The Label That Enables: Why a Diagnosis Can Be a Good Thing
If we don't know what's wrong, how can we fix it?
Posted October 3, 2019 | Reviewed by Gary Drevitch
We’ve all heard the slogans: Don’t put me in a box. Labeling is disabling. It’s true that diagnostic labels can feel confining. This is the number-one objection parents have to psychological evaluations. Whenever a school refers a child for one, parents are rightfully concerned that the label will become a prognosis, and then a prison.
But what if a diagnosis is less a prison, and more a road map? What if the world could learn to relate to diagnoses that way?
Donna is adamant that her son’s diagnosis should not be shared with his teacher. But humans label. Our brains are uniquely suited to categorizing and sorting. If Michael’s quirky behaviors, tendency to get out of his seat without permission, need to occasionally take long breaks, and poor social pragmatics aren’t explained to his teachers, they’re still going to label him. Those labels will also be confining and self-fulfilling. He’ll be labeled "rude," "disrespectful," "oppositional," and be called a bully. The teachers won’t treat him like everyone else, because he doesn’t act like everyone else, and if they don’t have a term for it, they’ll come up with one. Humans can’t escape labels because humans can’t escape human nature.
When we tell Michael’s teacher that he has High-Functioning Autism, we can also explain that his brain doesn’t always get social pragmatics immediately. We can ask her for insight into the social errors Michael is making. Then, we can incorporate that information into Michael’s parenting plan and into his therapy. If he has a hard time with personal space, his mother can practice that concept with him at home. If he has a hard time using tact, we can teach him the concept of a “social filter” and help him learn what thoughts should be expressed, and which ones should remain private.
If his ADHD keeps him out of his seat, we need a home, school, and a therapy plan for that. Michael needs movement and stimulation the way others might need sleep or food. A certain amount of time without it, and he just can’t function. If a child has chronic low blood sugar due to a medical condition, no reasonable teacher will stop him from eating a snack in class. The rule might be “no eating during class time,” but obviously, if there’s a medical need for food, an exception is made. Well, Michael has a documented neurological need for movement.
If I ask for an exception without giving an explanation, the teacher might comply, reluctantly, or be uncooperative. Instead, telling her “Michael has ADHD. These are his needs. If we fulfill them, he can be educated in your classroom,” is the best way of getting her onto Team Michael. Humans have an innate need to be successful. Giving Michael’s teacher the tools to help her be successful with him is common sense.
In my Targeted Parenting classes, I teach parents of children with diagnoses to educate their children about their brains. I call it “Educate For Effectiveness.” It’s the “E” in the TARGET System. We want children to understand their own neurology and tendencies, so that they can be effective managers of their own brains. I use the “superhero” analogy to help kids understand their diagnoses. (To read more about hacking your child’s challenges into superpowers, click here.) In every superhero story, there’s always the superpower gone awry, right? A superhero comes into his powers but doesn’t know how to control them. That causes all sorts of problems. Once a wise mentor comes to teach the superhero how to handle his powers, they become his or her greatest strengths.
Parents can be that wise mentor in the superhero narrative. In the TARGET system, we start with Theory. That’s our theory about this diagnosis, what superpowers it provides, and where the challenges are. (For more, click here.) We then move on to understanding our child’s behavior, so that we can predict it. That’s the “A” of the TARGET system, Antecedent Analysis. (For more, click here.)
We also need to understand what reinforces a child’s behavior and causes him to repeat maladaptive behavior, and how to teach more appropriate behavior. That’s the “R” of the TARGET system, Rewards and Reinforcers. We know that behavior that is rewarded is repeated. Our job is to understand what types of rewards to use so that we can help our children learn. (For more, click here.)
The GET strategies are what parents “get” out of Targeted Parenting. They are Goal Directed Behavior, Educate For Effectiveness, and Train It In. If you think about our children’s diagnoses, their superpowers, are also frequently what gets in the way of their goals. Michael might have the goal of having a good day in school, but his intense curiosity, passion, and need for stimulation, or his superpowers, get in the way of that goal. (For more, click here.)
We need to educate Michael, so he can be an effective manager of his superpower. Rather than seeing his diagnosis as prognosis or prison, let’s teach him that it’s actually a road map to his superpower. Let’s help him learn how to manage his own neurology. Maybe that means teaching him to fidget in place, or some social pragmatics skills. Maybe he needs to take stimulation breaks every so often. The older Michael gets, the more practice he will have with his superpowers, and the more effective he will be at utilizing them. Let’s not be afraid of his labels. Let’s use them to enable instead.
© Robyn Koslowitz, 2019
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