The Tyranny of Pathologizing our Kids

When did it happen?  When did the energetic child become the child with hyperactivity?  When did the opinionated child become the oppositional child?  The stubborn child become the defiant child?  Daydreamer start having attention deficits?  When did we start pathologizing our kids?

I guess in many ways, it doesn’t entirely matter how we got here, so long as we acknowledge that we are indeed here.  We have become deficit-focused.  We look at our kids’ behaviors and try to “fix them”, so we slap a diagnosis on, begin behavior modification programs, shove medications at them, and call it a day.  Sure, as a therapist, I fully accept and know that there are times when those diagnoses are needed and accurate.  I also know that many children are walking around being treated for disorders they do not, in actuality, have.  I’ve seen kids on medications they don’t need.  I’ve seen kids pigeon-holed based on diagnoses that merely describe symptomatic behavior rather than identify genuine disorders.

ODD, for example.  ODD stands for Oppositional and Defiant Disorder.  I’m going to be bold here and straight out say that I do not believe this to be a genuine disorder.  I have yet to encounter a child diagnosed with ODD whose behaviors weren’t explainable by an underlying situation or alternate mental health concern.  Sure, they may defy authority, but usually that’s because they are anxious, or insecure, or traumatized, or sensorily overloaded, or incapable of doing the task requested of them. 

ADHD is another example.  I will not be so black-and-white with this one, as I think there’s a case to be made in support of this disorder’s existence and a case to be made that this disorder is actually something else.  Either way, the one thing I do know for sure about ADHD is that it continues to be criminally over-diagnosed and over-medicated.  ADHD is meant to be a diagnosis of last resort.  A condition to be diagnosed only after all other possibilities have been ruled out.  And yet, it is often the first thing adults look to when they see a child who is a little bouncier than typical or a little more distractible than their age peers. 

Why should this matter?  Because when we slap on these diagnoses, and others, without careful differentiation, time, and observation, we end up missing the point.  We end up failing our kids.  Behavior is not a disorder.  Behavior is communication.  Instead of listening to and decoding the messages our kids are sending us, we end up treating symptoms.  And when it only works for a short time, we end up treating the symptoms more fiercely.  And all the while, the poor kid hasn’t had their real needs met in the slightest.

But, really, it goes beyond that.  Not only have they not had their needs met, but they’ve been told there’s something about them that needs fixing and that is wrong.  Kids whose behavior would be expected when the circumstances are understood, feel shamed for these very behaviors.

Our kids on the fringes of typicality are particularly vulnerable.  The child who’s sensory processing has a few glitches attempts to gain control of her environment in order to minimize the assault against her brain.  She’s diagnosed with ODD, gets labeled the bad kid, and continues to appear defiant because her sensory issues haven’t been addressed, so she needs to rely on the only coping skill she knows.  The profoundly gifted child whom everyone understands to be “smart”, but also experiences the world with such intensity that her body simply can’t sit still gets diagnosed with ADHD, thrown on medications which directly impact her brain chemistry.  Her cognitive abilities may drop, she may become more irritable, and her innate spark silently dims.

To be clear, I have no problem with medications when medications are actually needed.  I am an advocate for acknowledging real mental health issues and helping families find the support and treatment they need.  I think diagnoses can be helpful and informative.

I do have a problem with misunderstanding and misdiagnosing our most vulnerable.  I have a problem with pathologizing typical behaviors.  I have a problem with jumping to the quick answer with a quick treatment instead of taking the time to listen to what the child is trying to communicate under the surface.  I have a problem with blaming the child instead of looking to the environment to see how their needs aren’t being met.

Let’s stop pathologizing our kids.  Let’s learn more about the different needs of our atypically developing kids and find new ways to meet those needs.  Let’s listen to the behaviors instead of trying to quickly get rid of them.  Let’s actually give our kids what they need.

 I have learned so much from the other contributors to Hoagies' Blog Hops, and I encourage you to check them out!  This month's hop focuses on  The Misdiagnosis Initiative.

I have learned so much from the other contributors to Hoagies' Blog Hops, and I encourage you to check them out!  This month's hop focuses on The Misdiagnosis Initiative.