I am a school psychologist. My main job is to evaluate students to see if they are eligible for special education. In order for a child to be eligible they have to meet criteria for one of 13 disabilities under the Individuals with Disabilities Education Act (IDEA). If they do not meet criteria for at least one of these 13 disabilities, they cannot be found eligible for specialized support at school. This is unfortunate, because not all children fit into a perfect category/label. However, if I can’t find one to fit them into they won’t qualify for support. This is a dilemma that weighs on my personal and professional values. Something that people find funny about me is that although my job centers around giving labels to children, I actually hate labels. Why do we have to take a person’s individual set of differences and give it one name? Why can’t a child receive services based on what they need, without having to put one all-inclusive name on their behaviors, symptoms or differences?
The reason why we have labels is twofold in my opinion, one and I don’t really think this is an opinion, is that in order to provide any body with services, whether it is a child in school, an adult that is getting psychological counseling services, or a child who is receiving behavioral support in the community, funding will not be provided by the government or insurance unless that child has a documented diagnosis or label. So essentially, labels are used to obtain services. This is a decision made by the government, health care agencies, insurance, etc. This is tricky because naturally parents don’t want their children labeled. They want their children recognized for who they are, as an individual, with their unique set of strengths and needs; however, if they do not allow their child to be evaluated and subsequently given a label, then their child will not be able to get services. Hundreds of thousands of students in the US alone need support services. For example, some children need to improve their speech, other children need guidance for how to handle their emotions, other children need out-of-the-box strategies to learn to read, etc., but unfortunately, none of these children get additional documented and monitored support, unless we figure out what to “label” their unique set of challenges/differences or whatever you want to call their needs.
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Another reason that labels exist, frankly is out of laziness or convenience. It is much easier to say a child has ADHD, than to say that they have trouble focusing during lengthy verbal lessons, often lose their belongings, and seem to need to move more than the average child. It is much easier to say that a child has autism spectrum disorder than to say that they communicate and socialize differently than their peers. Think about it. We have labels for everything. The person who is “heavier than their average weight expectation” is fat. A person who is different than what we are used to seeing, and may act a bit outlandishly, may be called crazy.
Whatever the word is that is used, labels are often used as a way to describe characteristics in just one word. The problem with this is that it creates stereotypes for what that word means and then people use that word to insult or describe others and it creates stigmas. The terminology gets misused, people get offended and then we’re looking for alternate ways to describe something that will be less offensive. Then the new label often gets misused, stereotypes occur, and again we are looking for a new way to describe the same thing.
The important thing to remember is that no matter what anyone calls or labels your child (or you), as a way to describe their unique characteristics or needs, your child is still your child. Because society has determined that labels are needed to provide services and because society does not feel like describing characteristics and would rather use one word to sum something up, does not mean that something is wrong with your child. Do not hold off on services because you do not want your child labeled. Psychiatric and psychological evaluations can change from year-to-year and person to person (but that does not mean that they definitely will). I’ve seen the same child diagnosed with depression by one doctor, bi-polar by another, and told by another that nothing is wrong. Labels are not set in stone (barring genetic medical conditions, birth defects, neurological conditions, etc.), and are constructs created by humans. Unfortunately, there are humans out there that use these labels in malicious ways to make people feel bad about themselves. And, unfortunately we cannot only speak about a person’s strengths and needs to obtain funding to give them additional support. We have to label them. So maybe we need to start figuring out if labels are the appropriate answer to determine whether or not a child needs support, rather than holding off on labeling our kids because of the impact that it could have on them socially, emotionally, etc.
If you’re not concerned that your child needs support and his/her behaviors/symptoms are manageable, then there is no need for him/her to get an evaluation or a label. A label is only required in order to determine needed services at school and in the community. Also, consider the difference between a label (something that seems arbitrary and is subject to change) and a diagnosis (which can be permanent or be thought of as a medical condition). In the medical field and in schools, there is no distinction. All medical labels are called diagnoses. In US schools, disabilities under IDEA are referred to as educational classifications rather than diagnoses. In either case, labels/diagnoses/classifications only function to get a child services and to sum up their symptoms (which often vary among children with the same label). They never define a child or change who a child (or adult) is.
What are your thoughts on this topic? Please comment below.
Recommended book/e-book: Wrightslaw: From Emotions to Advocacy – The Special Education Survival Guide
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Rachel Wise is a certified school psychologist and licensed behavior specialist with a Master’s Degree in Education. She is also the head author and CEO at educationandbehavior.com, a site for parents, educators, and counselors to find effective, research-based strategies that work for children. Rachel has been working with individuals with academic and behavioral needs for over 20 years and has a passion for making a positive difference in the lives of children and the adults who support them.