Skill Thinking vs. Disorder Thinking

December 06, 2019

When I assess a child  my focus often centers on where skills (and the skills can range from cognitive/academic to emotional/social) are breaking down for the child, which then guides goals and “next-step thinking.”

Admittedly, I am less focused on labels (e.g., ADHD, LD, Dyslexia, Anxiety).

Parents, though, will place great deal of emphasis on the label, as in, for example, “Does my child have ADHD? Dyslexia? A Social Anxiety Disorder?”

I will hear things like the following:

  • “She gets nervous when she takes tests. Maybe she has an anxiety disorder?”
  • “The teacher says he has some trouble focusing – I wonder if it’s ADHD.”
  • “He doesn’t like to read – I think he may be dyslexic.”
  • “At birthday parties it’s hard for her to join in with some of the activities.She doesn’t have too many friends. I wonder if she has Asperger’s (a mild form of autism).”
  • “I can’t read his penmanship; I think it is dysgraphia.”
  • “Math is hard for her. Do you think she has dyscalculia?”

I find myself pushing back on this thinking, not questioning whether the child is struggling, but wondering whether there is a legitimate disorder or disability.

I don’t know how it happens, but every ten years or so we have a syndrome that somehow seems to become front and center in people’s consciousness or awareness.  In effect, it becomes a popular disability, if that is even possible. (We are squarely in the decade of dyslexia.)

All of the issues of concern occur on a “spectrum,” from very mild and just slightly below average to more severe and significantly below average.

So, if an eight year old boy is a little unfocused, does that make him ADHD?  Or if a seven year old is a bit of a weak reader, does that mean she’s dyslexic? In my opinion professionals (and parents) are concluding these and other common labels too hastily.

Unlike something like a broken bone or a tooth cavity, with these issues (and virtually all psychological variables) there is no “yes, he’s got it,” or “no, he does not have it” proposition.  (Trust me, there are many times I wish there were, as it would make my professional life that much easier.)

Since these concerns are all “spectrumy” (made up word), that means there is no x-ray or one test for any of them.  Assessment is a weighing of variables.

Mind you, I am not questioning whether these disorders or disabilities exist or not, but I am cautioning about quickly jumping to disorder or disability thinking.

I understand that the label provides some level of comfort in terms of an explanation for the skill breakdown.  My larger point is that before we jump to those labels, let’s target the skill breakdowns with good, sensible interventions and see how it unfolds.

Then after a reasonable period of time for allowing the intervention to work, if the child is stuck or not making great progress, then you can more comfortably talk about “disorder” or “disability.”


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  • Magge McCann
    December 07, 2019 at 12:54 pm

    Love your blogs and look forward to them every week as I always learn something. This week, I learned about dyscalculia-I had never heard of […] Read MoreLove your blogs and look forward to them every week as I always learn something. This week, I learned about dyscalculia-I had never heard of it before. Thank you and I look forward to more of your posts. Read Less

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