services from the public schools, a firm diagnosis may be the deciding factor in doing just that.
  5. When you want your insurance plan to pay for various types of treatment for your child.  Many insurance plans will not pay for services, such as occupational therapy or speech/language therapy, without having an actual diagnosis as justification for treatment.

Ultimately, Stephen’s diagnoses led to him receiving exceptional treatment, including reading tutoring at school, and medication that he took during the school year to help him concentrate and attend better.  His parents learned that the diagnosis was just another descriptor—one of dozens—that could be used to describe Stephen, and that without this firm diagnosis, he would not have so easily obtained the services he needed.

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Ellen Braaten

Ellen Braaten, Contributor

Ellen Braaten, Ph.D. is a contributor to The MGH Clay Center for Young Healthy Minds, and director of the Learning and Emotional Assessment Program (LEAP) at Massachusetts General Hos...

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